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Home » US Law » 2022 Maryland Statutes » Insurance » Title 15 - Health Insurance » Subtitle 2 - Individual Health Insurance Policy Forms and Provisions

Section 15-201 – Form of Policy

    (a)    A policy of health insurance may not be delivered or issued for delivery in the State unless the policy complies with the provisions of this section and other sections of this article.     (b)    Each policy of health insurance shall state explicitly:         (1)    any consideration, including the entire amount of money, given for the policy; and         (2)    the time […]

Section 15-202 – Language and Order of Policy Provisions

    (a)    Except as otherwise provided in this section, each policy of health insurance that is delivered or issued for delivery in the State:         (1)    shall contain the exact language of each provision that is required under §§ 15-207 through 15-218 of this subtitle and any optional provision in §§ 15-207 through 15-226 of this subtitle that is […]

Section 15-203 – Right to Refuse Renewal

    Other than a policy of accident only insurance, each policy of health insurance in which the insurer reserves the right to refuse renewal on an individual basis shall contain a provision, endorsement, or rider that provides in substance:         (1)    that, subject to the right to terminate the policy on nonpayment of premium when due, the right […]

Section 15-204 – Age Limit; Misstatement of Age

    (a)    If a policy of health insurance establishes, as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective, and the date falls within a period for which the insurer accepts a premium for the policy, or if the insurer accepts a premium for the policy after […]

Section 15-205 – Policies of Foreign or Alien Insurers; Policies of Domestic Insurers

    (a)    A policy of a foreign insurer or alien insurer that is delivered or issued for delivery in the State may contain a provision that:         (1)    is not less favorable to the insured or beneficiary than the provisions of this subtitle; and         (2)    is required by the law of the state or country under which the foreign insurer […]

Section 15-206 – Policies and Provisions at Variance With Subtitle

    (a)    A policy provision that is not subject to this subtitle may not make the policy or any part of the policy less favorable in any respect to the insured or beneficiary than the provisions of the policy that are subject to this subtitle.     (b)    A policy that is delivered or issued for delivery in the State […]

Section 15-207 – Entire Contract; Changes

    Each policy of health insurance shall contain the following provision:     “Entire contract; changes: This policy, including the endorsements and the attached papers, if any, constitutes the entire contract of insurance. No change in this policy shall be valid until approved by an executive officer of the insurer and unless such approval be endorsed hereon or […]

Section 15-208 – Time Limit on Specified Defenses

    (a)    Except as provided in subsection (c) of this section, each policy of health insurance shall contain the following provision:     “Time limit on certain defenses: (1) After two years from the date of issue of this policy no misstatements, except fraudulent misstatements, made by the applicant in the application for such policy shall be used to […]

Section 15-209 – Grace Period

    (a)    (1)    Subject to subsection (b) of this section, each policy of health insurance shall contain the following provision:     “Grace period: A grace period of …….. (insert a number not less than ‘7’ days for weekly premium policies, ‘10’ days for monthly premium policies and ‘31’ days for all other policies) days will be granted for the […]

Section 15-210 – Reinstatement

    (a)    Each policy of health insurance shall contain the following provision:     “Reinstatement: If any renewal premium be not paid within the time granted the insured for payment, a subsequent acceptance of premium by the insurer or by any insurance producer duly authorized by the insurer to accept such premium, without requiring in connection therewith an application […]

Section 15-211 – Notice of Claim

    (a)    Each policy of health insurance shall contain the following provision:     “Notice of claim: Written notice of claim must be given to the insurer within twenty (20) days after the occurrence or commencement of any loss covered by the policy, or as soon thereafter as is reasonably possible. Notice given by or on behalf of the […]

Section 15-212 – Claim Forms

    Each policy of health insurance shall contain the following provision:     “Claim forms: The insurer, upon receipt of a notice of claim, will furnish to the claimant such forms as are usually furnished by it for filing proofs of loss. If such forms are not furnished within fifteen days after the giving of such notice the […]

Section 15-213 – Proofs of Loss

    Except as provided in § 12–102(c) of this article, each policy of health insurance shall contain the following provision:     “Proofs of loss: Written proof of loss must be furnished to the insurer at its said office in case of claim for loss for which this policy provides any periodic payment contingent upon continuing loss within […]

Section 15-214 – Time of Payment of Claims

    (a)    Each policy of health insurance shall contain the following provision:     “Time of payment of claims: Indemnities payable under this policy for any loss other than loss for which this policy provides any periodic payment, will be paid immediately upon receipt of due written proof of such loss. Subject to due written proof of loss, all […]

Section 15-215 – Payment of Claims

    (a)    Each policy of health insurance shall contain the following provision:     “Payment of claims: Indemnity for loss of life will be payable in accordance with the beneficiary designation and the provisions respecting such payment which may be prescribed herein and effective at the time of payment. If no such designation or provision is then effective, such […]

Section 15-216 – Physical Examinations and Autopsy

    Each policy of health insurance shall contain the following provision:     “Physical examinations and autopsy: The insurer at its own expense shall have the right and opportunity to examine the person of the insured when and as often as it may reasonably require during the pendency of a claim hereunder and to make an autopsy in […]

Section 15-217 – Time for Bringing Legal Actions

    Each policy of health insurance shall contain the following provision:     “Legal actions: No action at law or in equity shall be brought to recover on this policy prior to the expiration of sixty days after written proof of loss has been furnished in accordance with the requirements of this policy. No such action shall be […]

Section 15-218 – Change of Beneficiary

    (a)    Subject to subsection (b) of this section, each policy of health insurance shall contain the following provision:     “Change of beneficiary: Unless the insured makes an irrevocable designation of beneficiary, the right to change a beneficiary is reserved to the insured and the consent of the beneficiary or beneficiaries shall not be requisite to surrender or […]

Section 15-219 – Change of Occupation

    A policy of health insurance may contain the following provision:     “Change of occupation: If the insured be injured or contract sickness after having changed his occupation to one classified by the insurer as more hazardous than that stated in this policy or while doing for compensation anything pertaining to an occupation so classified, the insurer […]

Section 15-220 – Misstatement of Age

    A policy of health insurance may contain the following provision:     “Misstatement of age: If the age of the insured has been misstated, all amounts payable under this policy shall be such as the premium paid would have purchased at the correct age.”