20-1341. Scope of article Nothing in this article shall apply to or affect: 1. Any policy of liability or workers’ compensation insurance with or without supplementary expense coverage therein. 2. Any group or blanket policy. 3. Life insurance, endowment or annuity contracts, or contracts supplemental thereto which contain only such provisions relating to disability insurance […]
20-1342. Scope and format of policy; definitions A. A policy of disability insurance shall not be delivered or issued for delivery to any person in this state unless it otherwise complies with this title and complies with the following: 1. The entire money and other considerations shall be expressed in the policy. 2. The time […]
20-1342.01. Children with disabilities An individual hospital or medical expense insurance policy delivered or issued for delivery in this state more than one hundred twenty days after August 27, 1977 that provides that coverage of a dependent child shall terminate on attainment of the limiting age for dependent children specified in the policy, shall also […]
20-1342.02. Disapproval of disability policy form The director may disapprove any disability policy form if the benefits provided in the policy form are unreasonable in relation to the premium charged.
20-1342.03. Disability insurance; clinical trials; cancer; definitions A. A disability insurer is not obligated to pay any costs, other than covered patient costs, that are directly associated with a cancer clinical trial that is offered in this state and in which the insured participates voluntarily. A cancer clinical trial is a course of treatment in […]
20-1342.04. Disability insurance policies; varying copayments and deductibles allowed A. Except as provided in sections 20-1379 and 20-2304, a disability insurer may offer one or more disability insurance policies that contain a choice of deductibles, coinsurance, copayments, out-of-pocket and any other cost sharing levels. Plans offered under this section shall clearly disclose in marketing materials, […]
20-1342.05. Eosinophilic gastrointestinal disorder; formula A. Any policy of disability insurance that is offered by a disability insurer and that contains a prescription drug benefit shall cover amino acid-based formula that is ordered by a physician or by a registered nurse practitioner if: 1. The insured has been diagnosed with an eosinophilic gastrointestinal disorder. 2. […]
20-1342.06. Contracts; dentists; covered services; definition A. A contract, entered into or renewed on or after January 1, 2011, between a disability insurer and a dentist who is licensed to practice in this state shall not require the dentist to provide services to an individual covered under a disability insurance policy based on a fee […]
20-1342.07. Contracts; optometrists; covered services; definition A. Except as provided in subsection C of this section, a contract, entered into or renewed on or after January 1, 2022, between a disability insurer and an optometrist who is licensed to practice in this state shall not: 1. Require the optometrist to provide a service to an […]
20-1343. Policies issued for delivery in another state If any policy is issued by a domestic insurer for delivery to a person residing in another state, and if the official having responsibility for the administration of the insurance laws of such other state has advised the director that any such policy is not subject to […]
20-1344. Policy provisions required; omissions; substitutions A. Except as provided in subsection B of this section, each such policy delivered or issued for delivery to any person in this state shall contain the provisions specified in sections 20-1345 to 20-1356, inclusive, in the words in which such provisions appear, except that the insurer may, at […]
20-1345. Policy and attachments as entire contract; changes in policy There shall be a provision as follows: " 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 […]
20-1346. Time limit on defenses A. There shall be a provision as follows: " Time limit on certain defenses: (a) 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 void the policy or to […]
20-1347. Grace period A. There shall be a provision as follows: " Grace period: A grace period of ______________ (insert a number not less than ‘seven’ for weekly premium policies, ‘ten’ for monthly premium policies and ‘thirty-one’ for all other policies) days will be granted for the payment of each premium falling due after the […]
20-1348. Reinstatement A. There shall be a provision as follows: " Reinstatement: If any renewal premium is not paid within the time granted the insured for payment, a subsequent acceptance of premium by the insurer or by any agent duly authorized by the insurer to accept such premium, without requiring in connection therewith an application […]
20-1349. Notice of claim A. There shall be a provision as follows: " Notice of claim: Written notice of claim must be given to the insurer within twenty 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 […]
20-1350. Claim forms There shall be a provision as follows: " 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 […]
20-1351. Proofs of loss There shall be a provision as follows: " 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 ninety days after the termination of the […]
20-1352. Time for payment of claims There shall be a provision as follows: " 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 […]
20-1353. Payment of claims A. There shall be a provision as follows: " 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 […]
