Okla. Stat. tit. 36, § 36-6593

Liability for damages - Application of act.

A. A health insurance carrier, health maintenance organization,

or other managed care entity for a health care plan has the duty to

exercise ordinary care when making health care treatment decisions

and shall be liable for damages for harm to an enrollee proximately

caused by breach of the duty to exercise ordinary care if:

1. The failure to exercise ordinary care resulted in the

denial, significant delay, or modification of the health care

service recommended for, or furnished to, an enrollee; and

2. The enrollee suffered harm.

B. The standards in subsection A of this section create no

obligation on the part of the health insurance carrier, health

maintenance organization, or other managed care entity to provide to

an enrollee treatment which is not covered by the health care plan.

C. This act does not create any liability on the part of an

employer or an employer group purchasing organization that sponsors

or participates in a health care plan or purchases coverage or

Oklahoma Statutes - Title 36. Insurance Page 1325

assumes risk on behalf of or for the benefit of its employees or the

employees of one or more subsidiaries or affiliates of the employer.

D. A health care plan, health insurance carrier, health

maintenance organization, or managed care entity may not remove a

health care provider from its plan or refuse to renew the health

care provider from its plan for advocating on behalf of an enrollee

for appropriate and medically necessary health care for the

enrollee.

E. A health insurance carrier, health maintenance organization,

or other managed care entity shall not seek indemnification from a

health care provider, whether contractual or equitable, for

liability imposed by this act. Any provision in a contract to the

contrary is void and unenforceable.

F. Nothing in any law of this state prohibiting a health

insurance carrier, health maintenance organization, or other managed

care entity from practicing medicine or being licensed to practice

medicine may be asserted as a defense by a health insurance carrier,

health maintenance organization, or other managed care entity in an

action brought against it pursuant to this section or any other law

of this state.

G. This section shall not create any new or additional

liability on the part of a health insurance carrier, health

maintenance organization, or managed care entity for harm caused

that is attributable to the medical negligence of a health care

provider.

H. An enrollee who files an action under this act shall comply

with all requirements relating to cost bonds, deposits, and expert

reports.

I. This act shall not apply to insurance agents licensed by the

Insurance Department.

J. This act shall not apply to workers’ compensation insurance.