§ 58-54-10. Standards for policy provisions. - North Carolina Statutes

§58‑54‑10.  Standards for policy provisions.

     (a)  No policy in force inthis State shall contain benefits that duplicate benefits provided by Medicare.

(b)        The Commissionershall adopt rules to establish specific standards for provisions of policies.Such standards shall be in addition to and in accordance with applicable Statelaw. No requirement of State law relating to minimum required policy benefits,other than the minimum standards contained in this Article, applies topolicies. The standards may include without limitation to: terms ofrenewability; initial and subsequent conditions of eligibility; nonduplicationof coverage; probationary periods; benefit limitations, exceptions, andreductions; elimination periods; requirements for replacement; recurrentconditions; and definitions of terms.

(c)        The Commissionermay adopt rules that specify prohibited policy provisions not otherwisespecifically authorized by State law that, in the opinion of the Commissioner,are unjust, unfair, or unfairly discriminatory to any person insured orproposed for coverage under a policy.

(d)        Notwithstanding anyother provision of State law, a policy may not deny a claim for losses incurredmore than six months from the effective date of coverage for a preexistingcondition. A policy may not define a preexisting condition more restrictivelythan a condition for which medical advice was given or treatment wasrecommended by or received from a physician within six months before theeffective date of coverage.

(e)        Repealed by SessionLaws 1991 (Regular Session, 1992), c. 815, s. 3. (1989, c. 729, s. 1; 1991, c.490, s. 6; 1991 (Reg. Sess., 1992), c. 815, s. 3.)