376.806. Refund of health insurance unearned premium on notice of death of insured--refunded to whom--definitions--exception--failure to notify within one year. - Missouri Statutes

Refund of health insurance unearned premium on notice of death ofinsured--refunded to whom--definitions--exception--failure tonotify within one year.

376.806. 1. As used in this section, the following termsmean:

(1) "Health insurance contract", any one of the followingwhen providing coverage to a resident of this state:

(a) Individual insurance policies providing coverage on anexpense incurred basis;

(b) Individual indemnity type contracts issued by a healthservices corporation;

(c) Any individual contract issued by a health maintenanceorganization;

(d) Any self-insured health benefit plan, except to theextent preempted by federal law;

(e) Group health insurance in which the insured pays thefull premium directly to the insurer, health services corporationor health maintenance corporation;

(2) "Health insurer", any entity issuing a health insurancecontract.

2. A health insurer shall refund promptly any premium whichit did not earn, upon notification of the death of any personcovered under the health insurer's health insurance contract.The health insurer shall earn only that part of the premiums paidon behalf of the decedent which the period of coverage duringwhich the decedent was alive bears to the whole period for whichpremiums were paid.

3. The refund of premiums shall be made directly to:

(1) The decedent's spouse at the time of the decedent'sdeath;

(2) The primary insured person under the health insurancecontract, if the decedent was not married at the time of deathand was covered under the health insurance contract as adependent;

(3) The decedent's estate, if neither subdivision (1) nor(2) of this subsection is applicable.

4. This section does not apply if the notification of thedeath of an insured person is given to the health insurer morethan one year after the death of the decedent.

(L. 1991 H.B. 561 § 1)