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...
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27-15-24
Section 27-15-24 Exclusions and restrictions in life insurance policies. (a) No policy of life
insurance shall be delivered or issued for delivery in this state if it contains any of the
following provisions: (1) A provision for a period shorter than that provided by statute within
which an action may be commenced on such a policy; and (2) A provision which excludes or restricts
liability for death caused in a certain specified manner or occurring while the insured has
a specified status; except, that a policy may contain provisions excluding or restricting
coverage as specified therein in the event of death under any one or more of the following
circumstances: a. Death as a result, directly or indirectly, of war, declared or undeclared,
or of action by military forces, or of any act or hazard of such war or action, or of service
in the military, naval, or air forces or in civilian forces auxiliary thereto, or from any
cause while a member of such military, naval, or air forces of any...
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11-91A-7
Section 11-91A-7 Jurisdiction of board; funding; powers of board. The board shall have full,
complete, and exclusive jurisdiction over the program and shall allocate funds from its treasury
for the fulfillment and accomplishment of its duties and responsibilities in a manner as may
be necessary and appropriate to carry out the purposes of this chapter. The board shall have
the general powers and authority granted under the laws of this state for health insurers,
and in addition thereto, the specific authority to do all of the following: (a) Subject to
compliance with Section 11-91A-8 where applicable, execute a contract or contracts to provide
for the administration of the program in accordance with this chapter. The contract or contracts
may be executed with one or more agencies or corporations licensed to transact or administer
group health care business in this state with similar plans of the state for the joint performance
of common administrative functions. (b) Establish, and...
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27-36A-18
Section 27-36A-18 Confidentiality. (a) For purposes of this section, "confidential information"
shall mean all of the following: (1) A memorandum in support of an opinion submitted under
Section 27-36A-4 and any other documents, materials, and other information, including, but
not limited to, all working papers, and copies thereof, created, produced, or obtained by
or disclosed to the commissioner or any other person in connection with such memorandum. (2)
All documents, materials, and other information, including, but not limited to, all working
papers, and copies thereof, created, produced, or obtained by or disclosed to the commissioner
or any other person in the course of an examination made under subsection (f) of Section 27-36A-15;
provided, however, that if an examination report or other material prepared in connection
with an examination made under Chapter 2 is not held as private and confidential information
under Section 27-2-24, an examination report or other material...
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27-52-2
Section 27-52-2 Authority. The plan shall have the general powers and authority granted under
the laws of this state to health insurers and in addition thereto, the specific authority
to do all of the following: (1) Enter into contracts as are necessary or proper to carry out
the provisions and purposes of this article, including the authority, with the approval of
the commissioner, to enter into contracts with similar plans of other states for the joint
performance of common administrative functions, or with persons or other organizations for
the performance of administrative functions. (2) Sue or be sued, including taking any legal
actions necessary or proper to recover or collect assessments due the plan. (3) Take legal
action as necessary to do any of the following: a. To avoid the payment of improper claims
against the plan or the coverage provided by or through the plan. b. To recover any amounts
erroneously or improperly paid by the plan. c. To recover any amounts paid by the...
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41-10-356
Section 41-10-356 Powers of authority. The authority shall have the following powers among
others specified in this article: (1) To have succession by its corporate name until dissolved
as provided in this article; (2) To sue and be sued and to prosecute and defend, at law or
in equity, in any court having jurisdiction of the subject matter and of the parties thereto;
(3) To have and to use a corporate seal and to alter the same at pleasure; (4) To make and
alter all needful bylaws, rules and regulations for the transaction of the authority's business
and the control of its property and affairs; (5) To provide for the acquisition, construction,
installation, equipping, operation and maintenance of mental health facilities, including
the equipping and improvement of existing mental health facilities; (6) To receive, take and
hold by sale, gift, lease, devise or otherwise, real and personal property of every description,
and to manage the same; (7) To acquire by purchase, gift, or any...
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27-34-30
Section 27-34-30 Life benefit certificate - Filing with commissioner; standard provisions.
(a) After January 1, 1973, no life benefit certificate shall be delivered, or issued for delivery,
in this state unless a copy of the form has been filed with the commissioner. (b) The certificate
shall contain in substance the following standard provisions or, in lieu thereof, provisions
which are more favorable to the member: (1) Title on the face and filing page of the certificate
clearly and correctly describing its form; (2) A provision stating the amount of rates, premiums,
or other required contributions, by whatever name known, which are payable by the insured
under the certificate; (3) A provision that the member is entitled to a grace period of not
less than a full month, or 30 days at the option of the society, in which the payment of any
premium after the first may be made. During such grace period the certificate shall continue
in full force, but in case the certificate becomes a...
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27-34-32
Section 27-34-32 Accident or health and total or permanent disability insurance contracts.
(a) No domestic, foreign, or alien society authorized to do business in this state shall issue
or deliver in this state any certificate or other evidence of any contract of accident insurance
or health insurance or of any total and permanent disability insurance contract unless and
until the form thereof, together with the form of application and all riders or endorsements
for use in connection therewith, shall have been filed with the commissioner. (b) The commissioner
shall have power, from time to time, to make, alter, and supersede reasonable regulations
prescribing the required, optional, and prohibited provisions in such contracts, and such
regulations shall conform, as far as practicable, to the provisions of Chapter 19 of this
title. Where the commissioner deems inapplicable, either in part or in their entirety, the
provisions of Chapter 19 of this title, he may prescribe the portions, or...
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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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11-26-4
Section 11-26-4 Health and accident group to establish trustees, bylaws, schedules, etc.; powers
generally. Each health and accident self-insurance group established under provisions of this
chapter shall have the power and authority to establish a governing body of trustees; establish
bylaws for the governing of such group; establish a schedule of benefits payable; establish
a schedule of charges to be collected from member counties for benefits provided; enter into
contracts with solvent insurance companies authorized to do business in this state; enter
into management and consultant contracts; hire attorneys and employees; and exercise such
powers and authority incident to the purposes of this chapter. (Acts 1981, No. 81-265, p.
348, §4.)...
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