PART II. GROUP AND BLANKET DISABILITY INSURANCE

 

Attorney General Opinions

 

  Section 431:10A-601 applied to all parts of article 10A ifthe category of policy under consideration included family coverage, as definedin §431:10A-103.  Att. Gen. Op. 97-10.

 

§431:10A-201  Definitions.  For thepurposes of this article:

(1)  (A)  Blanket disability insurance policy meansany policy or contract of accident and health or sickness insurance whichconforms with the description and complies with one of the followingrequirements:

(i)  A policy issued to any common carrier ofpassengers, which carrier shall be deemed the policyholder, covering a groupdefined as all persons who may become such passengers, and whereby suchpassengers shall be insured against loss or damage resulting from death orbodily injury either while, or as a result of, being such passengers.

(ii)  A policy issued in the name of anyvolunteer fire department, first aid or ambulance squad, or volunteer policeorganization, which shall be deemed the policyholder, and covering all themembers of any such organization against loss from accidents resulting fromhazards incidental to duties in connection with such organizations.

(iii)  A policy issued in the name of anyestablished organization whether incorporated or not, having communityrecognition and operated for the welfare of the community and its members andnot for profit, which shall be deemed the policyholder, and covering allvolunteer workers who serve without pecuniary compensation and the members ofthe organization, against loss from accidents occurring while engaged in theactual performance of duties on behalf of such organization or in theactivities thereof.

(iv)  A policy issued to an employer, who shallbe deemed the policyholder, covering any group of employees defined byreference to exceptional hazards incident to such employment, insuring suchemployees against death or bodily injury resulting while, or from, beingexposed to such exceptional hazards.

(v)  A policy covering students or employeesissued to a college, school, or other institution of learning or to the head orprincipal thereof, who or which shall be deemed the policyholder.

(vi)  A policy issued to a substantially similargroup who, in the discretion of the commissioner, may be properly eligible forblanket disability insurance.

(B)  Nothing in this section shall be deemed toaffect the liability of policyholders for the death of or injury to, any suchmember of such group.

(C)  Individual applications shall not berequired from individuals covered under a blanket disability insurancecontract.

(2)  The term employees shall be deemed to include asemployees of a single employer, the compensated officers, managers, andemployees of the employer and of subsidiary or affiliated corporations of acorporation employer, and the individual proprietors, partners, and employeesof individuals and firms of which the business is under common control throughstock ownership, contract, or otherwise.  The policy may provide that the termemployees shall include the individual proprietor or partners if the employeris an individual proprietor or a partnership.  The term employee may be deemedto include retired employees.

(3)  The term employer shall be deemed to include anymunicipal corporation or governmental unit, agency, or department thereof aswell as private individuals, firms, corporations, and other persons.

(4)  Group disability insurance means that form ofaccident and health or sickness insurance covering groups of persons, with orwithout their dependents and family members, and issued under a master policyto:

(A)  Such groups as qualify for group lifeinsurance under [sections] 431:10D-201 to 431:10D-211 of this code; or

(B)  An automobile club formed for purposesother than obtaining group insurance, covering the members of the club. [L1987, c 347, pt of §2; am L 2002, c 155, §60]