Chapter 7 - Policies and Policyholders
- Part 1 - General Provisions
- 56-7-101 - Contract of insurance Definition Restrictions and limitations Exceptions.
- 56-7-102 - Policies to contain entire contract Exceptions Construed as Tennessee contracts.
- 56-7-103 - Misrepresentation or warranty will not void policy Exceptions.
- 56-7-104 - Hostilities shall not invalidate policy.
- 56-7-105 - Additional liability upon insurers and bonding companies for bad-faith failure to pay promptly.
- 56-7-106 - Liability on policyholders when action not brought in good faith.
- 56-7-107 - Suit on certificate issued under group insurance policy Copy of policy attached to defendant's answer.
- 56-7-108 - Mortality tables.
- 56-7-109 - Definitions Timely reimbursement of health insurance claims.
- 56-7-110 - Part definitions Correction of payment errors Retroactive denial of reimbursements.
- 56-7-111 - Property or casualty insurance General contractor as a payee.
- 56-7-112 - Deferred individual annuity contracts Minimum guaranteed surrender value.
- 56-7-113 - , 56-7-114. [Transferred.]
- 56-7-115 - Medical malpractice insurance Availability for all classifications of practice.
- 56-7-116 - [Transferred.]
- 56-7-117 - Required use of mail-order pharmacy prohibited.
- 56-7-118 - Notice of premium increase.
- 56-7-119 - Excuse for absence of employee or student.
- 56-7-120 - Assignment of benefits to health care provider.
- 56-7-121 - Exclusion of coverage.
- 56-7-122 - Disclosure of agreements to limit services permitted.
- 56-7-123 - Policies to be in English Language of promotional material.
- 56-7-124 - Release of information relating to physical or mental health of patient.
- 56-7-125 - Written statement of rights for personal lines fire or homeowners insurance policyholders.
- 56-7-126 - Duty of pharmacy benefits manager Health insurance under TennCare program.
- 56-7-127 - Major medical insurance coverage for a catastrophic illness requiring in-patient hospital care.
- 56-7-128 - Medical insurance for uninsurable Risk pools.
- 56-7-129 - Subrogation of claims for damage caused by explosives.
- 56-7-130 - Sinkhole losses.
- 56-7-131 - Advanced payments Prior to trial.
- 56-7-132 - Successor coverage health claims.
- 56-7-133 - Provision in policy of group accident and health insurance requiring notification when person covered under group policy ceases to be covered.
- Part 2 - General ProvisionsLife Insurance
- 56-7-201 - Life insurance payable to surviving spouse and children Effect of proceeds being payable to estate.
- 56-7-202 - Insurance on married person's life, effected by spouse, not liable to debts of insured.
- 56-7-203 - Life insurance or annuity for or assigned to spouse or children or dependent relatives exempt from claims of creditors.
- 56-7-204 - Assignment of life insurance policy as security for loan.
- 56-7-205 - Life insurance Restrictions on deposits.
- 56-7-206 - Life insurance Proof of death for small policies.
- 56-7-207 - Refusal for sickle cell trait or hemoglobin C trait prohibited.
- Part 3 - Life Insurance Policies
- 56-7-301 - 56-7-304. [Transferred.]
- 56-7-305 - Submission to commissioner for approval.
- 56-7-306 - Revocation of license for violation of § 56-7-305 or § 56-7-2310.
- 56-7-307 - [Transferred.]
- 56-7-308 - Provisions in life insurance policies issued by foreign companies Provisions in foreign policies of domestic companies.
- 56-7-309 - Life insurance Policies for one-year preliminary term insurance Reserve value.
- 56-7-310 - Policies exemptions.
- 56-7-311 -
- 56-7-312 - Stipulated form of insurance or cash equal to net reserve upon default.
- 56-7-313 - Certain provisions as to defaulted policies, loans and reserves cannot be waived.
- 56-7-314 - Purchase or assignment of life insurance by charitable organization Date of insurable interest.
- 56-7-315 - Interest payable after receipt of claim.
- Part 4 - Standard Nonforfeiture Law
- Part 5 - Contingent and Mortality Contracts
- 56-7-501 - Contingent or mortality contracts Dividing policyholders or members into classes and paying benefits to oldest member of class prohibited Exceptions.
- 56-7-502 - Contingent and mortality endowment contracts Promising particular number or position in class or to division to policyholder prohibited Penalty.
- 56-7-503 - Commissioner to make orders for enforcement of contingent and mortality endowment contracts.
- Part 6 - Affordable Health Insurance for the Uninsured. [Obsolete.]
- Part 7 - Industrial Insurance
- 56-7-701 -
- 56-7-702 - Definitions Provisions required in all industrial life insurance policies.
- 56-7-703 - Industrial life insurance policies to which preceding section inapplicable Provisions in addition to other requirements.
- 56-7-704 - Provisions in industrial life insurance policies more favorable to policyholder permissible.
- 56-7-705 - Misrepresentations as to terms, benefits, or advantages of industrial life, health or accident insurance policies forbidden
- 56-7-706 - Premiums or assessments for industrial or fraternal insurance not to be received after insolvency.
- 56-7-707 - Industrial or fraternal insurance policies or certificates not to be issued to unhealthy persons.
- 56-7-708 - Fraudulent statements in application or claim under industrial or fraternal insurance forbidden.
- 56-7-709 - Penalty for violation of §§ 56-7-705 56-7-708.
- Part 8 - Fire Insurance
- 56-7-801 - Inspection of property insured against fire No insurance exceeding fair value of property.
- 56-7-802 - Measure of damages for loss by fire Insured reimbursed for excess premiums.
- 56-7-803 - Measure of damages in case of agent's failure to inspect property.
- 56-7-804 - Policies protecting trustees, mortgagees, assignees and like parties.
- Part 9 - Credit Life and Health Insurance
- 56-7-901 - Credit health and accident insurance.
- 56-7-902 - Compensation to creditors.
- 56-7-903 - Applicability of credit life insurance provisions.
- 56-7-904 - Definitions.
- 56-7-905 - Credit life insurance policies Prohibitions Prerequisites Filings Reports.
- 56-7-906 - Evidence of insurance Contents Exclusions Notice of termination Text Dividends.
- 56-7-907 - Initial amount Commencement and term of insurance Discharge of indebtedness.
- 56-7-908 - Rates and premiums.
- 56-7-909 - Termination of insurance Refunds and charges.
- 56-7-910 - Claims Verification of premiums and payments.
- 56-7-911 - Reserves.
- 56-7-912 - Powers and duties of commissioner.
- 56-7-913 - Advisory committee on credit life insurance rates.
- 56-7-914 - Annual declaration concerning compensation to creditors.
- Part 10 - Health and Accident Insurance
- 56-7-1001 - Credentialing and contracting of health care providers by health insurance entities.
- 56-7-1002 - 56-7-1007. [Transferred.]
- 56-7-1008 - Uniform claim forms authorized.
- 56-7-1009 - Health care provider credentialing applications from the Council on Affordable Quality Healthcare (CAQH).
- 56-7-1010 - Jurisdiction over insurers.
- 56-7-1011 - , 56-7-1012. [Transferred.]
- 56-7-1013 - Access to health carriers' payment policies Rules Fee Schedules.
- 56-7-1014 - Protocols and procedures for reimbursing physicians employed by federally qualified health centers Expedited credentialing process.
- Part 11 - General ProvisionsAuto Insurance
- 56-7-1101 - Priority and applicability of coverages.
- 56-7-1102 - Automobile liability insurance Noncancellable and guaranteed renewable policies.
- 56-7-1103 - Motor vehicle liability Requiring whereabouts of insured Application.
- 56-7-1104 - Notice to insurance carrier.
- 56-7-1105 - Liability for failure to comply.
- 56-7-1106 - Collision insurance purchased as a condition to financing automobile purchase.
- 56-7-1107 - Accident prevention course for older drivers Reductions in premiums.
- 56-7-1108 - Personal automobile insurance of municipal, county, and state employees.
- 56-7-1109 - Effect of accidents on premiums.
- 56-7-1110 - Insurance coverage or collision damages waivers for rental cars.
- 56-7-1111 - Antique automobiles Valuation.
- 56-7-1112 - Coverage of foreign exchange student.
- 56-7-1113 - Automobile glass replacement or repair Legislative findings.
- 56-7-1114 - Automobile glass replacement or repair Fraudulent and deceptive practices Damages.
- 56-7-1115 - Automobile glass replacement or repair Payment of claims.
- 56-7-1116 - Automobile glass replacement or repair Violations Remedies.
- 56-7-1117 - Intentional acts or omissions of vehicle owners.
- Part 12 - Uninsured Motor Vehicle Coverage
- 56-7-1201 - Requirements and types of coverage Presumptions Limitations of liability.
- 56-7-1202 -
- 56-7-1203 - Insolvency protection limitation More favorable protection not precluded.
- 56-7-1204 - Payment by insurer Subrogation.
- 56-7-1205 - Minimum policy limits not increased.
- 56-7-1206 - Service of process Actions by insurers John Doe warrants Arbitration.
- Part 13 - Cancellation of Auto Insurance
- Part 14 - Medicare Supplement Insurance
- 56-7-1401 - 56-7-1407. [Repealed.]
- 56-7-1408 - 56-7-1424. [Reserved.]
- 56-7-1425 - Short title.
- 56-7-1426 - Purpose.
- 56-7-1427 - Applicability.
- 56-7-1428 - Unfair or deceptive acts in replacement transactions.
- 56-7-1429 - Sale, offer for sale, or administration Unfair or deceptive acts.
- 56-7-1430 - Group insurance not included.
- 56-7-1431 - Advertising.
- 56-7-1432 - 56-7-1450. [Reserved.]
- 56-7-1451 - Definitions.
- 56-7-1452 - Applicability.
- 56-7-1453 - Contents of policies and certificates Duplicate benefits Preexisting conditions Rules and regulations.
- 56-7-1454 - Benefits Minimum standards.
- 56-7-1455 - Disclosure Outline of coverage Consumer information.
- 56-7-1456 - Notice Right to return Refunds.
- 56-7-1457 - Review of advertisements.
- 56-7-1458 - Regulations subject to Administrative Procedures Act.
- 56-7-1459 - Violations of part Powers to compel compliance.
- Part 15 - Conversion of Group Insurance. [Transferred.]
- Part 16 - Easy to Read Life and Health Insurance Policy Act
- 56-7-1601 - Short title.
- 56-7-1602 - Purpose of part.
- 56-7-1603 - Part definitions.
- 56-7-1604 - Applicability Exceptions.
- 56-7-1605 - Reading ease test score Procedure Certificate.
- 56-7-1606 - Issuance of policy form after filing.
- 56-7-1607 - Authorization of lower reading ease test scores.
- 56-7-1608 - Approval of policy notwithstanding other laws.
- 56-7-1609 - Dates of compliance Enforcement.
- Part 17 - Prepaid Dental Plans
- Part 18 - Cancellation of Commercial Risk Insurance Act
- 56-7-1801 - Short title.
- 56-7-1802 - Part definitions.
- 56-7-1803 - Prerequisites for effective notice of cancellation.
- 56-7-1804 - Prerequisites for effective notice of cancellation Contents of notices of cancellation Delivery of notice.
- 56-7-1805 - Failure to comply with notice requirements Policy extension When notice of nonrenewal not required.
- 56-7-1806 - Revision of rates.
- 56-7-1807 - Noncompliance with this part.
- 56-7-1808 - Promulgation of rules and regulations by commissioner.
- Part 19 - Cancellation of Personal Risk Insurance
- Part 20 - Memphis Plan Act of 1991
- Part 21 - Pet Insurance
- Part 22 - Tennessee Small Employer Group Health Coverage Reform Act
- 56-7-2201 - Short title.
- 56-7-2202 - Legislative purpose.
- 56-7-2203 - Part definitions.
- 56-7-2204 - Affiliated carriers.
- 56-7-2205 - Distinct grouping Additional groupings.
- 56-7-2206 - Applicability.
- 56-7-2207 - Small employer carrier committee.
- 56-7-2208 - Plans of coverage.
- 56-7-2209 - Health benefit plans Preexisting conditions Late enrollees Premiums Transfers Place of business Filings Documentation.
- 56-7-2210 - Election of carriers Risk assuming Reinsuring.
- 56-7-2211 - Risk-assuming carriers.
- 56-7-2212 - Reinsuring carriers.
- 56-7-2213 - 56-7-2220. [Reserved.]
- 56-7-2221 - Small employer health reinsurance pool.
- 56-7-2222 - Formation of health group cooperative of small employers Registration Organization.
- 56-7-2223 - Liability of health group cooperative.
- 56-7-2224 - Duties of a health group cooperative.
- 56-7-2225 - Contracting with a small employer insurer Compliance with federal laws.
- Part 23 - Mandated Insurer or Plan Coverage
- 56-7-2301 - Health insurance Newly born children Coverage Notification.
- 56-7-2302 - Dependent children under hospital or medical expense policies Coverage Services by charitable research hospitals.
- 56-7-2303 - Forfeiture and lapse restrictions.
- 56-7-2304 - Continuation of coverage on group contracts.
- 56-7-2305 - Group life Required provisions.
- 56-7-2306 - Group life insurance Prior policies unaffected.
- 56-7-2307 - Provisions and conditions required in life insurance policies.
- 56-7-2308 - Provisions and conditions prohibited in life insurance policies.
- 56-7-2309 - Loan provisions in life insurance policies.
- 56-7-2310 - Character of life insurance policies to be printed or stamped thereon.
- 56-7-2311 - Life insurance policy forms.
- 56-7-2312 - Continuation of terminated group coverage Conversion.
- 56-7-2313 - Converted policy Conditions.
- 56-7-2314 - Conditions exempting insurer from conversion requirement.
- 56-7-2315 - Requests for information from insured persons Grounds for nonrenewal of policy.
- 56-7-2316 - Ceiling on converted policy benefits.
- 56-7-2317 - Preexisting conditions Converted policy benefits in first policy year limited by group policy benefits.
- 56-7-2318 - Optional coverage.
- 56-7-2319 - Optional election of retirement conversion rights.
- 56-7-2320 - Medicare eligibility as affecting coverage Persons who may claim conversion privilege.
- 56-7-2321 - Provision of group coverage in lieu of converted individual coverage.
- 56-7-2322 - Notice of conversion privilege.
- 56-7-2323 - Reduction of benefits for school insurance benefits prohibited.
- 56-7-2324 - Student accident coverage Benefit reduction restricted.
- 56-7-2325 - Medical accident insurance issued to school children Coverage.
- 56-7-2326 - 56-7-2346. [Repealed.]
- 56-7-2347 - Coverage of children in custody of guardians.
- 56-7-2348 - Eligibility for medicaid.
- 56-7-2349 - Patients' right to truth Alternative medical care, treatments, programs, or pharmaceuticals.
- 56-7-2350 - Maternity benefits Minimum standards of coverage.
- 56-7-2351 - Pregnancy and maternity benefits Termination of coverage.
- 56-7-2352 - Coverage for off-label uses of approved drugs.
- 56-7-2353 - Coverage of dental procedures performed on certain minors in hospitals.
- 56-7-2354 - Early detection of prostate cancer.
- 56-7-2355 - Coverage of emergency services.
- 56-7-2356 - Sufficient network of providers Determining compliance Timeliness.
- 56-7-2357 - [Expired.]
- 56-7-2358 - Continuity of care.
- 56-7-2359 - Pharmacy and pharmacy access.
- 56-7-2360 - Coverage for mental health services.
- 56-7-2361 - Standardized pharmacy benefit identification card.
- 56-7-2362 - Payment on authorized services Correction of submitted claims.
- 56-7-2363 - Colorectal cancer early detection.
- 56-7-2364 - Medication counseling.
- 56-7-2365 - Health insurance coverage related to clinical trials.
- 56-7-2366 - Notice of termination of coverage for spouses and former spouses.
- 56-7-2367 - Autism spectrum disorders.
- Part 24 - Mandated Scope of Practice
- 56-7-2401 - Reimbursement for services of optometrists, psychologists, podiatrists and social workers.
- 56-7-2402 - Participation by optometrists, podiatrists and social workers in medical, hospital, and hospital and medical service plans.
- 56-7-2403 - Applicability and scope of §§ 56-7-2401 and 56-7-2402.
- 56-7-2404 - Reimbursable services within scope of practice of chiropractor Discrimination prohibited.
- 56-7-2405 - Health and accident policies Surgical procedures within scope of dentistry and podiatry.
- 56-7-2406 - Health care services provided by St. Jude Children's Research Hospital.
- 56-7-2407 - Nurse midwife services.
- 56-7-2408 - Reimbursement for services by nurse in advanced practice.
- Part 25 - Mandated Insurer or Plan Options
- 56-7-2501 - Sterilization operations Policy provisions.
- 56-7-2502 - Mammography screening.
- 56-7-2503 - Accident and sickness Denial of coverage for mental illness for lack of surgical facilities prohibited.
- 56-7-2504 - Cancer treatment.
- 56-7-2505 - Phenylketonuria (PKU) treatment.
- 56-7-2506 - Bone mass measurement coverage Osteoporosis.
- 56-7-2507 - Reconstructive breast surgery.
- 56-7-2508 - Coverage for infant hearing screening test.
- Part 26 - Mandated Offerings of Coverage
- 56-7-2601 - Health insurance Coverage of mental illness.
- 56-7-2602 - Alcoholism and drug dependence Coverage for treatment.
- 56-7-2603 - Treatment by licensed audiologists or speech pathologists.
- 56-7-2604 - Health insurance Newly born children Coverage Notification.
- 56-7-2605 - Equipment, supplies and outpatient services for diabetic patients.
- 56-7-2606 - Coverage for chlamydia screening.
- Part 27 - Genetic Information Nondiscrimination in Health Insurance Act
- 56-7-2701 - Short title.
- 56-7-2702 - Part definitions.
- 56-7-2703 - Discrimination on grounds of genetic services prohibited.
- 56-7-2704 - Genetic information Privacy Prohibited disclosures.
- 56-7-2705 - Applicability.
- 56-7-2706 - Routine examinations and analysis.
- 56-7-2707 - Coverage for genetic services not required.
- 56-7-2708 - Regulations.
- Part 28 - Health Insurance Portability, Availability and Renewability Act
- 56-7-2801 - Short title.
- 56-7-2802 - Part definitions.
- 56-7-2803 - Preexisting condition exclusions Period of creditable coverage Special enrollment periods.
- 56-7-2804 - Rules for eligibility Factors not to be considered.
- 56-7-2805 - Small group market Network plans Financial capacity limits Applicability.
- 56-7-2806 - Guaranteed renewability of coverage for employers in the group market.
- 56-7-2807 - Exclusion of certain plans.
- 56-7-2808 - Applicability Determination of creditable service.
- 56-7-2809 - Coverage without preexisting condition exclusion required Alternative coverage Network plans Financial capacity limit.
- 56-7-2810 - Guaranteed renewability of coverage for individuals.
- 56-7-2811 - Provisions applicable to individual as well as group markets.
- 56-7-2812 - Applicability of individual market requirements to excepted benefits under § 56-7-2802(10).
- 56-7-2813 - Construction with other laws Enforcement actions.
- 56-7-2814 - Legislative intent Rules and regulations.
- Part 29 - Access Tennessee Act of 2006 [Effective Until June 30, 2010]
- 56-7-2901 - Short title. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-2902 - Part definitions. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-2903 - Creation of Access Tennessee health insurance pool Board of directors Advisory committee Funding plan and plan of operation Promulgation of rules Errors and omissions by commissioner
- 56-7-2904 - Powers and authority. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-2905 - Annual report. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-2906 - Additional powers and duties Rules. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-2907 - Audit. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-2908 - Eligibility for program Unfair practices. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-2909 - Administration of the pool. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-2910 - Offering of coverage options Exclusion of charges and expenses Availability of third party payment Recovery of ineligible benefits paid. [Effective until June 30, 2010. See the Compile
- 56-7-2911 - Funding. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-2912 - Fraud and abuse. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-2913 - Federal funding. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-2914 - Legislative review. [Effective until June 30, 2010. See the Compiler
- 56-7-2915 - Creation of special joint committee. [Effective until June 30, 2010. See the Compiler
- Part 30 - Cover Tennessee Act of 2006 [Effective Until June 30, 2010]
- 56-7-3001 - Short title. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3002 - Part definitions. [Effective Until Various Dates. See the Compiler's Notes.]
- 56-7-3003 - Authority to establish Cover Tennessee. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3004 - Advisory committee. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3005 - Eligibility for the program. [Effective Until Various Dates. See the Compiler's Notes.]
- 56-7-3006 - Criteria and guidelines for employers to qualify as participating small employers. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3007 - Contracts to provide a plan of health benefits coverage. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3008 - Acceptance of eligible individuals and dependents Preexisting conditions. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3009 - Change of, or loss of, employment. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3010 - Contractor requirements. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3011 - Mandated coverage of other parts not required. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3012 - Tax exemption. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3013 - Premiums. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3014 - Entering contracts or interagency agreements for administration of program. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3015 - Coordination of program with other programs offered by state. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3016 - Evaluations of program. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3017 - Reporting and audit requirements Records. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3018 - Moneys remaining at end of fiscal year. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3019 - Construction Program not an entitlement to coverage. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3020 - Rules. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3021 - Duty and authority to review and audit expenses. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3022 - Investigation of fraud and abuse. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3023 - Certification of application. [Effective until June 30, 2010. See the Compiler's Notes.]
- 56-7-3024 - Report on the status of the health care proposal. [Effective until June 30, 2010. See the Compiler
- 56-7-3025 - Legislative review. [Effective until June 30, 2010. See the Compiler
- 56-7-3026 - Creation of special joint committee. [Effective until June 30, 2010. See the Compiler
- 56-7-3027 - Enrollment in program Establishment of criteria and guidelines. [Effective until midnight June 30, 2012. See the Compiler's Notes.]
- 56-7-3028 - Repealer. [Effective Until Various Dates. See the Compiler's Notes.]
- Part 31 - Pharmacy Benefits Managers
- Part 32 - Pharmacy Benefits [Effective January 1, 2010.]
- 56-7-3201 - Part definitions. [Effective January 1, 2010.]
- 56-7-3202 - Calculation of out-of-pocket costs for prescription drugs and covered services. [Effective January 1, 2010.]
- 56-7-3203 - Disclosure of the actual reimbursement for a particular prescription or covered service. [Effective January 1, 2010.]
- 56-7-3204 - Construction of part. [Effective January 1, 2010.]
- Part 33 - Contracts with Health Care Providers