38.2-3518 - Standards for policy provisions. - Virginia Statutes

§ 38.2-3518. Standards for policy provisions.

A. Pursuant to the authority granted in § 38.2-223, the Commission may issuerules and regulations to establish specific standards, including standards offull and fair disclosure, for the sale of individual accident and sicknessinsurance policies. These rules and regulations shall be in addition to andin accordance with applicable laws of this Commonwealth, including Chapter 34(§ 38.2-3400 et seq.) and Articles 1 (§ 38.2-3500 et seq.) and 2 (§ 38.2-3516et seq.) of this chapter which may cover but shall not be limited to:

1. Terms of renewability;

2. Initial and subsequent conditions of eligibility;

3. Nonduplication of coverage provisions;

4. Coverage of dependents;

5. Coverage of persons eligible for Medicare by reason of age;

6. Preexisting conditions;

7. Termination of insurance;

8. Probationary periods;

9. Limitations;

10. Exceptions;

11. Reductions;

12. Elimination periods;

13. Requirements for replacement;

14. Recurrent conditions; and

15. Definition of terms including but not limited to the following:hospital, accident, sickness, injury, physician, accidental means, totaldisability, partial disability, nervous disorder, guaranteed renewable, andnoncancellable.

For the purposes of this article, "licensed health care practitioners", tothe extent required by law, shall be deemed physicians.

B. Pursuant to the authority granted in § 38.2-223, the Commission may issuerules and regulations that specify prohibited policies or policy provisionsnot otherwise specifically authorized by statute that in the opinion of theCommission are unjust, unfair, or unfairly discriminatory to the policyowner,beneficiary, or any person insured under the policy.

(1980, c. 204, § 38.1-362.13; 1981, c. 575; 1986, c. 562.)