Title 56, Insurance

(a) (1) Except as provided in subdivision (a)(2), beginning upon approval of the next health insurance rate filing on or after January 1, 2020, a carrier offering a health plan in this state shall comply with this section.(2) On and after December 1, 2020, a carrier offering a he…

At the request of a patient, a healthcare provider licensed under title 63 or 68 shall provide a copy of an order for a comparable healthcare service within two (2) business days of the request.

The state insurance committee, created by § 8-27-201, shall publish a report no later than January 1, 2020, on examples of shared savings incentive programs that directly incentivize current enrollees and retirees to shop for lower cost care in other states and consider implement…

The commissioner is authorized to promulgate rules as necessary to implement this part. The rules must be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

(1) Except for § 56-7-3506, and notwithstanding § 56-7-1005, this part does not apply to:(1) Any managed care organization contracting with the state to provide insurance through the TennCare program or the CoverKids program; or(2) Any plan described in Section 1251 of the federa…

(a) (a) Notwithstanding this part, the total value of incentives offered to any one (1) enrollee must not exceed five hundred ninety-nine dollars ($599) in any year.(b) The monetary limit on incentives described in subdivision (a)(1) does not apply to § 56-7-610. (a) Notwithstand…

(a) An enrollee may choose to pay for a healthcare service out-of-pocket from an out-of-network provider. If an enrollee negotiates for a lower cost from an out-of-network provider than the average allowed amount paid by the carrier to a network provider for a comparable healthca…

(1) “Industrial life insurance,” as used in §§ 56-7-702 — 56-7-704, means that form of life insurance, the policies for which include the words “industrial policy” as part of the descriptive matter; and:(1) Under which the premiums are payable weekly; or(2) Under which the premiu…

(a) Definitions. As used in this section:(1) “Insurer” means any person, firm, corporation, partnership, association, trust, or other entity of any type engaged as a principal in the business of insurance in this state;(2) “Policyowner,” absent any policy provision to the contrar…

(1) The requirements of § 56-7-702 shall not be applicable as follows:(1) When an industrial life insurance policy is issued providing for accident and/or health benefits, in addition to natural death benefits, the requirements of § 56-7-702 shall apply only to the life insurance…

Any industrial life insurance contracts may be delivered or issued for delivery in this state, which contracts contain provisions more favorable to the policyholder than those required by §§ 56-7-701 — 56-7-704, and nothing in §§ 56-7-701 — 56-7-704 shall be construed as prohibit…

No insurance company or association transacting an industrial life, health, or accident business in this state, and no officer, director, or agent thereof, shall knowingly issue, circulate, or cause to be issued or circulated, any estimate, illustration, circular, or statement of…

No officer, director, or agent of an insurance company or association transacting an industrial insurance business in this state shall knowingly and willfully receive any premium or assessment on behalf of any industrial insurance company or association or fraternal organization,…

No officer, director, agent, physician, or other person shall, with intent to defraud, knowingly issue or cause to be issued or aid in issuing an industrial policy or benefit certificate to any infirm or unhealthy person who is not in insurable condition, nor aid in reinstating i…

No person shall knowingly or willfully make or aid in making any false or fraudulent statement of any material fact or thing in any written statement or certificate for the purpose of procuring or attempting to procure the payment of any false or fraudulent claim against any indu…

Any violation of §§ 56-7-705 — 56-7-708 is a Class C misdemeanor.

(a) Within ninety (90) days after making or writing any contract of fire insurance on any building or structure in this state, the company, its designee or agent, shall cause the building or structure to be inspected. (b) No company, agent or insurance producer shall knowingly is…

If buildings within the state insured against loss by fire are totally destroyed by fire, the company shall not be liable beyond the actual value of the insured property at the time of the loss or damage; and if it appears that the insured has paid premiums on an amount in excess…

If the company, its designee or agent, fails to place a reasonable value on any insured property within the ninety-day period provided in § 56-7-801, and that is agreed to by the insured, and a loss occurs, then the value as shown by the policy or application is conclusively pres…

When any person, as trustee, mortgagee, assignee, or otherwise, possesses or has any fire insurance policy on realty made payable to the person, or other person as that person's interest may appear, then the insurance as to the interest of the trustee, mortgagee, assignee or othe…

(a) Application of Law. All accident and health insurance for a term of ten (10) years or less in connection with loans or credit transactions shall be subject to this section, except insurance in connection with a loan or other credit transaction of more than fifteen (15) years'…

(a) (1) As used in this section:(A) “Compensation” includes commissions, dividends, except where they are the distribution of earnings to stockholders of an insurance company or insurance holding company, retrospective rate credits, service fees, expense allowances or reimburseme…

All life insurance policies and certificates issued in connection with loans or credit transactions for a duration of fifteen (15) years or less shall be subject to § 56-7-902 — 56-7-912, except in connection with a loan or other credit transaction where the period of coverage on…

(1) As used in § 56-7-903, this section and §§ 56-7-905 — 56-7-912, unless the context otherwise requires:(1) “Claims” means benefits payable on death or disability, excluding loss adjustment expense, claims settlement costs, or other additions of any kind;(2) “Claims incurred” m…

(a) Credit life insurance policies that provide benefits differing in kind or character from the following shall not be permitted:(1) Individual policies of credit life insurance issued to debtors on the term plan;(2) Group policies of credit life insurance issued to creditors pr…

(a) When credit life insurance is effected on a debtor, it shall be evidenced by an individual policy or, in the case of group insurance, by a certificate of group insurance, which policy or certificate shall be delivered to the debtor at the time the indebtedness is incurred or …

(a) The initial amount of credit life insurance issued in connection with a specific loan or other credit transaction shall not exceed the total amount repayable under the contract of indebtedness, which amount repayable may include the amount of the loan commitment by the credit…

(a) (1) No insurer shall issue any policy of group credit insurance covering debtors in this state, unless the rates are reasonable in relation to the benefits provided. The rates established prior to July 1, 1987, shall not be changed or adjusted until there has been an experien…

(a) Each individual policy of credit life insurance on which the premium is paid by the debtor and each group certificate for which an identifiable charge is made to the debtor shall provide that, in the event of termination of the insurance prior to the scheduled maturity date o…

(a) An insurer issuing credit life insurance shall be responsible for the settlement, adjustment and payment of all claims and shall establish and maintain adequate claim files, which may be reviewed and examined by the commissioner. All claims shall be promptly reported to the i…

(1) In order to assure that sufficient funds will be made available to make the refunds as required and to guarantee promised benefits to policyholders, aggregate reserves maintained by the insurer for credit life insurance shall be at least equal to the sum of the following:(1) …

(a) Within sixty (60) days of the filing of any item described in § 56-7-905(c), the commissioner shall approve the item unless it contains provisions that are contrary to this title. (b) The commissioner may adopt rules interpreting or making specific application of §§ 56-7-903 …

(a) There is established the advisory committee on credit life insurance rates to be composed of six (6) persons, at least two (2) of whom shall be directly associated with the credit life insurance business. The governor shall appoint the members for staggered six-year terms. Th…

(a) As part of its required annual statement, each company licensed to sell credit insurance in this state and each company authorized as a credit reinsurer in this state shall submit a declaration under oath executed by the company president stating whether the company or a subs…

(a) This part is known and may be cited as the “Tennessee Unfair Trade Practices and Unfair Claims Settlement Act of 2009.” (b) The purpose of this part is to regulate trade and claims settlement practices in the business of insurance in accordance with the intent of congress as …

(a) For the purposes of this part:(1) “Adjuster” means any person that is adjusting claims;(2) “Affiliate of a depository institution” means any company that controls, is controlled by, or is under common control with a depository institution;(3) (A) “Claim” means:(i) An oral, wr…

(1) No person shall engage in an unfair trade practice from, in or into this state that is defined in § 56-8-104 or § 56-8-106 or determined by rule pursuant to § 56-8-108 to be an unfair method of competition or an unfair or deceptive act or practice in the business of insurance…

(1) Misrepresentations and False Advertising of Insurance Policies. The following practices are defined as unfair trade practices in the business of insurance by any person:(1) Misrepresentations and False Advertising of Insurance Policies. Making, issuing, circulating, or causin…

(1) Any of the following acts by an insurer or person constitutes an unfair claims practice:(1) Knowingly misrepresenting relevant facts or policy provisions relating to coverages at issue;(2) Failing to acknowledge with reasonable promptness pertinent communications with respect…

(a) No person or depository institution, or affiliate of a depository institution, shall require as a condition precedent to the lending of money or extension of credit, or any renewal thereof, that the person to whom the money or credit is extended or whose obligation a creditor…

(a) The commissioner shall have power to examine and investigate the affairs of every person or insurer in this state in order to determine whether the person or insurer has been or is engaged in any unfair trade practice; however, in the case of depository institutions, the comm…

(a) In addition to any other authority granted in this part, the commissioner shall have the authority to declare by rule certain acts to be unfair trade practices or unfair methods of competition or unfair or deceptive acts or practices in the business of insurance that are not …

Whenever it appears to the commissioner that any person has violated or is about to violate this part or any rule promulgated under this part, the commissioner may, in the commissioner's discretion, bring an action in the chancery court of Davidson County to enjoin the violation …

The commissioner is authorized, after notice and hearing, to promulgate reasonable rules and orders as are necessary or proper to carry out and effectuate this part. The rules shall be subject to review in accordance with the Uniform Administrative Procedures Act, compiled in tit…

The powers vested in the commissioner by this part shall be in addition to any other powers in this title to enforce any penalties, fines or forfeitures authorized by law with respect to the methods, acts and practices declared to be unfair or deceptive by this part.

(a) An insurer issuing a group or individual benefit plan may offer a voluntary wellness or health improvement program that uses incentives or rewards, or any combination of incentives or rewards, to encourage or reward a plan member's participation in the program. Such incentive…