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27-21A-7
Section 27-21A-7 Evidence of coverage and charges for health care services. (a)(1) Every enrollee
residing in this state is entitled to an evidence of coverage. If the enrollee obtains such
coverage through an insurance policy or a contract issued by a health care service plan, the
insurer or the health care service plan shall issue the evidence of coverage. Otherwise, the
health maintenance organization shall issue the evidence of coverage. (2) No evidence of coverage,
or amendment thereto, shall be issued or delivered to any person in this state until a copy
of the basic form of the evidence of coverage, or amendment thereto, has been filed with the
commissioner and the State Health Officer, and approved by the commissioner. (3) An evidence
of coverage shall contain: a. No provisions or statements which encourage misrepresentation,
or which are untrue, misleading, or deceptive as defined in subsection (a) of Section 27-21A-13;
and b. A clear and concise statement, if a contract, or a...
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27-36A-8
Section 27-36A-8 Reserve valuation method - Life insurance and endowment benefits. (a) Except
as otherwise provided in Sections 27-36A-9, 27-36A-12, and 27-36A-14, reserves according to
the commissioners reserve valuation method, for the life insurance and endowment benefits
of policies providing for a uniform amount of insurance and requiring the payment of uniform
premiums, shall be the excess, if any, of the present value, at the date of valuation, of
the future guaranteed benefits provided for by the policies over the then present value of
any future modified net premiums therefor. The modified net premiums for a policy shall be
the uniform percentage of the respective contract premiums for the benefits, excluding extra
premiums on a substandard policy, that the present value, at the date of issue of the policy,
of all modified net premiums shall be equal to the sum of the then present value of the benefits
provided for by the policy and the excess of subdivision (1) over...
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27-54A-2
Section 27-54A-2 Treatment under certain policies and contracts. (a) As used in this section,
the following words have the following meanings: (1) APPLIED BEHAVIOR ANALYSIS. The design,
implementation, and evaluation of environmental modifications, using behavioral stimuli and
consequences, to produce socially significant improvement in human behavior, including the
use of direct observation, measurement, and functional analysis of the relationship between
environment and behavior. (2) AUTISM SPECTRUM DISORDER. Any of the pervasive developmental
disorders or autism spectrum disorders as defined by the most recent edition of the Diagnostic
and Statistical Manual of Mental Disorders (DSM) or the edition that was in effect at the
time of diagnosis. (3) BEHAVIORAL HEALTH TREATMENT. Counseling and treatment programs, including
applied behavior analysis that are both of the following: a. Necessary to develop, maintain,
or restore, to the maximum extent practicable, the functioning of an...
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27-12A-1
Section 27-12A-1 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) COMMISSIONER. The Alabama Commissioner of Insurance or his or her designee.
(2) DEPARTMENT. The Alabama Department of Insurance. (3) INSURANCE. As defined in Section
27-1-2, and specifically including any contract, arrangement, or agreement, in which one undertakes
to do any one of the following: a. Pay or indemnify another as to loss from certain contingencies
called risks. b. Pay or grant a specified amount or determinable benefit to another in connection
with ascertainable risk contingencies. c. Pay an annuity to another. d. Act as surety. For
the purposes of this chapter, insurance also includes any health benefit plan as defined in
Section 27-53-1. (4) INSURANCE PRODUCER or PRODUCER. As defined in Section 27-7-1. (5) INSURER.
A person entering into agreements, contracts of insurance, arrangements, or reinsurance, or
a health benefit plan, or a group health plan as...
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27-43-10
Section 27-43-10 Types of legal expense insurance; policy and certificate forms; issuance of
policies and certificates. (a) Legal expense insurance may be written as individual, group,
blanket, or franchise insurance. Each contractual obligation for legal expense insurance must
be evidenced by a policy. Each person insured under a group policy must be issued a certificate
of coverage. (b) No policy or certificate of legal expense insurance may be issued in this
state unless a copy of the form has been filed and approved by the commissioner. (c) The commissioner
may not approve any form that does not meet the following requirements: (1) Policies must
contain a list and description of the legal service payments promised or the legal matters
for which expenses are to be reimbursed and any limits on the amounts to be paid or reimbursed;
(2) Policies and certificates must indicate the name of the insurer and the full address of
its principal place of business; (3) Certificates issued under...
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27-14-3
Section 27-14-3 Insurable interest - Personal insurance; preneed contracts. (a) Insurable interest
with reference to personal insurance is an interest based upon a reasonable expectation of
pecuniary advantage through the continued life, health, or bodily safety of another person
and consequent loss by reason of his or her death or disability or a substantial interest
engendered by love and affection in the case of individuals closely related by blood or by
law. (b) An individual has an unlimited insurable interest in his or her own life, health,
and bodily safety and may lawfully take out a policy of insurance on his or her own life,
health, or bodily safety and have the same made payable to whomsoever he or she pleases, regardless
of whether the beneficiary so designated has an insurable interest. (c) A corporation, foreign
or domestic, has an insurable interest in the life or physical or mental ability of any of
its directors, officers, or employees, or the directors, officers, or...
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27-15-53
Section 27-15-53 Requirements for death master file comparisons. (a) An insurer shall perform
a comparison of its insureds' in-force life insurance policies, annuity contracts, and retained
asset accounts against a death master file, to identify potential death master file matches
of its insureds. Such comparison shall be completed by January 1, 2019. Thereafter, an insurer
shall maintain a program designed to compare each such policy, contract, or account with a
death master file no less frequently than every three years, it being the intent that insurers
fashion a program that best fits their business systems while at the same time protecting
consumers by assuring reasonable checks are being performed to identify unreported deaths.
For those potential death master file matches identified as a result of a death master file
comparison, the insurer shall do all of the following: (1) Within 90 days of a death master
file match: a. Complete a commercially reasonable effort, which shall be...
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27-36A-2
Section 27-36A-2 Definitions. For purposes of this chapter, the following definitions shall
apply on or after the operative date of the valuation manual as defined by Section 27-36A-15:
(1) ACCIDENT AND HEALTH INSURANCE. Contracts that incorporate morbidity risk and provide protection
against economic loss resulting from accident, sickness, or medical conditions and as may
be specified in the valuation manual. (2) APPOINTED ACTUARY. A qualified actuary who is appointed
in accordance with the valuation manual to prepare the actuarial opinion required in subsection
(b) of Section 27-36A-4. (3) COMPANY. An entity, which (i) has written, issued, or reinsured
life insurance contracts, accident and health insurance contracts, or deposit-type contracts
in this state and has at least one such policy in force or on claim or (ii) has written, issued,
or reinsured life insurance contracts, accident and health insurance contracts, or deposit-type
contracts in any state and is required to hold a...
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27-17A-10
Section 27-17A-10 Certificate required. (a) No person may sell a preneed contract without first
having a valid certificate of authority. (b)(1) No person may receive any funds for payment
on a preneed contract who does not hold a valid certificate of authority. (2) Any preneed
transaction in which a buyer pays to the seller before need, in whole or in part, a purchase
price for funeral or cemetery merchandise and services, and in which the seller is not obligated
to deliver the contracted for merchandise or to perform the services until need, in whole
or in part, shall be evidenced by a written preneed contract satisfying the requirements of
this chapter and signed by the seller and the purchaser. No person may receive or accept any
form of consideration in such a transaction without a fully signed written preneed contract.
A transaction not evidenced by a signed written preneed contract shall be voidable at the
election of the buyer and, if such election is made, the seller shall...
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27-60-2
Section 27-60-2 Interstate Insurance Product Regulation Compact. The State of Alabama hereby
agrees to the following interstate compact known as the Interstate Insurance Product Regulation
Compact: ARTICLE I. PURPOSES. The purposes of this compact are, through means of joint and
cooperative action among the compacting states: 1. To promote and protect the interest of
consumers of individual and group annuity, life insurance, disability income, and long-term
care insurance products; 2. To develop uniform standards for insurance products covered under
the compact; 3. To establish a central clearinghouse to receive and provide prompt review
of insurance products covered under the compact and, in certain cases, advertisements related
thereto, submitted by insurers authorized to do business in one or more compacting states;
4. To give appropriate regulatory approval to those product filings and advertisements satisfying
the applicable uniform standard; 5. To improve coordination of...
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