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22-21-361
Section 22-21-361 Definitions. The following terms shall have the meanings respectively ascribed
by this section unless the context clearly indicates otherwise: (1) COMMISSIONER. The commissioner
of insurance of this state. (2) DENTAL SERVICE PLAN or PLAN. Any plan or other arrangement
whereby dental services are provided in whole or in part through a dental service corporation
by dentists participating in the plan to provide dental services to those members of the public
who become subscribers to the plan under a contract with such corporation. The terms "dental
service plan" or "plan" do not include an insurer authorized by the insurance
department to transact insurance in this state or to a nonprofit health insurance plan organized
pursuant to Section 10-4-100, or to any policy of insurance or contract which includes dental
benefits issued by such insurer or nonprofit health insurance plan. (3) DEPARTMENT. The Department
of Insurance. (4) LICENSE. The certificate of authority issued...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-21-361.htm - 1K - Match Info - Similar pages
22-6-221
Section 22-6-221 Service by integrated care network; board of directors. (a) An integrated
care network shall serve only Medicaid beneficiaries in providing medical care and services.
For the purposes of this article, a beneficiary cannot be a member of both an integrated care
network and a regional care organization. (b) An integrated care network shall provide required
medical care and services to Medicaid beneficiaries and may coordinate care provided by or
through an affiliation of other health care providers or other programs as the Medicaid Agency
shall determine. (c) Notwithstanding any other provision of law, the integrated care network
shall not be deemed an insurance company under state law. (d)(1) An integrated care network
shall have a governing board of directors composed of the following members: a. Twelve members
shall be persons representing risk bearing participants. A participant bears risk by contributing
cash, capital, or other assets to the integrated care network....
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-221.htm - 2K - Match Info - Similar pages
27-19-103
would result in economies of acquisition or administration. 3. The benefits are reasonable
in relation to the premiums charged. (5) LONG-TERM CARE INSURANCE. Any insurance policy or
rider advertised, marketed, offered, or designed to provide coverage for not less than 12
consecutive months for each covered person on an expense incurred, indemnity, prepaid, or
other basis for one or more necessary or medically necessary diagnostic, preventive, therapeutic,
rehabilitative, maintenance, or personal care services, provided in a setting other
than an acute care unit of a hospital. This term includes group and individual annuities and
life insurance policies or riders that provide directly or that supplement long-term care
insurance. This term also includes a policy or rider that provides for payment of benefits
based upon cognitive impairment or the loss of functional capacity. The term shall also include
qualified long-term care insurance contracts. Long-term care insurance may be...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-103.htm - 9K - Match Info - Similar pages
27-31A-2
investment policies, and reinsurance agreements. g. Identification of each state in which the
risk retention group has obtained, or sought to obtain, a charter and license, and a description
of its status in each state. h. Other matters as may be prescribed by the Commissioner of
Insurance, or like official, in which the risk retention group is chartered for liability
insurance companies authorized by the insurance laws of that state. (9) PRODUCT LIABILITY.
Liability for damages because of any personal injury, death, emotional harm,
consequential economic damage, or property damage, including damages resulting from the loss
of use of property, arising out of the manufacture, design, importation, distribution, packaging,
labeling, lease, or sale of a product, but does not include the liability of any person for
those damages if the product involved was in the possession of the person when the incident
giving rise to the claim occurred. (10) PURCHASING GROUP. Any group which meets all...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-31A-2.htm - 8K - Match Info - Similar pages
27-44-8
Section 27-44-8 Powers and duties of association. (a) If a member insurer is an impaired insurer,
the association may, in its discretion and subject to any conditions imposed by the association
that do not impair the contractual obligations of the impaired insurer, and that are approved
by the commissioner: (1) Guarantee or reinsure, or cause to be guaranteed, assumed, or reinsured,
any or all of the covered policies of the impaired insurers. (2) Provide such moneys, pledges,
notes, guarantees, or other means as are proper to effectuate subdivision (1), and assure
payment of the contractual obligations of the impaired insurer pending action under subdivision
(1). (b) If a member insurer is an insolvent insurer, the association shall, in its discretion
and subject to the approval of the commissioner, do either of the following: (1)a. Guarantee,
assume, or reinsure, or cause to be guaranteed, assumed, or reinsured, the covered policies
of the insolvent insurer. b. Assure payment of the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-44-8.htm - 24K - Match Info - Similar pages
27-42-5
Section 27-42-5 Definitions. As used in this chapter, the following terms shall have the following
meanings, respectively, unless the context clearly indicates otherwise: (1) ACCOUNT. Any one
of the three accounts created by Section 27-42-6. (2) AFFILIATE. A person who directly, or
indirectly, through one or more intermediaries, controls, is controlled by, or is under common
control with another person on December 31 of the year immediately preceding the date the
insurer becomes an insolvent insurer. (3) ASSOCIATION. The Alabama Insurance Guaranty Association
created under Section 27-42-6. (4) CLAIMANT. Any insured making a first party claim or any
person instituting a liability claim. The term does not include a person who is an affiliate
of an insolvent insurer. (5) COMMISSIONER. The Commissioner of Insurance of the State of Alabama.
(6) CONTROL. The possession, direct or indirect, of the power to direct or cause the direction
of the management and policies of a person, whether...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-42-5.htm - 5K - Match Info - Similar pages
27-61-1
functions. 5. CORPORATE RECORDS OF THE COMMISSION The Commission shall maintain its corporate
books and records in accordance with the Bylaws. 6. QUALIFIED IMMUNITY, DEFENSE, AND INDEMNIFICATION
a. The Members, officers, executive director, employees, and representatives of the Commission,
the Executive Committee, and any other Committee of the Commission shall be immune from suit
and liability, either personally or in their official capacity, for any claim for damage to
or loss of property or personal injury or other civil liability caused by or
arising out of any actual or alleged act, error, or omission that occurred, or that the person
against whom the claim is made had a reasonable basis for believing occurred within the scope
of Commission employment, duties, or responsibilities; provided that nothing in this paragraph
shall be construed to protect any such person from suit and/or liability for any damage, loss,
injury, or liability caused by the intentional or willful or wanton...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-61-1.htm - 62K - Match Info - Similar pages
16-44B-1
Commission may deem appropriate. The executive director shall serve as secretary to the Interstate
Commission, but shall not be a Member of the Interstate Commission. The executive director
shall hire and supervise such other persons as may be authorized by the Interstate Commission.
D. The Interstate Commission's executive director and its employees shall be immune from suit
and liability, either personally or in their official capacity, for a claim for damage to
or loss of property or personal injury or other civil liability caused or arising
out of or relating to an actual or alleged act, error, or omission that occurred, or that
such person had a reasonable basis for believing occurred, within the scope of Interstate
Commission employment, duties, or responsibilities; provided, that such person shall not be
protected from suit or liability for damage, loss, injury, or liability caused by the
intentional or willful and wanton misconduct of such person. 1. The liability of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/16-44B-1.htm - 46K - Match Info - Similar pages
27-1-17
Section 27-1-17 Limitation periods for payment of claims; overdue claims; retroactive denials,
adjustments, etc.; penalties. (a) Each insurer, health service corporation, and health benefit
plan that issues or renews any policy of accident or health insurance providing benefits for
medical or hospital expenses for its insured persons shall pay for services rendered by Alabama
health care providers within 45 calendar days upon receipt of a clean written claim or 30
calendar days upon receipt of a clean electronic claim. If the insurer, health service corporation,
or health benefit plan is denying or pending the claim, the insurer, health service corporation,
or health benefit plan shall, within 45 calendar days for a written claim and 30 calendar
days for an electronic claim, notify the health care provider or certificate holder of the
reason for denying or pending the claim and what, if any, additional information is required
to process the claim. Any undisputed portion of the claim...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-17.htm - 17K - Match Info - Similar pages
15-22-1.1
by the Interstate Commission, but shall not be a member. (c) Corporate records of the Interstate
Commission. The Interstate Commission shall maintain its corporate books and records in accordance
with the bylaws. (d) Qualified immunity, defense and indemnification. (1) The members, officers,
executive director, and employees of the Interstate Commission shall be immune from suit and
liability, either personally or in their official capacity, for any claim for damage to or
loss of property or personal injury or other civil liability caused or arising
out of any actual or alleged act, error or omission that occurred within the scope of Interstate
Commission employment, duties or responsibilities; provided, that nothing in this paragraph
shall be construed to protect any such person from suit and/or liability for any damage, loss,
injury or liability caused by the intentional or willful and wanton misconduct of any
such person. (2) The Interstate Commission shall defend the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/15-22-1.1.htm - 43K - Match Info - Similar pages
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