38.2-109 - Accident and sickness. - Virginia Statutes

§ 38.2-109. Accident and sickness.

A. "Accident and sickness insurance" means insurance against loss resultingfrom sickness, or from bodily injury or death by accident or accidentalmeans, or from a combination of any or all of these perils. As used in thistitle, unless the context requires otherwise, the term "accident andsickness insurance" shall be deemed to include "credit accident andsickness insurance."

B. The term "accident and sickness insurance" shall also include agreementsinsuring against losses resulting from health care claims or expenses ofhealth care in excess of a specific or aggregate dollar amount, when suchagreements are used to provide coverage to (i) an employee welfare benefitplan or any other plan providing accident and sickness benefits, (ii) ahealth maintenance organization, or (iii) a provider associated with amanaged care network, provided:

1. The agreement clearly discloses the extent and duration of the liabilityassumed by the insurer once the policyholder's liability has been exceeded;and

2. The insurer maintains reserves in accordance with § 38.2-1314 for theliability it assumes under the agreement.

Such agreements shall not be subject to the requirements of Chapters 34 (§38.2-3400 et seq.) and 35 (§ 38.2-3500 et seq.) of this title.

(1952, c. 317, § 38.1-5; 1986, c. 562; 1997, c. 28.)