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Home » US Law » 2022 Ohio Revised Code » Title 39 | Insurance » Chapter 3923 | Sickness and Accident Insurance

Section 3923.01 | Policy of Sickness and Accident Insurance Defined.

Effective: November 24, 1995 Latest Legislation: Senate Bill 150 – 121st General Assembly As used in this chapter, “policy of sickness and accident insurance” includes any policy, contract, or certificate of insurance against loss or expense resulting from the sickness of the insured, or from the bodily injury or death of the insured by accident, […]

Section 3923.011 | Sickness and Accident Insurance Definitions.

Effective: January 9, 1961 Latest Legislation: House Bill 1 – 104th General Assembly As used in any policy of sickness and accident insurance delivered, issued for delivery, or used in this state, unless otherwise provided in the policy or in an indorsement thereon or in a rider attached thereto: (A) “Total disability” means inability to […]

Section 3923.02 | Form of Policy Filed With Superintendent.

Effective: July 1, 1955 Latest Legislation: House Bill 881 – 101st General Assembly No certificate shall be furnished by any insurer in connection with, or pursuant to any provision of, any group sickness and accident insurance policy delivered, issued for delivery, or used in this state, and no policy of sickness and accident insurance shall […]

Section 3923.021 | Approval or Disapproval of Premium Rates.

Effective: January 1, 2021 Latest Legislation: House Bill 339 – 133rd General Assembly (A) As used in this section: (1) “Benefits provided are not unreasonable in relation to the premium charged” means the rates were calculated in accordance with sound actuarial principles. (2) “Individual policy of sickness and accident insurance” includes sickness and accident insurance […]

Section 3923.022 | Maximum Aggregate Administrative Expenses.

Effective: March 23, 2015 Latest Legislation: House Bill 201 – 130th General Assembly (A) As used in this section: (1)(a) “Administrative expense” means the amount resulting from the following: the amount of premiums earned by the insurer for sickness and accident insurance business plus the amount of losses recovered from reinsurance coverage minus the sum […]

Section 3923.03 | Necessary Provisions.

Effective: October 1, 1953 Latest Legislation: House Bill 1 – 100th General Assembly No policy of sickness and accident insurance shall be delivered, issued for delivery, or used in this state unless all the following requirements are complied with: (A) The entire money and other considerations therefor are expressed therein. (B) The time at which […]

Section 3923.04 | Policy Standard Provisions.

Effective: January 1, 2021 Latest Legislation: House Bill 339 – 133rd General Assembly Except as provided in section 3923.07 of the Revised Code, every policy of sickness and accident insurance delivered, issued for delivery, or used in this state shall contain the standard provisions specified in this section in the words in which the same […]

Section 3923.041 | Policies With Prior Authorization Requirement Provisions.

Effective: September 29, 2017 Latest Legislation: House Bill 49 – 132nd General Assembly (A) As used in this section: (1) “Chronic condition” means a medical condition that has persisted after reasonable efforts have been made to relieve or cure its cause and has continued, either continuously or episodically, for longer than six continuous months. (2) […]

Section 3923.05 | Provisions to Conform to Prescribed Wording.

Effective: April 7, 2009 Latest Legislation: House Bill 493 – 127th General Assembly Except as provided in section 3923.07 of the Revised Code, no policy of sickness and accident insurance delivered, issued for delivery, or used in this state shall contain provisions respecting the matters set forth in this section unless such provisions are in […]

Section 3923.06 | Order of Presentation of Policy Provisions.

Effective: July 1, 1955 Latest Legislation: House Bill 881 – 101st General Assembly The policy provisions set forth in sections 3923.04 and 3923.05 of the Revised Code or any corresponding policy provisions used in lieu thereof in accordance with section 3923.07 of the Revised Code shall be printed in each policy of sickness and accident […]

Section 3923.07 | Omission or Substitution of Provisions.

Effective: October 14, 1953 Latest Legislation: Senate Bill 268 – 100th General Assembly If any policy provision set forth in section 3923.04 or 3923.05 of the Revised Code is in whole or in part inapplicable or inconsistent with the coverage provided by a policy of sickness and accident insurance, the insurer shall, with the approval […]

Section 3923.071 | Policies, Applications, Riders or Indorsements Issued Prior to 10-1-53.

Effective: October 14, 1953 Latest Legislation: Senate Bill 268 – 100th General Assembly Any policy of sickness and accident insurance, indorsement, rider, or application which could have been lawfully delivered, issued for delivery, or used in this state on October 1, 1953, may be delivered, issued for delivery, or used in this state until January […]

Section 3923.08 | Nonconflicting Provisions Permitted in Policy.

Effective: October 1, 1953 Latest Legislation: House Bill 1 – 100th General Assembly Any foreign or alien insurer authorized to do business in this state may, with the approval of the superintendent of insurance, insert in any policy of sickness and accident insurance, delivered, issued for delivery, or used in this state, any provision required […]

Section 3923.09 | Validity of Nonconforming Policy.

Effective: October 1, 1953 Latest Legislation: House Bill 1 – 100th General Assembly A policy of sickness and accident insurance issued in violation of sections 3923.01 to 3923.22, inclusive, of the Revised Code, is valid but shall be construed as provided by such sections, and when any provision in such policy is in conflict with […]

Section 3923.10 | Industrial Sickness and Accident Insurance.

Effective: July 1, 1955 Latest Legislation: House Bill 881 – 101st General Assembly Industrial sickness and accident insurance is that form of sickness and accident insurance under individual policies for which the premium is payable weekly, and includes any such policy which covers sickness only or accident only. Any insurer authorized to make, transact, or […]

Section 3923.11 | Sickness and Accident Insurance on a Franchise Plan.

Effective: October 16, 2009 Latest Legislation: House Bill 1 – 128th General Assembly (A) Sickness and accident insurance on a franchise plan is that form of sickness and accident insurance issued to either of the following: (1) Five or more or, with respect to long-term care or disability income insurance, two or more employees of […]

Section 3923.12 | Group Sickness and Accident Insurance.

Effective: April 11, 1991 Latest Legislation: House Bill 737 – 118th General Assembly (A) Group sickness and accident insurance is that form of sickness and accident insurance covering any group of two or more employees, members, or other persons, with or without one or more of their dependents and members of their immediate families. Such […]

Section 3923.122 | [Suspended Eff. 1/1/2014 to 1/1/2026, per Section 3 of s.b. 9 of the 130th General Assembly, as Amended] Option for Conversion From Group Policy to Individual Policy.

Effective: October 16, 2009 Latest Legislation: House Bill 1 – 128th General Assembly (A) Every policy of group sickness and accident insurance providing hospital, surgical, or medical expense coverage for other than specific diseases or accidents only, and delivered, issued for delivery, or renewed in this state on or after January 1, 1976, shall include […]