Chapter 431 — Chapter 431

§431:10-220 Policy must contain entire contract. (a) No agreement in conflict with, modifying, or extending any contract of insurance shall be valid unless in writing and made a part of the policy. (b) No insurer or its representatives shall make any insurance contract or agreeme…

§431:10-221 Prohibited policy provisions: limiting actions and jurisdictions. (a) No insurance contract delivered or issued for delivery in this State and covering subjects located, resident or to be performed in this State, shall contain any condition, stipulation or agreement: …

§431:10-222 Construction industry; indemnity agreements invalid. Any covenant, promise, agreement or understanding in, or in connection with or collateral to, a contract or agreement relative to the construction, alteration, repair or maintenance of a building, structure, appurte…

§431:10-222.5 Pooled insurance. (a) Insurers may offer pooled insurance which allows liability insurance and all other types of insurance required by law, not including prepaid health insurance, to be obtained for a construction project. Pooled insurance may be purchased by: Pool…

§431:10-223 Underwriters and combination policies. Two or more authorized insurers may together issue: This section shall not apply to co-surety obligations. [L 1987, c 347, pt of §2]

§431:10-224 Execution of policies. (a) Every insurance contract shall be executed in the name of and on behalf of the insurer by its officer, employee or authorized representative. (b) A facsimile signature of any executing officer, employee or representative may be used in lieu …

§431:10-225 Delivery of policy. (a) Subject to the insurer's requirements as to payment of premium, every policy shall be mailed or delivered to the insured or to the person entitled thereto within a reasonable period of time after its issuance. (b) In the event the original poli…

§431:10-226 Renewal of policy; new policy not required. At the option of the insurer, any insurance policy terminating at a specified expiration date and not otherwise renewable, may be renewed or extended, upon a currently authorized policy form and at the premium rate then requ…

§431:10-226.5 Notice of cancellation or nonrenewal; notice of cancellation or nonrenewal for policies of property insurance. (a) Except as provided in subsection (b), in the case of cancellation of a policy, the insurer shall give written notice to the insured not fewer than ten …

§431:10-227 Retroactive annulment of liability policies prohibited. No contract insuring against loss through liability for the bodily injury or death by accident of any individual shall be retroactively annulled by any agreement between the insurer and the insured after the occu…

§431:10-228 Assignment of policies. (a) A policy may be assignable or not assignable, as provided by its terms. (b) Subject to the terms of the policy, any policy providing the beneficiary may be changed upon the sole request of the insured, may be assigned by either pledge or tr…

§431:10-229 Dividends payable to the real party. (a) Every insurer issuing participating policies, shall pay dividends, unused premium refunds, or savings distributed on account of any such policy, only to: (b) Any person who is shown by the insurer's records to have paid for the…

§431:10-230 Payment discharges insurer. Whenever the proceeds of, or payments under, a policy or contract for life insurance, or accident and health or sickness insurance become payable in accordance with the terms of the policy or the exercise of any right or privilege under the…

§431:10-231 Exemption of proceeds; accident and health or sickness. The proceeds of all contracts of accident and health or sickness insurance and of provisions providing benefits on account of the insured's disability which are supplemental to life insurance or annuity contracts…

§431:10-232 Exemption of proceeds; life, endowment and annuity. (a) All proceeds payable because of the death of the insured and the aggregate net cash value of any or all life and endowment policies and annuity contracts payable to a spouse of the insured, or to a child, parent …

§431:10-233 Exemption of proceeds; group life. (a) A policy of group life insurance or the proceeds thereof payable to the individual insured or to the beneficiary thereunder, shall not be liable, either before or after payment, to be applied to any legal or equitable process to …

§431:10-234 Spouses' and reciprocal beneficiaries' right in life insurance policy. (a) Every life insurance policy made payable to or for the benefit of the spouse or the reciprocal beneficiary of the insured, and every life insurance policy assigned, transferred, or in any way m…

§431:10-235 Forms for proof of loss furnished. Upon written request of any person claiming to have a loss under any insurance contract, an insurer shall furnish forms of proof of loss for completion by the person. The insurer shall not, by reason of the requirement to furnish for…

§431:10-236 Claim administration not waiver. None of the following acts by or on behalf of an insurer shall be deemed to constitute a waiver of any provision of a policy or of any defense of the insurer under the policy:

§431:10-237 Construction of policies. Every insurance contract shall be construed according to the entirety of its terms and conditions as set forth in the policy, and as amplified, extended, restricted, or modified by any rider, endorsement or application attached to and made a …

§431:10-238 Validity of noncomplying forms. Any insurance policy, rider or endorsement hereafter issued and otherwise valid, is not rendered invalid by the inclusion of any condition or provision not in compliance with the requirements of this part, but shall be construed and app…

§431:10-239 Intervening breach. If any breach of warranty or condition in any insurance contract occurs prior to a loss under the contract, the breach shall not avoid the contract nor avail the insurer to avoid liability, unless the breach exists at the time of loss. [L 1987, c 3…

§431:10-240 Insurance contracts; punitive damages. Coverage under any policy of insurance issued in this State shall not be construed to provide coverage for punitive or exemplary damages unless specifically included. [L 1987, c 347, pt of §2]

§431:10-241 Venue in certain actions. An insured may bring a civil action against the insured's insurer in the state judicial circuit in which the insured resides or where the insured has its principal place of business provided the insured purchased the policy within the State. …

§431:10-242 Policyholder and other suits against insurer. Where an insurer has contested its liability under a policy and is ordered by the courts to pay benefits under the policy, the policyholder, the beneficiary under a policy, or the person who has acquired the rights of the …

§431:10-243 Interest upon proceeds of life insurance policies. (a) Except as provided in subsection (d), in the event an action to recover the proceeds due under a life insurance policy or annuity contract is commenced and results in a judgment against the insurer, interest shall…

ARTICLE 10A ACCIDENT AND HEALTH OR SICKNESS INSURANCE CONTRACTS PART I. INDIVIDUAL ACCIDENT AND HEALTH OR SICKNESS POLICIES §431:10A-101 Applications and exceptions. This part shall apply to all policies of accident and health or sickness insurance delivered or issued for deliver…

§431:10A-102 Accident and health or sickness insurance policy defined. The term, policy of accident and health or sickness insurance, includes any policy or contract covering the class of insurance described in section 431:1-205. [L 1987, c 347, pt of §2; am L 2002, c 155, §50]

§431:10A-103 Family coverage defined. As used in this part, family coverage means a policy that insures, originally or upon subsequent amendment, an adult member of a family who shall be deemed the policyholder and any two or more eligible members of that family, including spouse…

§431:10A-104 Form of policy. (a) A policy of accident and health or sickness insurance shall neither be delivered nor issued for delivery to any person in this State unless: (b) If any policy is issued by an insurer domiciled in this State for delivery to a person residing in a t…

§431:10A-105 Required provisions. Except as provided in section 431:10A-107, each policy of accident and health or sickness insurance delivered or issued for delivery to any person in this State shall contain the provisions set forth below. These provisions shall be in the words …

§431:10A-106 Optional provisions. Except as provided in section 431:10A-107, no policy of accident and health or sickness insurance delivered or issued for delivery to any person in this State shall contain the provisions set forth below unless the provisions are in the words in …

§431:10A-107 Inapplicable or inconsistent provisions. If any provision of section 431:10A-105 to section 431:10A-111 is in whole or in part inapplicable to or inconsistent with the coverage provided by a particular form of policy, the insurer shall omit from the policy any inappl…

§431:10A-108 Order of certain policy provisions. The provisions which are the subject of section 431:10A-105 and section 431:10A-106, or any corresponding provisions which are used in lieu thereof, shall be printed in the consecutive order of the provisions in such sections or, a…

§431:10A-109 Third party ownership. The word, insured, as used in this part, 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 su…

§431:10A-110 Requirements of other jurisdictions. (a) Any 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 p…

§431:10A-111 Other policy provisions. No policy provision which is not subject to section 431:10A-105 or section 431:10A-106 shall make a policy, or any portion of the policy, less favorable in any respect to the insured or the beneficiary than the provisions which are subject to…

§431:10A-112 Policy conflicting with this part. A policy delivered or issued for delivery to any person in this State in violation of this part shall be held valid, but shall be construed as provided in this part. When any provision in a policy governed by this part is in conflic…

§431:10A-113 Filing procedure. The commissioner may adopt reasonable rules concerning the procedure for the filing or submission of policies subject to this article as are necessary, proper, or advisable to the administration of this article. Each filing shall be accompanied by a…

§431:10A-114 Age limit. If any policy of accident and health or sickness insurance contains a provision establishing as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective, and if such date falls within a period for which premiu…

§431:10A-115 Coverage of newborn children. (a) All policies providing family coverage, as defined in section 431:10A-103 and reciprocal beneficiary family coverage, as defined in section 431:10A-601, on an expense incurred basis shall provide that the benefits applicable for chil…

§431:10A-116 Coverage for specific services. Every person insured under a policy of accident and health or sickness insurance delivered or issued for delivery in this State shall be entitled to the reimbursements and coverages specified below:

§431:10A-116.3 Coverage for telehealth. (a) [Repeal and reenactment on December 31, 2027. L 2025, c 217, §1.] It is the intent of the legislature to recognize the application of telehealth as a reimbursable service by which an individual shall receive medical services from a heal…

§431:10A-116.5 In vitro fertilization procedure coverage. (a) All individual and group accident and health or sickness insurance policies which provide pregnancy-related benefits shall include in addition to any other benefits for treating infertility, a one-time only benefit for…

§431:10A-116.6 Contraceptive services. (a) Notwithstanding any provision of law to the contrary, each employer group accident and health or sickness policy, contract, plan, or agreement issued or renewed in this State on or after January 1, 2000, shall cease to exclude contracept…

§431:10A-116.7 Contraceptive services; religious employers exemption. (a) A "religious employer" is an entity for which each of the following is true: For the purpose of this definition, any educational, health care, or other nonprofit institution or organization owned or control…

§431:10A-117 Franchise plan. (a) As used in this section, "employees" include: (b) Insurance may be issued pursuant to this part on a franchise plan under the terms of which accident and health or sickness insurance is issued to:

§431:10A-118 Genetic information nondiscrimination in accident and health or sickness insurance coverage. (a) No insurer may: (b) As used in this section: "Family member" means, with respect to the individual, another individual related by blood to that individual. "Genetic infor…

§431:10A-118.3 Nondiscrimination on the basis of actual gender identity or perceived gender identity; coverage for services. (a) No individual or group accident and health or sickness policy, contract, plan, or agreement that provides health care coverage shall discriminate with …

§431:10A-119 Hospice care coverage. (a) Any other law to the contrary notwithstanding, commencing on January 1, 2000, all authorized insurers that provide for payment of or reimbursement for hospice care shall reimburse hospice care services for each insured policyholder covered …