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27-20-7
Section 27-20-7 Blanket disability insurance - Payment of benefits. All benefits under any
blanket disability policy shall be payable to the person insured, or to his employer, or to
his designated beneficiary or beneficiaries or to his estate; except, that if the person insured
be a minor or mental incompetent, such benefits may be made payable to his parent, guardian,
or other person actually supporting him, or, if the entire cost of the insurance has been
borne by the employer, such benefits may be made payable to the employer; provided, however,
that the policy may provide that all, or any portion, of any indemnities provided by such
policy on account of hospital, nursing, medical, or surgical services may, at the insurer's
option, be paid directly to the hospital or person rendering such services; but the policy
may not require that the service be rendered by a particular hospital or person. Payment so
made shall discharge the insurer's obligation with respect to the amount of...
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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...
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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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25-4-10
situations); (v) In a position which, under or pursuant to the laws of this state or of an
Indian tribe, is designated as a major nontenured policymaking or advisory position or a policymaking
or advisory position the performance of the duties of which ordinarily does not require more
than 8 hours per week; or d. In a facility conducted for the purpose of carrying out a program
of rehabilitation for individuals whose earning capacity is impaired by age or physical or
mental deficiency or injury or providing remunerative work for individuals who because
of their impaired physical or mental capacity cannot be readily absorbed in the competitive
labor market by an individual receiving such rehabilitation or remunerative work; provided
however, if an individual's employment is otherwise characterized as employment under subsection
(a) and the individual is performing work under the Javits Wagner O'Day Act or a similar set-aside
program under the laws of the United States, the...
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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...
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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...
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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...
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36-29-1
Section 36-29-1 Definitions. When used in this chapter, the following terms shall have the
following meanings, respectively, unless the context clearly indicates otherwise: (1) BOARD.
The State Employees' Insurance Board. (2) CLASS. An employee or retiree shall be included
in one of the following classes: (i) active employee single, (ii) active employee family,
(iii) non-Medicare retiree single, (iv) non-Medicare retiree family, (v) Medicare retiree
single, (vi) Medicare retiree family, (vii) non-Medicare retiree with Medicare eligible dependent(s),
or (viii) Medicare retiree with non-Medicare dependent(s). (3) EMPLOYEE. A person who works
full time for the State of Alabama or for a county health department and who receives his
or her full compensation on a monthly basis through means of a state warrant drawn upon the
State Treasury or by check drawn by the Treasurer of the Alabama State Port Authority or by
check drawn by the treasurer of the Alabama state agency for surplus property...
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25-5-1
an artificial member of the body by accidental means. (8) INJURIES BY AN ACCIDENT ARISING OUT
OF AND IN THE COURSE OF THE EMPLOYMENT. Without otherwise affecting either the meaning or
interpretation of the clause, the clause does not cover workers except while engaged in or
about the premises where their services are being performed or where their service requires
their presence as a part of service at the time of the accident and during the hours of service
as workers. (9) INJURY. "Injury and personal injury"
shall mean only injury by accident arising out of and in the course of the employment,
and shall not include a disease in any form, except for an occupational disease or where it
results naturally and unavoidably from the accident. Injury shall include physical
injury caused either by carpal tunnel syndrome disorder or by other cumulative trauma
disorder if either disorder arises out of and in the course of the employment, and breakage
or damage to eyeglasses, hearing aids,...
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45-37-123.01
RETIREMENT BENEFIT. A benefit payable pursuant to the terms of subsection (a) of Section 45-37-123.100.
(52) SYSTEM or PLAN. The General Retirement System for Employees of Jefferson County, which
system or plan may sue or be sued, and in such name all of its business shall be transacted.
(53) SPOUSE. The legal wife or husband of a member as determined in accordance with federal
law. (54) TOTAL DISABILITY. A permanent physical or mental condition of a member resulting
from bodily injury, disease, or mental disorder which renders such member incapable
of continuing usual and customary employment with the county. The disability of a member shall
be determined by a licensed medical advisor. (55) TRUSTEE. The pension board or the person
or entity appointed by the pension board and named as trustee herein or in any separate trust
forming a part of the plan, and any successors. (56) TRUST FUND. The tax-qualified trust in
which certain plan funds are held, disbursed, transferred,...
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