Title INS — California Ins. Code
0 chapters · 3,633 sections in this title.
Ins. Code § 10273.3 Section 10273.3
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The term “guaranteed renewable policy” as used in this chapter (commencing with Section 10270) means a policy which the insured has the right to continue in force subject to its terms by the timely payment of premium (a) until at least age 50, or (b) in the case of a policy issue…
Ins. Code § 10273.4 Section 10273.4
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All disability insurers writing, issuing, or administering group health benefit plans shall make all of these health benefit plans renewable with respect to the policyholder, contractholder, or employer except in case of the following: (a) (1) Nonpayment of the required premiums …
Ins. Code § 10273.5 Section 10273.5
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No person shall cause or permit to be issued, circulated or used any representation that a policy defined in Section 10273.3 is “non-can,” noncancelable (not cancelable) or noncancelable and guaranteed renewable. No person shall cause or permit to be issued, circulated or used an…
Ins. Code § 10273.6 Section 10273.6
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All individual health benefit plans shall be renewable with respect to all eligible individuals or dependents at the option of the individual except as follows: (a) (1) Except as otherwise specified in paragraph (3), for nonpayment of the required premiums by the individual if th…
Ins. Code § 10273.7 Section 10273.7
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(a) A policyholder, certificate holder, or other insured who alleges that a policy or coverage has been or will be canceled, rescinded, or not renewed in violation of Section 10713, 10273.4, 10273.6, 10384.17, or 10384, or any regulations promulgated thereunder, may request a rev…
Ins. Code § 10274 Section 10274
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The term “endorsement” as used in this chapter means any amendment, change, limitation, alteration or restriction of the printed text of a policy by a rider upon a separate piece of paper made a part of such policy.
Ins. Code § 10275 Section 10275
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The term “policy of accident and sickness insurance” as used in this chapter includes any policy or contract covering the kind or kinds of insurance described in Section 106.
Ins. Code § 10276 Section 10276
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Every individual accident and health policy or contract, except single premium nonrenewable policies or contracts, issued for delivery in this state on or after July 1, 1962, by an insurance company, nonprofit hospital service plan or medical service corporation, shall have print…
Ins. Code § 10277 Section 10277
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(a) A group health insurance policy that provides that coverage of a dependent child of an employee or other member of the covered group shall terminate upon attainment of the limiting age for dependent children specified in the policy, shall also provide that attainment of the l…
Ins. Code § 10278 Section 10278
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(a) An individual health insurance policy that provides that coverage of a dependent child shall terminate upon attainment of the limiting age for dependent children specified in the policy, shall also provide that attainment of the limiting age shall not operate to terminate the…
Ins. Code § 10278.1 Section 10278.1
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(a) An individual health insurance policy issued, amended, or renewed on or after January 1, 2023, that provides dependent coverage shall make dependent coverage available to a parent or stepparent who meets the definition of a qualifying relative under Section 152(d) of Title 26…
Ins. Code § 10279 Section 10279
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(a) Every disability insurer that provides group or individual policies of disability, or both, that provides, operates, or contracts for, telephone medical advice services to its insureds shall do all of the following: (1) Ensure that the in-state or out-of-state telephone medic…
Ins. Code § 10290 Section 10290
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A disability policy shall not be issued or delivered to any person in this state until both of the following conditions are met: (a) A copy of the form thereof and, if more than one class of risks is written, of the classification of risks, and the premium rates pertaining theret…
Ins. Code § 10291 Section 10291
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If the commissioner notifies the insurer, in writing, that the filed form does not comply with the requirements of law, specifying the reasons for his opinion, it is unlawful thereafter for any such insurer to issue any policy in such form. (Enacted by Stats. 1935, Ch. 145.)
Ins. Code § 10291.5 Section 10291.5
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(a) The purpose of this section is to achieve both of the following: (1) Prevent, in respect to disability insurance, fraud, unfair trade practices, and insurance economically unsound to the insured. (2) Assure that the language of all insurance policies can be readily understood…
Ins. Code § 10291.6 Section 10291.6
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Insofar as the reduction of any original benefit on account of age of the insured is concerned, a noncancellable policy may be approved if such reduction does not exceed that permitted by Section 10291.5(b)(9), or if the only such reduction is one having the effect of reducing th…
Ins. Code § 10292 Section 10292
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(a) A supplemental benefit described in subdivision (a) of Section 10271 shall not be delivered or issued for delivery to any person in this state until a copy of the form thereof is submitted to, and approved by, the commissioner. If the supplemental benefit is an integral part …
Ins. Code § 10293 Section 10293
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(a) The commissioner shall, after notice and hearing, withdraw approval of an individual or mass-marketed policy of disability insurance if after consideration of all relevant factors the commissioner finds that the benefits provided under the policy are unreasonable in relation …
Ins. Code § 10295 Section 10295
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(a) An accelerated death benefit, as described in this section, shall not be offered, sold, issued, or marketed as health, accident, or long-term care insurance. An accelerated death benefit shall not reimburse or provide specific coverage for any health, accident, or long-term c…
Ins. Code § 10295.1 Section 10295.1
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(a) An accelerated death benefit as defined in paragraph (1) of subdivision (b) of Section 10295 shall comply with, and shall explain all of, the following: (1) That the accelerated death benefit is fixed at the time the insurer approves the request for the accelerated death bene…
Ins. Code § 10295.10 Section 10295.10
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An insurer may not: (a) Cancel, nonrenew, or otherwise terminate an accelerated death benefit on the grounds of the age or the deterioration of the mental or physical health of the insured individual or certificate holder. (b) Terminate a policy, certificate, or rider, or contain…
Ins. Code § 10295.11 Section 10295.11
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(a) An accelerated death benefit shall not be advertised or marketed as long-term care insurance, nursing home insurance, or home care insurance. Any advertisement, description, comparison, marketing material, or illustration shall state in bold type: “This is a life insurance be…
Ins. Code § 10295.12 Section 10295.12
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(a) Insurers shall ensure that agents offering, marketing, or selling accelerated death benefits on their behalf are able to describe the differences between benefits provided under an accelerated death benefit and benefits provided under long-term care insurance, as follows: (1)…
Ins. Code § 10295.13 Section 10295.13
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In addition to other unfair trade practices described in this code, the following acts and practices in the sale of insurance under this article are prohibited: (a) Twisting. Knowingly making any misleading representation or incomplete or fraudulent comparison of any insurance po…
Ins. Code § 10295.14 Section 10295.14
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(a) Accelerated death benefits shall comply with the provisions in Sections 10113.71 and 10113.72. (b) Every insurer offering term life insurance with accelerated death benefits or any rider that provides for accelerated death benefits described in Section 10295 shall also offer …
Ins. Code § 10295.15 Section 10295.15
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(a) Except at the request of the policyholder or contractholder, all accelerated death benefit provisions or supplemental contracts shall be renewable for the life of the underlying life insurance policy, provided the premiums are timely paid. The statement shall be prominently d…
Ins. Code § 10295.16 Section 10295.16
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Termination of an accelerated death benefit shall not prejudice the payment of benefits for any qualifying event that occurred while the accelerated death benefit was in force.
Ins. Code § 10295.17 Section 10295.17
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An insurer that fails to conform to the requirements provided under this article shall be subject to Article 6.5 (commencing with Section 790) of Chapter 1 of Part 2 of Division 1.
Ins. Code § 10295.18 Section 10295.18
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Accelerated death benefits shall not limit or exclude coverage by type of illness, treatment, medical condition, or accident, except under the circumstances described in paragraphs (1) to (4), inclusive, of subdivision (g) of Section 10271.
Ins. Code § 10295.19 Section 10295.19
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A policy, certificate, rider, or endorsement shall include a provision giving the policyholder or certificate holder the right to appeal to the insurer a decision regarding benefit eligibility.
Ins. Code § 10295.2 Section 10295.2
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A life insurance contract with an accelerated death benefit or an accelerated death benefit in the form of a rider or endorsement shall be submitted for the approval of the commissioner in the same manner as required under Section 10292 and shall be submitted with the following a…
Ins. Code § 10295.3 Section 10295.3
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(a) A written disclosure, as set forth below, shall be included with the filing for the commissioner’s approval, and shall be given to each applicant. The same written disclosure shall be attached to the policy or certificate delivered to the insured. (b) The required written dis…
Ins. Code § 10295.4 Section 10295.4
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An insurer shall file with the commissioner an actuarial memorandum prepared, dated, and signed by a member of the American Academy of Actuaries that includes all of the following information: (a) A description of the accelerated death benefit, including the effects of payment of…
Ins. Code § 10295.5 Section 10295.5
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(a) Applications, if any, or forms supporting an application, if any, for accelerated death benefits shall contain clear, unambiguous, short, and simple questions designed to ascertain the health condition of the applicant. Each health-related question shall contain only one heal…
Ins. Code § 10295.6 Section 10295.6
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(a) When a policyholder or certificate holder requests an acceleration of death benefits, the insurer shall send a statement to the policyholder or certificate holder and irrevocable beneficiary showing any effect that the payment of the accelerated death benefit would have on th…
Ins. Code § 10295.7 Section 10295.7
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(a) The insurer may require a premium charge or cost of insurance charge for the accelerated death benefit. This charge shall be based on sound actuarial principles. In the case of group insurance, the additional cost may also be reflected in the experience rating. (b) (1) The in…
Ins. Code § 10295.8 Section 10295.8
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(a) An applicant for an accelerated death benefit shall have the right to return the accelerated death benefit policy or certificate by first-class United States mail within 30 days of its delivery and to have the premium refunded if, after examination of the policy or certificat…
Ins. Code § 10295.9 Section 10295.9
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(a) Application forms for accelerated death benefits shall include a question designed to elicit information as to whether the accelerated death benefit is intended to replace any long-term care insurance presently in force. A supplementary application or other form to be signed …
Ins. Code § 10320 Section 10320
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No policy of accident and sickness insurance shall be delivered or issued for delivery to any person in this state unless all of the following apply: (a) The entire money and other considerations therefor are expressed therein. (b) The time at which the insurance takes effect and…
Ins. Code § 10321 Section 10321
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After issuance a disability policy shall not be amended, changed, limited, altered, or restricted by any means other than rider upon a separate piece of paper.
Ins. Code § 10322 Section 10322
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If any disability policy is issued by an insurer domiciled in this State 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 shall have advised the commissioner that any suc…
Ins. Code § 10323 Section 10323
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If any provision set forth in Article 4a or 5a of this chapter is in whole or in part inapplicable to or inconsistent with the coverage provided by a particular form of policy the insurer, with the approval of the commissioner, shall omit from such policy any inapplicable provisi…
Ins. Code § 10324 Section 10324
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The provisions which are the subject of Article 4a or 5a of this chapter or any corresponding provisions which are used in lieu thereof in accordance with such articles, shall be printed in the consecutive order of the provisions in such articles or, at the option of the insurer,…
Ins. Code § 10325 Section 10325
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The word “insured,” as used in this chapter, shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under such a policy to any indemnities, b…
Ins. Code § 10326 Section 10326
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Any disability policy of a foreign or alien insurer, when delivered or issued for delivery to any person in this State, may contain any provision which is not less favorable to the insured or the beneficiary than the provisions of this chapter and which is prescribed or required …
Ins. Code § 10326.5 Section 10326.5
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Any disability policy of a domestic insurer may, when issued for delivery in any other state or country, contain any provision permitted or required by the laws of such other state or country.
Ins. Code § 10327 Section 10327
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The commissioner may make such reasonable rules and regulations concerning the procedure for the filing or submission of policies subject to this chapter as are necessary, proper or advisable to its administration. This provision shall not abridge any other authority granted the …
Ins. Code § 10328 Section 10328
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No policy provision which is not subject to Article 4a or 5a of this chapter shall make a policy or any portion thereof less favorable in any respect to the insured or the beneficiary than the provisions thereof which are subject to such articles.
Ins. Code § 10350 Section 10350
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Except as provided in Section 10323, each disability policy delivered or issued for delivery to any person in this State shall contain the provisions specified in Sections 10350.1 to 10350.12, inclusive, in the words in which the same appear in such sections; provided, however, t…
Ins. Code § 10350.1 Section 10350.1
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A disability policy shall contain a provision which shall be in the form set forth herein. 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 unti…