SPRINGFIELD – A new law sponsored by State Senator Laura Fine creates transparency in health care plans by clarifying when a consumer is able to challenge an insurance company’s decision to deny their claim.

“When a health insurance provider refuses to pay for treatment, it presents unnecessary struggles for patients,” said Fine (D-Glenview). “By ensuring individuals have a clear way to appeal these denials, we can promote transparency between the patients and the insurance company.”

Health insurance providers may deny coverage or refuse to pay for a service, which is known as an adverse benefit determination. However, consumers are able to request an external review of this denial to evaluate its appropriateness. Fine’s law clarifies when a consumer can appeal a denial of benefits or request an external review.

“Consumers should be able to rely on the insurance they are paying for to cover the treatments they need,” said Fine. “My aim is to streamline access to affordable health care services in the most efficient manner for patients.”

House Bill 2472 was signed into law Friday and goes into effect Jan. 1, 2025.