§ 58-53-75. Information. - North Carolina Statutes

§58‑53‑75.  Information.

A converted policy may providethat an insurer may at any time request information of an insured policyholderwith respect to any person covered thereunder as to whether he is covered forthe similar benefits described in G.S. 58‑53‑70(1)a or is or couldbe covered for the similar benefits described in G.S. 58‑53‑70(1)band 58‑53‑70(1)c. The converted policy may provide that as of anypremium due date an insurer may refuse to renew the policy or the coverage ofany insured person for the following reasons only:

(1)        Either those similarbenefits for which such person is or could be covered, together with theconverted policy's benefits, would result in overinsurance according to theinsurer's standards for overinsurance, or the policyholder of the convertedpolicy fails to provide the requested information;

(2)        Fraud or materialmisrepresentation in applying for any benefits under the converted policy;

(3)        Eligibility of anyinsured person for coverage under Medicare, or under any other State or federallaw providing benefits substantially similar to those provided by the convertedpolicy; or

(4)        Termination of anenrollee's enrollment in a health maintenance organization for cause in accordwith the terms of the enrollee's evidence of coverage or the health maintenanceorganization's contract with the group. (1981, c. 706, s. 1; 1991, c.195, s. 3.)