2005 Illinois 215 ILCS 5/ Illinois Insurance Code. Article XXXIX - Group Legal Expense Insurance
(215 ILCS 5/Art. XXXIX heading)ARTICLE XXXIX.
GROUP LEGAL EXPENSE INSURANCE
(215 ILCS 5/900) (from Ch. 73, par. 1065.600)
Sec. 900.
Group legal expense defined.
Group legal expense insurance
means that form of legal expense insurance covering not less than 10 employees,
members, or employees of members, written under a master policy issued to
any governmental corporation, unit, agency or department thereof, or to
any corporation, copartnership, individual employer, or to any association
upon application of an executive officer or trustee of such association
having a constitution or bylaws and formed in good faith for purposes other
than that of obtaining insurance, where officers, members, employees, employees
of members or classes or departments thereof may be insured for their individual
benefit. In addition, a group legal expense policy may be written to insure
any group which may be insured under a group life insurance policy. The
term "employees" includes the officers, managers and employees or subsidiary
or affiliated corporations, and the individual proprietors, partners, and
employees of affiliated individuals and firms, when the business of such
subsidiary or affiliated corporations, firms or individuals is controlled
by a common employer through stock ownership, contract or otherwise.
(Source: P.A. 81‑1361.)
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(215 ILCS 5/901) (from Ch. 73, par. 1065.601)
Sec. 901.
Group legal expense insurance authorized.) Any insurance company
authorized to write legal expense insurance in this State shall have the
power to issue group legal expense insurance policies. No policy,
certificate, endorsement, rider, or application which becomes or is designed
to become a part of any such policy of group legal expense insurance may
be issued or delivered in this State unless a copy of the form shall have
been filed with the Director of Insurance in accordance with Section 143
of this Code. Such policy, certificate, endorsement, rider, or application
must contain those provisions required by Sections 902 through 906
of the Code.
No such policy, certificate, endorsement, application or rider
shall contain any provision which would interfere with the freedom of choice
by the insured in the selection
of attorneys except that the insurer
may select and contract with attorneys to verify plan coverage and to provide
the insureds with legal services which consist of initial advice and consultation.
Nothing herein shall prevent an insured, after plan coverage has been verified,
from choosing to go directly to his or her own attorney of choice for initial
advice and consultation, subject to applicable policy limitations.
Every such policy, certificate, endorsement, application or rider shall
prominently display language advising the insured of such freedom of choice
by the insured in the selection of attorneys
and that no company issuing such policy, certificate, endorsement, application
or rider may require, suggest or recommend the use of any attorney
or firm of attorneys, provided, however, that dissemination by an insurer
of the names of attorneys who have agreed to accept legal expense insurance
benefits as payment for certain legal services shall not constitute a requirement,
suggestion or recommendation of the use of any attorney or firm of attorneys.
The foregoing shall not prohibit referral of insured by the insurer to
any lawyer referral service authorized or operated by a state, county, local
or other bar association.
Any insurance company issuing such policies shall in no way interfere with
the attorney‑client relationship nor with the independent exercise of professional
judgment by any attorney.
(Source: P.A. 83‑774.)
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(215 ILCS 5/902) (from Ch. 73, par. 1065.602)
Sec. 902.
"Entire Contract" specified.) Each group legal expense insurance
policy shall provide that the policy, the application of the employer, or
executive officer or trustee of any association, and the individual applications,
if any, of the employees, members or employees of members insured shall
constitute the entire contract between the parties, and that all statements
made by the employer, or the executive officer or trustee, or by the individual
employees, members or employees of members shall, in the absence of fraud,
be deemed representations and not warrantees, and that no such statement
shall be used in defense to a claim under the policy, unless it is contained
in a written application.
(Source: P.A. 81‑1361.)
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(215 ILCS 5/903) (from Ch. 73, par. 1065.603)
Sec. 903.
Certificates Required.) Each group legal expense insurance
policy shall provide that the insurer shall issue to the employer, or to
the executive officer or trustee of the association, for delivery to the
employee, member or employee of a member, who is insured under such policy,
an individual certificate setting forth a statement as to the insurance
protection to which he or she is entitled and to whom payable, if appropriate.
(Source: P.A. 81‑1361.)
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(215 ILCS 5/904) (from Ch. 73, par. 1065.604)
Sec. 904.
New Members of Group.) Each group legal expense insurance policy
shall provide that to the group or class thereof originally insured
shall be added from time to time all new employees of the employer, members
of the association or employees of members eligible to and applying for
insurance in such group or class, but participation in the group plan shall
not be required as a condition of employment, nor shall any member not participating
in the plan be coerced or discriminated against.
(Source: P.A. 81‑1361.)
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(215 ILCS 5/905) (from Ch. 73, par. 1065.605)
Sec. 905.
Conversion Rights.) Each group legal expense insurance policy
shall provide that any member of the group shall have the right to convert
his group policy to an individual standard policy of insurance in the same
company as offered by the insurer to the non‑group insureds upon termination
of his connection with the group extending to him or her the same limits of coverage.
(Source: P.A. 81‑1361.)
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(215 ILCS 5/906) (from Ch. 73, par. 1065.606)
Sec. 906.
Cancellation Restricted.
An insurer may not cancel the coverage
of an individual member of a group to which the insurer provides coverage
under a group legal expense insurance policy except for the nonpayment of
premium by such member, or the group policyholder if premium is paid or
collected by it for transmittal to the insurer or unless the insurance for
the entire group is cancelled. In the event of cancellation the insurer shall:
(1) If it has in its actual possession the names and addresses of individual
members insured under such group legal expense insurance policy, deliver
to the individual member written notice of cancellation stating when, not
less than 30 days thereafter, such cancellation shall be effective provided,
however, that if such cancellation is the result of nonpayment of premium
by such member or the group policyholder, a notice of 10 days shall be sufficient.
(2) In the event the insurer does not administer the group legal expense
insurance policy and is not in actual possession of the names and addresses
of individual members insured under such policy, the insurer shall deliver
to the employer or to the executive officer or trustee of the association for delivery
to the employee, member or employee of a member who is insured under such
policy individual notice of cancellation forms stating when, not less than
30 days thereafter, such cancellation shall be effective provided, however,
that if such cancellation is the result of nonpayment of premium a notice
of 10 days shall be sufficient. The insurer shall not be required to furnish
notice of cancellation under this Section to the group policyholder when
an individual member's insurance is terminated by reason of nonpayment of
premium unless it has specific knowledge of the individual's failure to pay premium.
Delivery shall be considered effective by the mailing of such notice if
subsection (1) above is applicable to the last address of the member as
shown on the records of the insurer, and under subsection (2) by the mailing
of such notice to the last address of the group policyholder as shown on
the records of the insurer.
(Source: P.A. 81‑1361.)
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