Title 27, INSURANCE

Sec. 9. Where the reason for cancellation does not accompany or is not included in the notice of cancellation, the insurer shall upon written request of the named insured, mailed or delivered to the insurer not less than fifteen (15) days prior to the effective date of cancellati…

Sec. 0.1. The addition of section 4 of this chapter by P.L.153-1990 applies to a group or an individual policy or agreement providing comprehensive accident and health benefits that is issued, entered into, or renewed after June 30, 1990. As added by P.L.220-2011, SEC.437.

Sec. 1. Notwithstanding any provision of any individual or group policy of accident and health insurance, or any provision of a policy, contract, plan, or agreement for hospital or medical service or indemnity, wherever such policy, contract, plan, or agreement provides for reimb…

Sec. 2. The provisions of section 1 of this chapter shall not apply to any policy, contract, plan, or agreement in effect prior to May 1, 1969. Formerly: Acts 1969, c.409, s.2. As amended by P.L.252-1985, SEC.311.

Sec. 3. The amendments to this chapter made by Acts 1974, P.L.126 do not apply to a policy, contract, plan, or agreement in effect before June 11, 1974. As added by P.L.1-1989, SEC.55.

Sec. 4. (a) This section does not apply to any of the following: (1) A health maintenance organization (as defined in IC 27-13-1-19) or limited service health maintenance organization (as defined in IC 27-13-34-4). (2) A preferred provider plan (as defined in IC 27-8-11-1). (3) A…

Sec. 5. (a) As used in this section, "certified registered nurse anesthetist" has the meaning set forth in IC 25-23-1-1.4. (b) As used in this section, "insured" means an individual who is entitled to the benefits provided by a policy of accident and sickness insurance. The term …

Sec. 6. (a) As used in this section, "policy of accident and sickness insurance" has the meaning set forth in IC 27-8-5-1. However, the term does not include the following: (1) Accident only, credit, dental, vision, Medicare supplement, long term care, or disability income insura…

Sec. 7. (a) As used in this section, "policy of accident and sickness insurance" has the meaning set forth in IC 27-8-5-1. (b) A policy of accident and sickness insurance that provides coverage for substance abuse or chemical dependency treatment shall provide the coverage for su…

Sec. 8. (a) As used in this section, "emergency medical services" has the meaning set forth in IC 16-18-2-110. (b) As used in this section, "emergency medical services provider organization" means a provider of emergency medical services that is certified by the Indiana emergency…

Sec. 1. (a) A society may provide the following contractual benefits in any form: (1) Death benefits. (2) Endowment benefits. (3) Annuity benefits. (4) Temporary or permanent disability benefits. (5) Hospital, medical, or nursing benefits. (6) Monument or tombstone benefits to th…

Sec. 10. Benefit contracts issued on the lives of persons below the society's minimum age for adult membership may provide for transfer of control of ownership to the insured at an age specified in the certificate. A society may require approval of an application for membership i…

Sec. 11. A society may specify the terms and conditions on which benefit contracts may be assigned. As added by P.L.262-1985, SEC.1.

Sec. 12. (a) For certificates issued before January 1, 1987, the value of every paid-up nonforfeiture benefit and the amount of any cash surrender value, loan, or other option granted shall comply with the provisions of law applicable on December 31, 1985. (b) For certificates is…

Sec. 2. (a) The owner of a benefit contract is entitled to change the beneficiary or beneficiaries in accordance with the laws or rules of the society unless the owner waives this right by specifically requesting in writing that the beneficiary designation be irrevocable. A socie…

Sec. 3. No money or other benefit, charity, relief, or aid to be paid, provided, or rendered by any society shall be liable to attachment, garnishment, or other process or to be seized, taken, appropriated, or applied by any legal or equitable process or operation of law to pay a…

Sec. 4. Every society authorized to do business in this state shall issue to each owner of a benefit contract a certificate specifying the amount of benefits provided. The certificate, together with any riders or endorsements attached to the certificate, the laws of the society, …

Sec. 5. Any changes, additions, or amendments to the laws of the society duly made or enacted subsequent to the issuance of the certificate shall bind the owner and the beneficiaries and shall govern and control the benefit contract in all respects as though the changes, addition…

Sec. 6. Any person upon whose life a benefit contract is issued before attaining the age of majority shall be bound by the terms of the application and certificate and by all the laws and rules of the society to the same extent as though the age of majority had been attained at t…

Sec. 7. A society shall provide in its laws that if its reserves as to all or any class of certificates become impaired its board of directors or corresponding body may require that there shall be paid by the owner to the society the amount of the owner's equitable proportion of …

Sec. 8. Copies of any of the documents mentioned in this chapter, certified by the secretary or corresponding officer of the society, shall be received in evidence of the terms and conditions thereof. As added by P.L.262-1985, SEC.1.

Sec. 9. A certificate shall not be delivered or issued for delivery in Indiana unless a copy of the form has been filed with the commissioner in the manner provided for like policies issued by life insurers in Indiana. Every life, accident, health, or disability insurance certifi…

Sec. 1. (a) A health maintenance organization shall establish procedures based on professionally recognized standards to assess and monitor the health care services provided to enrollees of the organization. (b) The procedures established under this section must include mechanism…

Sec. 10. (a) A health maintenance organization may not refuse to enter into an agreement with a hospital solely because the hospital has not obtained accreditation from an accreditation organization that: (1) establishes standards for the organization and operation of hospitals; …

Sec. 2. A health maintenance organization shall have an ongoing internal quality management program to monitor and evaluate the health care services it provides, including: (1) primary and specialist physician services; and (2) ancillary and preventive health care services; acros…

Sec. 3. The quality management program required by section 2 of this chapter must include at least the following: (1) A written statement of the scope and purpose of the health maintenance organization's quality management program, including a written statement of goals and objec…

Sec. 4. The quality management program required by section 2 of this chapter must contain a written statement describing the system of ongoing quality management activities, including the following: (1) Problem assessment, identification, selection, and study. (2) Corrective acti…

Sec. 5. The quality management program required by section 2 of this chapter must contain written plans for taking appropriate corrective action whenever the quality management program determines that: (1) inappropriate or substandard services have been provided; or (2) services …

Sec. 6. A health maintenance organization shall ensure the use and maintenance of an adequate patient record system that will facilitate: (1) documentation and retrieval of clinical information to enable the health maintenance organization to evaluate continuity and coordination …

Sec. 7. A health maintenance organization shall establish a mechanism for periodic reporting of quality management program activities to the governing body, providers, and appropriate staff of the organization. As added by P.L.26-1994, SEC.25.

Sec. 8. A health maintenance organization shall: (1) record the proceedings of formal quality management program activities; and (2) maintain its documentation of the quality management program in a confidential manner. As added by P.L.26-1994, SEC.25.

Sec. 9. The commissioner may inspect the records of a health maintenance organization's quality management program. The health maintenance organization shall cooperate with the inspections by making available to the commissioner the records requested by the commissioner, while pr…

Sec. 1. After the proposed plan of conversion and amendment to the converting mutual's articles of incorporation are approved by the commissioner and approved by the members under this article, the converting mutual may proceed to consummate the plan and comply with IC 27-1-8. As…

Sec. 2. The plan of conversion and the amendment to the articles of incorporation of the converting mutual become effective upon the date and time of return of the articles of amendment by the secretary of state as provided in IC 27-1-8-8, unless a later date and time are specifi…

Sec. 3. When the plan of conversion and the amendment to the articles of incorporation of the converting mutual become effective: (1) the converting mutual shall: (A) be converted from a domestic mutual insurance company to a domestic stock insurance company; and (B) have all the…

Sec. 4. The former mutual shall be a continuation of the original converting mutual in all of the following respects: (1) The former mutual shall be recognized as an insurance company formed under the laws of this state as of the date of the company's original organization. (2) T…

Sec. 5. The former mutual shall comply with the minimum capital and surplus requirements applicable to domestic stock insurance companies as though the former mutual was organized as a stock insurance company on its original date of organization. As added by P.L.94-1999, SEC.3.

Sec. 1. (a) A PEO or PEO group shall do one (1) of the following: (1) Maintain positive working capital, as reflected in the financial statement submitted to the department by the PEO or PEO group under IC 27-16-4. (2) If the PEO or PEO group does not meet the requirement of subd…

Sec. 2. An instrument or cash described in section 1(a)(2) of this chapter must not be included in the calculation of the positive working capital described in section 1(a)(1) of this chapter. As added by P.L.245-2005, SEC.7. Amended by P.L.11-2011, SEC.45.

Sec. 1. Before using an advertisement, marketing materials, or a brochure, a discount medical card program organization shall file the advertisement, marketing materials, or brochure with the commissioner and: (1) obtain the commissioner's approval for use; or (2) wait at least s…

Sec. 2. (a) The commissioner shall: (1) notify a discount medical card program organization of the commissioner's approval or disapproval of a filing under section 1 of this chapter; and (2) specify in the notice the reason for a disapproval. (b) A discount medical card program o…

Sec. 1. (a) This article, while independent of any other law, is supplemental to IC 27-1-2 through IC 27-1-20. (b) All provisions of IC 27-1-2 through IC 27-1-20 are fully and completely applicable to this article in the same manner as if the provisions of this article had been a…

Sec. 2. All information, documents, and copies of information and documents obtained by or disclosed to the commissioner or to any other person in the course of an examination or approval of a plan under this article: (1) are declared confidential for purposes of IC 5-14-3-4(a)(1…

Sec. 3. Any action: (1) challenging the validity of; or (2) arising out of; an action that is taken or proposed to be taken under this article must commence not later than thirty (30) days after the approval by the commissioner of the plan under which or in respect of which the a…

Sec. 4. The provisions of this article are severable in the manner provided in IC 1-1-1-8(b). As added by P.L.226-2023, SEC.30.

Sec. 5. (a) A person who is aggrieved by an agency action of the commissioner under this article may petition for judicial review of the action in accordance, so far as practicable, with IC 4-21.5-5. (b) A person who is aggrieved by a failure of the commissioner to act or make a …