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What happens if an insurer disagrees with the IROs decision to overturn a noncertification?

April 26, 2017decision disagrees happens insurer iro noncertification overturn

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What happens if an insurer disagrees with the IROs decision to overturn a noncertification?

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Pursuant to NCGS 58-50-84, the decision of the IRO is binding on the insurer. Therefore, the insurer must reverse its denial and provide coverage once notified of an IRO’s decision to overturn the noncertification.