Title 56, Insurance

(a) (1) An individual hospital or medical expense insurance policy or contract, as provided under chapter 26, 28 or 29 of this title, delivered or issued for delivery in this state, or that is amended or renewed by agreement or otherwise, on or after August 13, 1986, and that pro…

(a) No insurance company doing business in this state shall declare any life insurance policy or any noncancellable or guaranteed renewable accident and health insurance policy owned by a resident of this state forfeited or lapsed within six (6) months after default in payment of…

The commissioner is authorized to adopt rules applicable to insurance policies and subscriber contracts provided by an insurance company or a nonprofit service corporation on a group or group-type basis establishing reasonable requirements for extension of benefits and determinat…

(a) (1) Subject to the limitations of subdivision (a)(2), no policy of group life insurance shall be delivered in this state unless it contains in substance the provisions contained in subdivision (a)(3), or provisions that, in the opinion of the commissioner, are more favorable …

Section 56-7-2305 does not apply to any policy or contract of group life insurance legally in effect March 8, 1957, or any renewal or renewals of the policy or contract.

(1) Payment of Premiums. No policy of life insurance shall be issued in this state or be issued by a life insurance company organized under the laws of this state unless the policy contains the following:(1) Payment of Premiums. A provision that all premiums after the first shall…

(1) Forfeiture of Policy for Failure to Repay Loans; Proposed Benefits Not Strictly Insurance. No policy of life insurance in a form other than as prescribed in § 56-7-2307 shall be issued or delivered in this state, or be issued by a life insurance company organized under the la…

(a) In the case of those policies issued prior to the operative date of § 56-7-401, the Standard Nonforfeiture Law, the loan value referred to in § 56-7-2307(7) shall be the reserve at the end of the current policy year on the policy and on any dividend additions to the policy, l…

All life insurance companies authorized to do the business of life insurance in this state are required to print, in conspicuous type, on the face or first page of each policy sold to citizens of this state, words correctly describing the character of the policy.

(a) Filing and Approval. No policy of life insurance shall be delivered or issued for delivery in this state, nor shall any endorsement, rider, or application that becomes a part of the policy be used in connection with the policy until a copy of the form has been filed with the …

(a) As used in this section:(1) “Department” means the department of health;(2) “Detransition procedure”, “gender”, “gender clinic”, “gender transition procedure”, “health professional”, “minor”, “perceived gender”, “perceived sex”, and “sex” have the same meanings as defined in …

No group policy of accident and sickness insurance offered for sale in this state shall be issued or renewed by any insurer or hospital service corporation or medical service corporation transacting business in this state that, by the terms of the policy, excludes or reduces the …

Under any student accident coverage, regardless of the form of the contract, no provision may be included that reduces the benefits payable on account of the existence of group or individual insurance contracts that provide health insurance coverage on the student; provided, that…

Where any policy of insurance, group or individual, issued after July 1, 1973, to school children, contains a provision whereby incurred medical benefits for accidents are payable for a specified number of days following the covered accident and if, during the specified period, w…

(1) A policy or contract for a health benefit plan, as defined in § 56-7-2203, that is issued, renewed, or entered into on or after January 1, 2018, and provides coverage for prescription eye drops shall not deny coverage for a refill of a prescription that is a covered benefit u…

(a) This section is known and may be cited as the “Proton Therapy Access Act.” (b) As used in this section:(1) “Aggregate amount” means the total amount paid under the state group insurance program for the applicable radiation treatment delivery CPT codes to deliver a biological …

(a) As used in this section:(1) “Contraceptive” means any device, medication, biological product, or procedure that is intended for use in the prevention of pregnancy, whether specifically intended to prevent pregnancy or for other health needs, and that is legally marketed under…

(a) Notwithstanding any other law to the contrary, any individual, franchise, blanket or group policy issued pursuant to this title or any medical service plan, contract, hospital service corporation contract, hospital and medical service contract, fraternal benefit society or he…

(a) All entities providing health care benefits, including, but not limited to, insurers, ERISA group health plans, health maintenance organizations and nonprofit hospital and medical service plans, are prohibited from considering the availability or eligibility for medical assis…

(a) This section is known and may be cited as the “Patients' Right to Truth Act of 1996.” (b) Each managed care organization, health maintenance organization or preferred provider organization, referred to as the “plan” in this section, shall not in any way restrict medical perso…

(a) The general assembly finds that Tennesseans are increasingly concerned that mothers and newborns receive proper medical care prior to hospital discharge. The general assembly further finds that the lack of proper medical care jeopardizes the health, safety and well-being of t…

Any individual and group health insurance policy providing coverage on an expense incurred basis or any individual and group service or indemnity type contract issued by a nonprofit corporation or the TennCare program that provides coverage for pregnancy and/or maternity benefits…

(a) The general assembly finds and declares the following:(1) The citizens of this state rely upon health insurance to cover the cost of obtaining health care;(2) It is essential that the citizens' expectation that their health care costs will be paid by their insurance policies …

(a) Any accident or sickness insurance or hospital, medical service contract or policy under this chapter or chapter 26, 27, 28, 29, or 32 of this title that takes effect on or after July 1, 1997, shall provide for reimbursement of anesthesia expenses, hospital expenses and physi…

(a) As used in this section:(1) “Cost sharing requirement” means a deductible, coinsurance, copayment, or a maximum limitation on the application of a deductible, coinsurance, copayment, or other out-of-pocket expense;(2) “Health benefit plan”:(A) Means a hospital or medical expe…

(a) As used in this section, unless the context otherwise requires:(1) “Emergency medical condition” means a medical condition that manifests itself by symptoms of sufficient severity, including severe pain, regardless of the final diagnosis of the symptoms, that a prudent layper…

(a) (1) Each managed health insurance issuer that offers a plan that limits its enrollees' choice of providers shall maintain a network that is sufficient in numbers and types of providers to assure that all covered benefits to covered persons will be accessible without unreasona…

(a) As used in this section:(1) “Managed health insurance issuer” has the same meaning as defined in § 56-32-128(a); and(2) “Medical laboratory” has the same meaning as defined in § 68-29-103. (1) “Managed health insurance issuer” has the same meaning as defined in § 56-32-128(a)…

(a) If a provider who is a member of a managed health insurance issuer's network terminates its agreement with the issuer, or the issuer terminates the provider without cause, then the provider and issuer shall allow a subscriber or enrollee who is:(1) Under active treatment for …

(a) No health insurance issuer and no managed health insurance issuer may:(1) Deny any licensed pharmacy or licensed pharmacist the right to participate as a participating provider in any policy, contract or plan on the same terms and conditions as are offered to any other provid…

(a) (1) As used in this section:(A) “Aggregate lifetime limit” means a dollar limitation on the total amount that may be paid for benefits under a health plan with respect to an individual or other coverage unit;(B) “Annual limit” means a dollar limitation on the total amount tha…

(a) Every health benefit plan that provides coverage for prescription drugs or devices or services, or administers such a plan, including, but not limited to, health maintenance organizations, third party administrators for self insured plans and state administered plans, shall i…

(a) (1) If authorization is given and a pharmacy claim is adjudicated by a health insurer or its agent to any pharmacy services provider for care to be delivered to a covered beneficiary under any individual, franchise, blanket or group health insurance policy, medical service pl…

(a) All individual and group health insurance policies providing coverage on an expense incurred basis, individual and group service contracts issued by a health maintenance organization, all self-insured group arrangements to the extent not preempted by federal law and all manag…

(a) Notwithstanding any other law to the contrary, any insurer providing individual, franchise, blanket or group policy of insurance issued pursuant to this title, medical service plan, contract, hospital service corporation contract, hospital and medical service corporation cont…

(a) As used in this section, unless the context otherwise requires:(1) “Health benefit plan” means any hospital or medical expense policy, health, hospital or medical service corporation contract, a policy or agreement entered into by a health insurer or health maintenance organi…

(a) Every insured or policy holder of a group policy of accident and sickness insurance offered for sale in this state, that provides coverage for hospital or medical expenses that also provides coverage to the spouse of the insured, shall provide at least thirty (30) days' prior…

(a) As used in this section, “autism spectrum disorders” means neurological disorders, usually appearing in the first three (3) years of a person's life, that affect normal brain functions and are typically manifested by impairments in communication and social interaction, as wel…

(a) As used in this section, unless the context otherwise requires:(1) “Child” or “children” means any person under eighteen (18) years of age; and(2) “Hearing aid” means any wearable, nonexperimental, nondisposable instrument or device designed for the ear and used to aid or com…

(a) As used in this section:(1) “Biomarker”:(A) Means a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a specific therapeutic intervention, including known gene-drug int…

(a) Whenever any policy of insurance issued in this state provides for reimbursement for any service that is within the lawful scope of practice of a duly licensed optometrist, as defined in § 63-8-102; a licensed psychologist designated as a health service provider, as provided …

(a) Whenever any subscribers under any medical service plan or hospital service contract or hospital and medical service contract, as provided under chapters 27-29 of this title or any similar statutes, or any other persons covered by the plan or contract, are entitled to reimbur…

(a) Sections 56-7-2401 and 56-7-2402 are not applicable to any policy or policies of insurance issued in this state prior to June 1, 1965, nor shall any part of §§ 56-7-2401 and 56-7-2402 be construed as enlarging the scope of practice of optometry or podiatry or the requiring of…

(a) (1) Whenever any policy of insurance issued in this state provides for reimbursement for any service that is within the lawful scope of practice of a duly licensed chiropractor, the insured or other person entitled to benefits under the policy shall be entitled to reimburseme…

(a) “Physician” or “doctor,” whenever used in any group or individual health or accident insurance policy issued in this state or in a medical service plan or hospital service contract or hospital and medical service contract, as provided in chapters 27-29 of this title or any si…

(a) Each managed care organization (MCO), preferred provider organization (PPO), health maintenance organization (HMO), and other health organizations shall provide, through direct contract with St. Jude Children's Research Hospital or otherwise, all enrollees in the health care …