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27-20-5
for a copy of such application, and the insurer shall, within 15 days after the receipt of
such request at its home office or any branch office of the insurer, deliver or mail to the
person making such request a copy of such application. If such copy shall not be so delivered
or mailed, the insurer shall be precluded from introducing such application as evidence in
any action based upon, or involving, any statements contained therein; (2) A provision that
written notice of sickness or of injury must be given to the insurer within 20 days
after the date when such sickness or injury occurred. Failure to give notice within
such time shall not invalidate nor reduce any claim if it shall be shown not to have been
reasonably possible to give such notice and that notice was given as soon as was reasonably
possible; (3) A provision that the insurer will furnish to the policyholder such forms as
are usually furnished by it for filing proof of loss. If such forms are not furnished before
the...
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11-104-2
Section 11-104-2 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) DEPENDENTS. The spouse, children, or other dependents of the retired employee,
as defined by and covered under the documents governing the governmental entities' benefit
plans that provide post-employment benefits. (2) EMPLOYEE. Any person who is an employee of
any governmental entity located in the state who may become eligible for post-employment benefits
from the governmental entity. (3) EMPLOYER. Any governmental entity that sponsors, in whole
or in part, post-employment benefits. (4) FISCAL YEAR. The annual period at the end of which
a governmental entity determines its financial condition. (5) GASB. The Governmental Accounting
Standards Board. (6) GOVERNMENTAL ENTITY. Any political subdivision of the state, any department,
agency, board, commission, or authority of any such political subdivision, or any public corporation,
authority, agency, instrumentality, board,...
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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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35-11-371
persons, firms, or corporations claimed by the injured person, or the legal representative
of the person, to be liable for damages arising from the injuries. The claimant shall also
within one day after the filing of the claim or lien, mail a copy thereof by registered or
certified mail, postage prepaid, for each person, firm, or corporation so claimed to be liable
on account of the injuries, at the addresses so given in the statement, and to the patient,
his or her guardian, or his or her personal representative at the address given at
the time of admission. (d) The filing of a claim or lien shall be notice thereof to all persons,
firms, or corporations liable for damages, whether or not they are named in the claim or lien.
Nothing shall be deemed to preclude the hospital from perfecting its lien outside of the time
limits stated in this section through providing actual notice to persons, firms, or corporations.
(e) The judge of probate shall endorse thereon the date and hour of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/35-11-371.htm - 5K - Match Info - Similar pages
16-25A-8
Section 16-25A-8 Funding of health insurance plan; participation; Public Education Employees'
Health Insurance Fund. (a) The Public Education Employees' Health Insurance Board is hereby
authorized to provide under the contract or contracts entered into under the provisions of
this article an insurance benefit plan for each covered employee and, under certain conditions,
retired employees; the cost of such plan may be funded in part or in full through monthly
premiums per active employee from the same source of funds as those used for the payment of
salaries of active members and in part from other funds. (b) On or before January 1 next preceding
each regular meeting of the Legislature, the board shall certify to the Governor and to the
Legislature the amount or amounts necessary to fund coverage for benefits authorized by this
article for the following fiscal year for employees and for retired employees as a monthly
premium per active member per month. The Legislature shall set the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/16-25A-8.htm - 6K - Match Info - Similar pages
25-4-16
Section 25-4-16 Wages. (a) Prior to January 1, 1983, "wages," as used in this chapter,
shall mean such remuneration as was defined in this section prior to such date. (b) On and
after January 1, 1983, "wages," as used in this chapter, shall mean every form of
remuneration paid or received for personal services, including the cash value of any
remuneration paid in any medium other than cash. The reasonable cash value of remuneration
paid in any medium other than cash shall be determined in accordance with rules prescribed
by the director; except that effective on May 28, 1980, and for the purposes of reporting
and computing the amount of contributions due, back pay awarded as the result of an agreement,
arbitration, or order of a court of competent jurisdiction on a retroactive basis shall be
considered "wages" during the calendar quarter in which such retroactive payments
are made. The term "wages," however, shall not include: (1) That part of remuneration,
which after remuneration...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/25-4-16.htm - 6K - Match Info - Similar pages
27-21A-1
organization. (5) EVIDENCE OF COVERAGE. Any certificate, agreement, or contract issued to an
enrollee setting out the coverage to which he is entitled. (6) HEALTH CARE SERVICES. Any services
included in the furnishing to any individual of medical or dental care, or hospitalization
or incident to the furnishing of such care or hospitalization, as well as the furnishing to
any person of any and all other services for the purpose of preventing, alleviating, curing,
or healing human illness, injury, or physical disability. (7) HEALTH MAINTENANCE ORGANIZATION.
Any person that undertakes to provide or arrange for basic health care services through an
organized system which combines the delivery and financing of health care to enrollees. The
organization shall provide physician services directly through physician employees or under
contractual arrangements with either individual physicians or a group or groups of physicians.
The organization shall provide basic health care services...
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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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25-4-145
Section 25-4-145 Penalties; limitation of actions; collection of overpayments; waiver of overpayments.
(a) Penalties. (1) Whoever willfully makes a false statement or representation or who willfully
fails to disclose a material fact to obtain or increase any benefit or payment under this
chapter, or under an unemployment insurance law of any other state or government, either for
himself or herself or for any other person, whether such benefit or payment is actually received
or not, shall be guilty of an offense as follows and each such false statement or representation
shall constitute a separate and distinct offense: a. If the aggregate amount involved in the
offense exceeds two thousand five hundred dollars ($2,500) in value, that shall constitute
a Class B felony. b. If the aggregate amount involved in the offense exceeds five hundred
dollars ($500) but does not exceed two thousand five hundred dollars ($2,500), that shall
constitute a Class C felony. c. If the aggregate amount...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/25-4-145.htm - 8K - Match Info - Similar pages
27-1-10.1
Section 27-1-10.1 Insurance coverage for drugs to treat life-threatening illnesses. (a) The
Legislature finds and declares the following: (1) The citizens of this state rely upon health
insurance to cover the cost of obtaining health care and it is essential that the citizens'
expectation that their health care costs will be paid by their insurance policies is not disappointed
and that they obtain the coverage necessary and appropriate for their care within the terms
of their insurance policies. (2) Some insurers deny payment for drugs that have been approved
by the Federal Food and Drug Administration, hereafter referred to as FDA, when the drugs
are used for indications other than those stated in the labelling approved by the FDA, off-label
use, while other insurers with similar coverage terms do pay for off-label use. (3) Denial
of payment for off-label use can interrupt or effectively deny access to necessary and appropriate
treatment for a person being treated for a...
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