27-1-16
Section 27-1-16 Standard health insurance claim form; electronic claims form; various
claim forms. (a)(1) The Commissioner of the Department of Insurance shall prescribe a standard
health insurance claim form to be used by all hospitals. The forms shall be prescribed in
a format which allows for the use of generally accepted diagnosis and treatment coding systems
by providers of health care and payors. The standard form shall be accepted and used by all
insurers doing business in the State of Alabama and by all state agencies which pay providers
of health care for hospital services. (2) The Commissioner of the Department of Insurance
shall also prescribe a format for all health insurance claims transmitted or submitted for
payment by electronic or electro-mechanical means. Such a format shall be used by all insurers
doing business in the State of Alabama and by all state agencies which pay providers of health
care for hospital services. (b) An advisory committee of five persons, two...
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27-19-33
Section 27-19-33 Addition of endorsements or riders to existing policies. Any insurer
writing disability insurance policies may, with approval of the commissioner, add endorsements
or riders to existing policies of such insurance, with or without increase in premium, provided
there is shown separately on the endorsement or rider a stated premium charge for additional
coverage. (Acts 1957, No. 597, p. 834; Acts 1971, No. 407, p. 707, §453.)...
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27-31-17
Section 27-31-17 Determination of financial condition. In determining the financial
condition of a reciprocal insurer, the commissioner shall apply the following rules: (1) He
shall charge as liabilities the same reserves as are required of incorporated insurers issuing
nonassessable policies on a reserve basis; (2) The surplus deposits of subscribers shall be
allowed as assets, except that any premium deposits delinquent for 90 days shall first be
charged against such surplus deposit; (3) The surplus deposits of subscribers shall not be
charged as a liability; (4) All premium deposits delinquent less than 90 days shall be allowed
as assets; (5) An assessment levied upon subscribers and not collected shall not be allowed
as an asset; (6) The contingent liability of subscribers shall not be allowed as an asset;
and (7) The computation of reserves shall be based upon premium deposits, other than membership
fees, and without any deduction for expenses and the compensation of the attorney....
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27-31-25
Section 27-31-25 Nonassessable policies. (a) If a reciprocal insurer has a surplus of
assets over all liabilities at least equal to the minimum capital stock required of a domestic
stock insurer authorized to transact like kinds of insurance, upon application of the attorney
and as approved by the subscribers' advisory committee, the commissioner shall issue his certificate
authorizing the insurer to extinguish the contingent liability of subscribers under its policies
then in force in this state and to omit provisions imposing contingent liability in all policies
delivered, or issued for delivery, in this state for so long as all such surplus remains unimpaired.
(b) Upon impairment of such surplus, the commissioner shall forthwith revoke the certificate.
Such revocation shall not render subject to contingent liability any policy then in force
and for the remainder of the period for which the premium has theretofore been paid; but after
such revocation, no policy shall be issued or...
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27-52-1
Section 27-52-1 Creation; cessation and reestablishment of operations. (a) There is
hereby created the Alabama Health Insurance Plan which shall, as a high risk pool in the State
of Alabama, provide health insurance coverage to eligible individuals as an alternative to
requiring insurers to offer guaranteed-issue policies, as provided in the Health Insurance
Portability and Accountability Act of 1996 (Pub.L. 104-191, also known as HIPAA). (b) In the
event any federal mandate includes market reform provisions which satisfy the guaranteed-issue
requirements of HIPAA, the Alabama Health Insurance Plan may cease operations upon giving
sufficient time for current participants to transition out of the plan. After operation of
the Alabama Health Insurance Plan ceases and all current and future liabilities of the plan
have been satisfied, any unspent and unencumbered funds of the plan shall be transferred to
the State General Fund. (c) In the event a federal mandate requires the State of...
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27-18-2
Section 27-18-2 Policy provisions - Generally. No policy of group life insurance shall
be delivered in this state unless it contains in substance the applicable provisions set forth
in Sections 27-18-3 through 27-18-13, or provisions which in the opinion of the commissioner
are more favorable to the persons insured or at least as favorable to the persons insured
and more favorable to the policyholder; except, however, that: (1) Sections 27-18-9 and 27-18-13
inclusive shall not apply to policies issued to a creditor to insure debtors of such creditor;
(2) The standard provisions required for individual life insurance policies shall not apply
to group life insurance policies; and (3) If the group life insurance policy is on a plan
of insurance other than the term plan, it shall contain a nonforfeiture provision, or provisions,
which, in the opinion of the commissioner, is, or are, equitable to the insured persons and
to the policyholder, but nothing in this section shall be construed to...
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27-27-17
Section 27-27-17 Domestic mutual insurers - Solicitation of qualifying applications
for insurance. (a) Upon receipt of the commissioner's approval of the bond or deposit as provided
in Section 27-27-16 the directors and officers of the proposed domestic mutual insurer
may commence solicitation of such requisite applications for insurance policies as they may
accept and may receive deposits of premiums thereon. (b) All such applications shall be in
writing signed by the applicant, covering subjects of insurance resident, located or to be
performed in this state. (c) All such applications shall provide that: (1) Issuance of the
policy is contingent upon the insurer qualifying for and receiving a certificate of authority;
(2) No insurance is in effect unless and until the certificate of authority has been issued;
and (3) The prepaid premium or deposit and membership or policy fee, if any, shall be refunded
in full to the applicant if organization is not completed and the certificate of...
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27-29B-5
Section 27-29B-5 Contents of Corporate Governance Annual Disclosure. (a) The insurer
or insurance group shall have discretion over the responses to the CGAD inquiries, provided
the CGAD shall contain the material information necessary to permit the commissioner to gain
an understanding of the insurer's or insurance group's corporate governance structure, policies,
and practices. The commissioner may request additional information that the commissioner deems
material and necessary to provide the commissioner with a clear understanding of the corporate
governance policies or the reporting or information system or controls implementing those
policies. (b) Notwithstanding subsection (a), the CGAD shall be prepared consistent with rules
adopted by the commissioner which shall be substantially similar to the Corporate Governance
Annual Disclosure Model Regulation developed by the NAIC. Documentation and supporting information
shall be maintained and made available upon examination or upon...
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27-17-2
Section 27-17-2 Policy provisions - Generally. No policy of burial insurance shall be
delivered or issued for delivery in this state unless it contains in substance the provisions
set forth in Sections 27-17-3 through 27-17-14, or corresponding provisions, which in the
opinion of the commissioner are not less favorable in any respect to the policyholder. Any
of such provisions, or portions thereof, not applicable to single premium policies shall to
that extent be omitted therefrom. (Acts 1971, No. 407, p. 707, §393.)...
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27-30-16
Section 27-30-16 Contracts - Annual valuation - Benefits payable in cash. (a) The commissioner
shall each year compute the net value as of December 31 of the preceding year of all benefits
payable in cash under all outstanding contracts or policies of each mutual aid association.
Such valuation shall be made upon the basis of the "combined experience" or "actuaries
table" or "the American experience table" rate of mortality (Illinois standard
of valuation), with interest at the rate of four percent per annum. The aggregate net value
so ascertained of such contracts or policies of the association shall be deemed its liability
on account of such cash benefits, other than accrued claims, for the purpose of any determination
of its financial condition. (b) Funds of the association in amount not less than the value
of such benefits, as valued under this section, shall be held by the association in
cash or in investments as authorized under Section 27-30-20. (Acts 1935, No. 114, p.
165; Acts...
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