33-29-8
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33-29-8.
(a)
Except as provided in subsection (b) of this Code section, every insurer
delivering or issuing for delivery in this state policies of accident and
sickness insurance which are renewable at the option of the insurer or
cancelable at the option of the insurer shall provide in said policies a
provision as follows:
'If
the company cancels or refuses to renew this policy except for nonpayment of
premiums prior to age ______________ (insert age which shall not be less than
60), it will refund 75 percent of the premiums paid in excess of the benefits
received. The requirements of this provision shall not apply to cancellation or
refusal to accept renewal premiums because of change in occupation of the
insured to an occupation generally classified by the insurer as to all
applicants as uninsurable.'
(b)
This Code section shall not apply to and the provision prescribed in subsection
(a) of this Code section need not be included in any major medical policy which
provides that the insurer may cancel or refuse to renew the policy as of an
anniversary date when also canceling or refusing to renew all policies with the
same provisions and premium rate basis in the jurisdiction in which the insured
resides, and then only if either or both of the following conditions are
applicable:
(1)
The insured is or could be covered by benefits, substantially similar in both
kind and amount to those of the policy, in accordance with any federal or state
governmental health insurance program; or
(2)
The insurer is prevented by any law or any regulation or ruling of a
governmental agency from applying to the policy a table of premium rates which
the insurer certifies, based on its experience, is reasonable in relation to the
benefits provided.
(c)
For the purpose of this chapter, a major medical policy is any policy which
provides benefits of at least 75 percent of necessary, reasonable, and customary
charges for medical care, including hospitalization in semiprivate
accommodations, with maximum lifetime benefit of at least $100,000.00, subject
only to such exceptions, restrictions, limitations, and deductible as the
Commissioner may deem reasonable.