689C.197 - Carrier prohibited from denying coverage because insured was intoxicated or under influence of controlled substance; exceptions. - Nevada Statutes

689C.197  Carrier prohibited from denying coverage because insured was intoxicated or under influence of controlled substance; exceptions.

      1.  Except as otherwise provided in subsection 2, a carrier shall not:

      (a) Deny a claim under a health benefit plan solely because the claim involves an injury sustained by an insured as a consequence of being intoxicated or under the influence of a controlled substance.

      (b) Cancel participation under a health benefit plan solely because an insured has made a claim involving an injury sustained by the insured as a consequence of being intoxicated or under the influence of a controlled substance.

      (c) Refuse participation under a health benefit plan to an eligible applicant solely because the applicant has made a claim involving an injury sustained by the applicant as a consequence of being intoxicated or under the influence of a controlled substance.

      2.  The provisions of subsection 1 do not prohibit a carrier from enforcing a provision included in a health benefit plan to:

      (a) Deny a claim which involves an injury to which a contributing cause was the insured’s commission of or attempt to commit a felony;

      (b) Cancel participation in a health benefit plan solely because of such a claim; or

      (c) Refuse participation in a health benefit plan to an eligible applicant solely because of such a claim.

      3.  The provisions of this section do not apply to a carrier under a health benefit plan that provides coverage for long-term care or disability income.

      (Added to NRS by 2005, 2344; A 2007, 85)