Chapter 44 — INSURANCE
2,728 sections in this chapter.
Neb. Rev. Stat. § 44-787 Individual health insurance policies and contracts; renewal; exceptions; failure to renew; effect; certificate of creditable coverage.
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(1) All individual health insurance policies and contracts issued by health carriers providing benefits consisting of medical care, which are provided directly, through insurance or reimbursement, under any hospital or medical service policy, hospital or medical service plan cont…
Neb. Rev. Stat. § 44-788 Coverage for cancer, human immunodeficiency virus, or acquired immunodeficiency syndrome treatment; requirements.
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(1) Notwithstanding section 44-3,131, any individual or group sickness and accident insurance policy or subscriber contract delivered, issued for delivery, or renewed in this state and any hospital, medical, or surgical expense-incurred policy, except for policies that provide co…
Neb. Rev. Stat. § 44-789 Coverage for bone or joint treatment; requirements.
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Notwithstanding section 44-3,131, no group policy of accident or health insurance, health services plan, or health maintenance organization subscription shall be offered for sale in this state on or after January 1, 2009, unless such policy, plan, subscription, or contract which …
Neb. Rev. Stat. § 44-790 Coverage for diabetes; requirements.
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(1) Notwithstanding section 44-3,131, (a) any individual or group sickness and accident insurance policy or subscriber contract delivered, issued for delivery, or renewed in this state and any hospital, medical, or surgical expense-incurred policy, except for policies that provid…
Neb. Rev. Stat. § 44-790.01 Covered prescription insulin drug; maximum payment; ensure access; requirements.
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(1) Except as provided in subsection (3) of this section, beginning January 1, 2024, and notwithstanding section 44-3,131, (a) any individual or group sickness and accident insurance policy or subscriber contract delivered, issued for delivery, or renewed in this state and any ho…
Neb. Rev. Stat. § 44-7901 Act, how cited.
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Sections 44-7901 to 44-7903 shall be known and may be cited as the Property and Casualty Actuarial Opinion Act.
Neb. Rev. Stat. § 44-7902 Statement of Actuarial Opinion; filing; supporting documents; appointed actuary; immunity.
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(1) Beginning January 1, 2007, every property and casualty insurance company doing business in this state, unless otherwise exempted by the domiciliary commissioner, shall annually submit the opinion of an appointed actuary entitled Statement of Actuarial Opinion. This opinion sh…
Neb. Rev. Stat. § 44-7903 Statement of Actuarial Opinion; supporting documents; disclosure allowed; when.
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(1) The Statement of Actuarial Opinion shall be provided with the annual statement in accordance with the appropriate National Association of Insurance Commissioners Property and Casualty Annual Statement Instructions and shall be a public document. (2)(a) Documents, materials, o…
Neb. Rev. Stat. § 44-791 Mental health conditions; legislative findings.
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The Legislature finds that mental health conditions affect a significant number of Nebraskans. Mental health conditions, like severe physical injuries or illness, can be life-altering and debilitating in nature. If properly treated and managed by mental health professionals, pers…
Neb. Rev. Stat. § 44-792 Mental health conditions; terms, defined.
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For purposes of sections 44-791 to 44-795: (1) Health insurance plan means (a) any group sickness and accident insurance policy, group health maintenance organization contract, or group subscriber contract delivered, issued for delivery, or renewed in this state and (b) any self-…
Neb. Rev. Stat. § 44-793 Mental health conditions; coverage; requirements.
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(1) On or after January 1, 2000, notwithstanding section 44-3,131, any health insurance plan delivered, issued, or renewed in this state (a) if coverage is provided for treatment of mental health conditions other than alcohol or substance abuse, (i) shall not establish any rate, …
Neb. Rev. Stat. § 44-794 Mental health conditions; sections; how construed.
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(1) Sections 44-791 to 44-795 shall not be construed to: (a) Require a health insurance plan to provide coverage for mental health conditions or serious mental illnesses; (b) Require a health insurance plan to provide the same rates, terms, or conditions between treatments for se…
Neb. Rev. Stat. § 44-795 Mental health conditions; rules and regulations.
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The Director of Insurance may adopt and promulgate rules and regulations to carry out sections 44-791 to 44-795.
Neb. Rev. Stat. § 44-796 Coverage for certain hearing screening tests; requirements.
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(1) Notwithstanding section 44-3,131: (a) Under a health insurance plan which provides coverage for hearing screening tests for newborns and infants, such coverage shall be subject to copayment, coinsurance, deductible, and dollar-limit provisions to the extent that other medical…
Neb. Rev. Stat. § 44-797 Coverage for breast reconstruction; requirements; exceptions.
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(1)(a) Any individual or group sickness and accident insurance policy, subscriber contract, or group health maintenance organization contract that provides medical and surgical benefits with respect to a mastectomy shall provide, in a case of a participant or beneficiary who is r…
Neb. Rev. Stat. § 44-798 Coverage for dental care requiring hospitalization and general anesthesia; requirements.
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(1) Notwithstanding section 44-3,131, (a) any employer group sickness and accident insurance policy or subscriber contract delivered, issued for delivery, or renewed in this state and any employer group hospital, medical, or surgical expense-incurred policy, except for policies t…
Neb. Rev. Stat. § 44-799 Coverage for newly adopted children; requirements.
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(1)(a) Any individual or group sickness and accident insurance policy or subscriber contract delivered, issued for delivery, or renewed in this state and any hospital, medical, or surgical expense-incurred policy, except for policies that provide coverage for a specified disease …
Neb. Rev. Stat. § 44-8001 Act, how cited.
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Sections 44-8001 to 44-8010 shall be known and may be cited as the Health Care Prompt Payment Act.
Neb. Rev. Stat. § 44-8002 Terms, defined.
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For purposes of the Health Care Prompt Payment Act: (1) Claim form means an insurer's standard printed or electronic transaction form that complies with the standards issued by the Secretary of the United States Department of Health and Human Services or, if an insurer does not h…
Neb. Rev. Stat. § 44-8003 Claim; date of receipt; rebuttable presumption.
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If a claim is submitted electronically, the claim is presumed to have been received on the date of the electronic verification of receipt by the insurer or the insurer's clearinghouse. If a claim is submitted by mail, the claim is presumed to have been received five business days…
Neb. Rev. Stat. § 44-8004 Action on claim; deadline.
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(1) A clean claim shall be paid, denied, or settled within thirty calendar days after receipt by the insurer if submitted electronically and within forty-five calendar days after receipt if submitted in a form other than electronically. (2) If the resolution of a claim requires a…
Neb. Rev. Stat. § 44-8005 Interest; rate; payment.
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(1) An insurer that fails to pay, deny, or settle a clean claim in accordance with the time periods set forth in subsection (1) of section 44-8004 or to take other required action within the time periods set forth in subsection (2) of section 44-8004 shall pay interest at the rat…
Neb. Rev. Stat. § 44-8006 Prompt payment act compliance statement; filing; effect; list available.
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An insurer shall be exempt from the requirements of section 44-8005 during a calendar year when the insurer has a prompt payment act compliance statement on file with the director. Any insurer desiring to obtain the exemption shall file a prompt payment act compliance statement w…
Neb. Rev. Stat. § 44-8007 Claims processing functions; delegation; requirements.
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If an insurer delegates its claims processing functions to a third party, the delegation agreement shall provide that the third party shall consent to an examination and cooperate with that examination by the director and shall comply with the requirements of the Health Care Prom…
Neb. Rev. Stat. § 44-8008 Compliance with act; unfair payment pattern; director; powers and duties; enforcement; penalty.
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(1) An insured, a representative of an insured, or a health care provider acting on behalf of the insured may notify the director of activities related to an unfair payment pattern. The director shall compile a record of notices, and if it appears to the director that an insurer,…
Neb. Rev. Stat. § 44-8009 Applicability of act.
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The Health Care Prompt Payment Act does not apply to any individual or group policies that provide coverage for a specific disease, accident-only coverage, hospital indemnity coverage, disability income coverage, medicare supplement coverage, long-term care coverage, or other lim…
Neb. Rev. Stat. § 44-801 Domestic associations; special and additional requirements; amendments to bylaws; approval of department required.
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No domestic assessment association shall begin to transact the business of insurance until (1) its bylaws, stating in detail its scheme and method of doing business, shall have been approved by the Department of Insurance; and (2) it has received one hundred or more applications …
Neb. Rev. Stat. § 44-8010 Rules and regulations.
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The director may adopt and promulgate rules and regulations to carry out the Health Care Prompt Payment Act.
Neb. Rev. Stat. § 44-802 Assessments; how determined; by whom made.
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All assessments shall be determined by proper classification and rating of the risks which an assessment association may assume, so that every member may be assessed in a proper proportion to his risk. The method of estimating the pro rata amount of each member's liability for lo…
Neb. Rev. Stat. § 44-803 Assessments; limitations.
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Any assessment association which has accumulated and maintains the same reserve for liabilities that is required of a stock or mutual company organized to transact the same business, and either a surplus or a contingency fund equal to the surplus required to be maintained by a st…
Neb. Rev. Stat. § 44-804 Assessments; when authorized.
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No assessment shall be made on a member for liability occurring prior to his membership. A member may be excluded from all benefits during the time he is in default of payment of any assessment.
Neb. Rev. Stat. § 44-805 Membership; withdrawal.
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Any member may withdraw by surrendering his or her policy for cancellation at any time by giving notice in writing to the secretary of the association and paying the amount of his or her share of all claims then existing against the company in accordance with the bylaws of the co…
Neb. Rev. Stat. § 44-806 Losses; notice; adjustment.
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Every member of such association who may sustain loss or damage shall, as soon as practicable thereafter, notify the secretary thereof, stating the amount of damage or loss claimed. The person or persons authorized by such company to adjust losses shall proceed to ascertain the a…
Neb. Rev. Stat. § 44-807 Assessments and losses; actions to recover.
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Suits at law may be brought against any member who shall neglect or refuse to pay any assessment made against him, in the same manner as for the collection of any other debt; and a member may bring an action against the company for any loss sustained.
Neb. Rev. Stat. § 44-808 Losses; officers; liability.
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If the officers and directors of an assessment association fail or refuse, after receiving notice of a loss, to act upon the notice of loss, they shall render themselves individually liable therefor, and an action may be maintained against them to collect such amount.
Neb. Rev. Stat. § 44-809 Membership fees; amount; purpose.
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Every such association may collect, at the time of the issuing of a policy, a membership fee not exceeding five dollars, and, if insuring property, a percentage of the amount insured not exceeding two and one-half percent, as an advance assessment, as the bylaws may provide. From…
Neb. Rev. Stat. § 44-810 Claims; payment; power to borrow.
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Whenever the cash on hand, not including the contingency fund, shall be insufficient to pay all claims, then such deficiency may be taken from the contingency fund. If this fund is insufficient to meet all claims, then the company may borrow money for such purposes. Any diminutio…
Neb. Rev. Stat. § 44-8101 Act, how cited.
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Sections 44-8101 to 44-8109 shall be known and may be cited as the Nebraska Protection in Annuity Transactions Act.
Neb. Rev. Stat. § 44-8102 Purpose of act; cause of action; liability; act, how construed.
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(1) The purpose of the Nebraska Protection in Annuity Transactions Act is to require producers to act in the best interest of the consumer when making a recommendation of an annuity and to require insurers to establish and maintain a system to supervise recommendations so that th…
Neb. Rev. Stat. § 44-8103 Applicability of act; rules and regulations.
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(1) The Nebraska Protection in Annuity Transactions Act applies to any recommendation or sale of an annuity. (2) The Director of Insurance may adopt and promulgate rules and regulations to carry out the Nebraska Protection in Annuity Transactions Act.
Neb. Rev. Stat. § 44-8104 Act; exemptions.
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Unless otherwise specifically included, the Nebraska Protection in Annuity Transactions Act does not apply to transactions involving: (1) Direct response solicitations if there is no recommendation based on information collected from the consumer pursuant to the act; or (2) Contr…
Neb. Rev. Stat. § 44-8105 Terms, defined.
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For purposes of the Nebraska Protection in Annuity Transactions Act: (1) Annuity means an annuity that is an insurance product under state law and is individually solicited, whether the product is classified as an individual or group annuity; (2) Cash compensation means any disco…
Neb. Rev. Stat. § 44-8106 Recommendation of annuity; obligations; requirements; supervision system, required; producer; insurer; prohibited acts; safe harbor requirements; maintenance of records; Director of Insurance; powers.
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(1) The producer, when making a recommendation of an annuity, shall act in the best interest of the consumer under the circumstances known at the time the recommendation is made, without placing the producer's or the insurer's financial interest ahead of the consumer's interest. …
Neb. Rev. Stat. § 44-8107 Insurer; duties; Director of Insurance; powers; violations.
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(1) An insurer is responsible for compliance with the Nebraska Protection in Annuity Transactions Act. If a violation occurs, either because of the action or inaction of the insurer or its producer, the Director of Insurance may order: (a) An insurer to take reasonably appropriat…
Neb. Rev. Stat. § 44-8108 Producer; duties.
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(1) A producer shall not solicit the sale of an annuity product unless the producer has adequate knowledge of the product to recommend the annuity and the producer is in compliance with the insurer's standards for product training. A producer may rely on insurer-provided product-…
Neb. Rev. Stat. § 44-8109 Changes made to act; applicability.
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The changes made to the Nebraska Protection in Annuity Transactions Act by Laws 2021, LB22, shall apply to solicitations occurring on and after January 1, 2022.
Neb. Rev. Stat. § 44-811 Losses; arbitration of claims; copy of award furnished.
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Any such association may provide in its bylaws for arbitrating any claim for loss or damage, where a member and the association fail to agree thereon. A copy of any adjustment or arbitration award on any claim for loss or damage shall be furnished the policyholder by the adjuster…
Neb. Rev. Stat. § 44-812 Policies; maximum coverage; exceptions.
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No certificate or policy of an assessment association, insuring property, shall cover a longer period than five years from its date, unless such assessment association shall provide in its bylaws for readjustment or reappraisement of such property insured at least once in five ye…
Repealed. Laws 1989, LB 92, § 278.
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[Repealed or reserved.]
Repealed. Laws 1989, LB 92, § 278.
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[Repealed or reserved.]