|
27-19-105
Section 27-19-105 Regulations for long-term care policies; outline of coverage, policy
summary, and monthly report. (a) The commissioner may adopt regulations that include standards
for full and fair disclosure setting forth the manner, content, and required disclosures for
the sale of long-term care insurance policies, terms of renewability, initial and subsequent
conditions of eligibility, nonduplication of coverage provisions, coverage of dependents,
preexisting conditions, termination of insurance, continuation or conversion, probationary
periods, limitations, exceptions, reductions, elimination periods, requirements for replacement,
recurrent conditions, and definitions of terms. Regulations under this subsection should recognize
the developing and unique nature of long-term care insurance and the distinction between group
and individual long-term insurance policies. (b) No long-term care insurance policy may do
any of the following: (1) Be cancelled, nonrenewed, or otherwise...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-105.htm - 11K - Match Info - Similar pages
27-19-103
Section 27-19-103 Definitions. Unless the context requires otherwise, the definitions
in this section apply throughout this article. (1) APPLICANT. In the case of: a. An
individual long-term care insurance policy, the person who seeks to contract for benefits.
b. A group long-term care insurance policy, the proposed certificate holder. (2) CERTIFICATE.
Any certificate issued under a group long-term care insurance policy, which policy has been
delivered or issued for delivery in this state. (3) COMMISSIONER. The Alabama Commissioner
of Insurance. (4) GROUP LONG-TERM CARE INSURANCE. A long-term care insurance policy which
is delivered or issued for delivery in this state and issued to any of the following: a. One
or more employers or labor organizations, or to a trust or to the trustees of a fund established
by one or more employers or labor organizations, or a combination thereof, for employees or
former employees or a combination thereof, or for members or former members or a...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-103.htm - 9K - Match Info - Similar pages
27-19-106
Section 27-19-106 Effect of misrepresentation; field issuance. (a) For a policy or certificate
that has been in force for less than six months an insurer may rescind a long-term care insurance
policy or certificate or deny an otherwise valid long-term care insurance claim upon a showing
of misrepresentation that is material to the acceptance for coverage. (b) For a policy or
certificate that has been in force for at least six months but less than two years an insurer
may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term
care insurance claim upon a showing of misrepresentation that is both material to the acceptance
for coverage and which pertains to the condition for which benefits are sought. (c) After
a policy or certificate has been in force for two years it is not contestable upon the grounds
of misrepresentation alone but may be contested only upon a showing that the insured knowingly
and intentionally misrepresented relevant facts...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-106.htm - 2K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-54A-2.htm - 10K - Match Info - Similar pages
27-55-2
Section 27-55-2 Definitions. As used in this chapter, these terms shall have the following
meanings: (1) ABUSE. The occurrence of one or more of the following acts by a family or household
member, as defined by subdivision (3) of subsection (b) of Section 15-10-3: a. Attempting
to cause or intentionally, knowingly, or recklessly causing another person, including a minor
child, bodily injury, severe emotional injury, or psychological trauma or conduct which constitutes
the crime of rape. b. Intentionally following another person, including a minor child, without
proper authority, under circumstances that place the person in reasonable fear of bodily injury
or physical harm. c. Subjecting another person, including a minor child, to false imprisonment
or kidnapping. d. Attempting to cause or intentionally, knowingly, or recklessly causing damage
to property to intimidate or attempt to control the behavior of another person, including
a minor child. e. Assault, child abuse, criminal...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-55-2.htm - 5K - Match Info - Similar pages
27-44-3
Section 27-44-3 Scope of chapter. (a) This chapter shall provide coverage for the policies
and contracts specified in subsection (b) as follows: (1) To persons who, regardless of where
they reside (except for non-resident certificate holders under group policies or contracts),
are the beneficiaries, assignees, or payees of the persons covered under subdivision (2).
(2) To persons who are owners of or certificate holders under the policies or contracts, other
than structured settlement annuities, and in each case who are either of the following: a.
Residents b. Not residents, but only under all of the following conditions: 1. The insurer
that issued the policies or contracts is domiciled in this state. 2. The states in which the
persons reside have associations similar to the association created by this chapter. 3. The
persons are not eligible for coverage by an association in any other state due to the fact
the insurer was not licensed in the state at the time specified in the state's...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-44-3.htm - 12K - Match Info - Similar pages
27-19-107
Section 27-19-107 Nonforfeiture benefits. (a) Except as provided in subsection (b),
a long-term care insurance policy may not be delivered or issued for delivery in this state
unless the policyholder or certificateholder has been offered the option of purchasing a policy
or certificate including a nonforfeiture benefit. The offer of a nonforfeiture benefit may
be in the form of a rider that is attached to the policy. In the event the policyholder or
certificateholder declines the nonforfeiture benefit, the insurer shall provide a contingent
benefit upon lapse that shall be available for a specified period of time following a substantial
increase in premium rates. (b) When a group long-term care insurance policy is issued, the
offer required in subsection (a) shall be made to the group policyholder. However, if the
policy is issued as group long-term care insurance, as defined in Section 27-19-103(4)d.,
other than to a continuing care retirement community or other similar entity, the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-107.htm - 1K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-60-2.htm - 45K - Match Info - Similar pages
27-44-5
Section 27-44-5 Definitions. As used in this chapter, the following terms shall have
the following meanings, respectively, unless the context clearly indicates otherwise: (1)
ACCOUNT. Either of the three accounts created under Section 27-44-6. (2) ASSOCIATION.
The Alabama Life and Disability Insurance Guaranty Association created under Section
27-44-6. (3) AUTHORIZED ASSESSMENT or the term AUTHORIZED when used in the context of assessments.
A resolution by the board of directors has been passed whereby an assessment will be called
immediately or in the future from member insurers for a specified amount. An assessment is
authorized when the resolution is passed. (4) BENEFIT PLAN. A specific employee, union, or
association of natural persons benefit plan. (5) CALLED ASSESSMENT or the term CALLED when
used in the context of assessments. A notice that has been issued by the association to member
insurers requiring that an authorized assessment be paid within the time frame set forth within...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-44-5.htm - 7K - 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
|