Ind. Code § 27-1-24.5-12 — Indiana Code / Title 27 / Article 1 / Chapter 24.5 / Section 27-1-24.5-12
"Pharmacy benefit manager"
Status: in_force

Sec. 12. (a) As used in this chapter, "pharmacy benefit manager" means:

(1) a person who, under a written agreement with an insurer, health plan, state agency, managed care organization, or other third party payor, directly or indirectly provides one (1) or more pharmacy benefit management services on behalf of the insurer, health plan, state agency, managed care organization, or other third party payor; and

(2) an agent, a contractor, an intermediary, an affiliate, a subsidiary, or a related entity of a person described in subdivision (1) who facilitates, provides, directs, or oversees the provision of the pharmacy benefit management services.

(b) The term does not include the following:

(1) A person licensed under IC 16.

(2) A health provider who is:

(A) described in IC 25-0.5-1; and

(B) licensed or registered under IC 25.

(3) A consultant who only provides advice concerning the selection or performance of a pharmacy benefit manager.

As added by P.L.68-2020, SEC.1. Amended by P.L.32-2021, SEC.77; P.L.237-2025, SEC.6.
Ind. Code § 27-1-24.5-4.5 — Indiana Code / Title 27 / Article 1 / Chapter 24.5 / Section 27-1-24.5-4.5
"Health care service"
Status: in_force

Sec. 4.5. As used in this chapter, "health care service" means a service or good furnished for the purpose of preventing, alleviating, curing, or healing:

(1) human illness;

(2) physical disability; or

(3) injury.

As added by P.L.237-2025, SEC.2.
Ind. Code § 27-2-23-5 — Indiana Code / Title 27 / Article 2 / Chapter 23 / Section 27-2-23-5
"Death master file"
Status: in_force

Sec. 5. As used in this chapter, "death master file" refers to:

(1) the federal Social Security Administration's Death Master File; or

(2) another data source that, for the purpose of determining that a person is reported to have died, is at least as comprehensive as the federal Social Security Administration's Death Master File.

As added by P.L.90-2014, SEC.1.
Ind. Code § 27-17-2-1 — Indiana Code / Title 27 / Article 17 / Chapter 2 / Section 27-17-2-1
Requirements to transact business
Status: in_force

Sec. 1. A discount medical card program organization may not transact business in Indiana unless the discount medical card program organization is:

(1) authorized to transact business in Indiana; and

(2) registered under this chapter.

As added by P.L.73-2006, SEC.3.
Ind. Code § 27-8-5-19 — Indiana Code / Title 27 / Article 8 / Chapter 5 / Section 27-8-5-19
Contents; group accident and sickness insurance
Status: in_force

Sec. 19. (a) As used in this chapter, "late enrollee" has the meaning set forth in 26 U.S.C. 9801(b)(3).

(b) A policy of group accident and sickness insurance may not be issued to a group that has a legal situs in Indiana unless it contains in substance:

(1) the provisions described in subsection (c); or

(2) provisions that, in the opinion of the commissioner, are:

(A) more favorable to the persons insured; or

(B) at least as favorable to the persons insured and more favorable to the policyholder;

than the provisions set forth in subsection (c).

(c) The provisions referred to in subsection (b)(1) are as follows:

(1) A provision that the policyholder is entitled to a grace period of thirty-one (31) days for the payment of any premium due except the first, during which grace period the policy will continue in force, unless the policyholder has given the insurer written notice of discontinuance in advance of the date of discontinuance and in accordance with the terms of the policy. The policy may provide that the policyholder is liable to the insurer for the payment of a pro rata premium for the time the policy was in force during the grace period. A provision under this subdivision may provide that the insurer is not obligated to pay claims incurred during the grace period until the premium due is received.

(2) A provision that the validity of the policy may not be contested, except for nonpayment of premiums, after the policy has been in force for two (2) years after its date of issue, and that no statement made by a person covered under the policy relating to the person's insurability may be used in contesting the validity of the insurance with respect to which the statement was made, unless:

(A) the insurance has not been in force for a period of two (2) years or longer during the person's lifetime; or

(B) the statement is contained in a written instrument signed by the insured person.

However, a provision under this subdivision may not preclude the assertion at any time of defenses based upon a person's ineligibility for coverage under the policy or based upon other provisions in the policy.

(3) A provision that a copy of the application, if there is one, of the policyholder must be attached to the policy when issued, that all statements made by the policyholder or by the persons insured are to be deemed representations and not warranties, and that no statement made by any person insured may be used in any contest unless a copy of the instrument containing the statement is or has been furnished to the insured person or, in the event of death or incapacity of the insured person, to the insured person's beneficiary or personal representative.

(4) A provision setting forth the conditions, if any, under which the insurer reserves the right to require a person eligible for insurance to furnish evidence of individual insurability satisfactory to the insurer as a condition to part or all of the person's coverage.

(5) A provision specifying any additional exclusions or limitations applicable under the policy with respect to a disease or physical condition of a person that existed before the effective date of the person's coverage under the policy and that is not otherwise excluded from the person's coverage by name or specific description effective on the date of the person's loss. An exclusion or limitation that must be specified in a provision under this subdivision:

(A) may apply only to a disease or physical condition for which medical advice, diagnosis, care, or treatment was received by the person or recommended to the person during the six (6) months before the effective date of the person's coverage; and

(B) may not apply to a loss incurred or disability beginning after the earlier of:

(i) the end of a continuous period of twelve (12) months beginning on or after the effective date of the person's coverage; or

(ii) the end of a continuous period of eighteen (18) months beginning on the effective date of the person's coverage if the person is a late enrollee.

This subdivision applies only to group policies of accident and sickness insurance other than those described in section 2.5(a)(1) through 2.5(a)(8) and 2.5(b)(2) of this chapter.

(6) A provision specifying any additional exclusions or limitations applicable under the policy with respect to a disease or physical condition of a person that existed before the effective date of the person's coverage under the policy. An exclusion or limitation that must be specified in a provision under this subdivision:

(A) may apply only to a disease or physical condition for which medical advice or treatment was received by the person during a period of three hundred sixty-five (365) days before the effective date of the person's coverage; and

(B) may not apply to a loss incurred or disability beginning after the earlier of the following:

(i) The end of a continuous period of three hundred sixty-five (365) days, beginning on or after the effective date of the person's coverage, during which the person did not receive medical advice or treatment in connection with the disease or physical condition.

(ii) The end of the two (2) year period beginning on the effective date of the person's coverage.

This subdivision applies only to group policies of accident and sickness insurance described in section 2.5(a)(1) through 2.5(a)(8) of this chapter.

(7) If premiums or benefits under the policy vary according to a person's age, a provision specifying an equitable adjustment of:

(A) premiums;

(B) benefits; or

(C) both premiums and benefits;

to be made if the age of a covered person has been misstated. A provision under this subdivision must contain a clear statement of the method of adjustment to be used.

(8) A provision that the insurer will issue to the policyholder, for delivery to each person insured, a certificate, in electronic or paper form, setting forth a statement that:

(A) explains the insurance protection to which the person insured is entitled;

(B) indicates to whom the insurance benefits are payable; and

(C) explains any family member's or dependent's coverage under the policy.

The provision must specify that the certificate will be provided in paper form upon the request of the insured.

(9) A provision stating that written notice of a claim must be given to the insurer within twenty (20) days after the occurrence or commencement of any loss covered by the policy, but that a failure to give notice within the twenty (20) day period does not invalidate or reduce any claim if it can be shown that it was not reasonably possible to give notice within that period and that notice was given as soon as was reasonably possible.

(10) A provision stating that:

(A) the insurer will furnish to the person making a claim, or to the policyholder for delivery to the person making a claim, forms usually furnished by the insurer for filing proof of loss; and

(B) if the forms are not furnished within fifteen (15) days after the insurer received notice of a claim, the person making the claim will be deemed to have complied with the requirements of the policy as to proof of loss upon submitting, within the time fixed in the policy for filing proof of loss, written proof covering the occurrence, character, and extent of the loss for which the claim is made.

(11) A provision stating that:

(A) in the case of a claim for loss of time for disability, written proof of the loss must be furnished to the insurer within ninety (90) days after the commencement of the period for which the insurer is liable, and that subsequent written proofs of the continuance of the disability must be furnished to the insurer at reasonable intervals as may be required by the insurer;

(B) in the case of a claim for any other loss, written proof of the loss must be furnished to the insurer within ninety (90) days after the date of the loss; and

(C) the failure to furnish proof within the time required under clause (A) or (B) does not invalidate or reduce any claim if it was not reasonably possible to furnish proof within that time, and if proof is furnished as soon as reasonably possible but (except in case of the absence of legal capacity of the claimant) no later than one (1) year from the time proof is otherwise required under the policy.

(12) A provision that:

(A) all benefits payable under the policy (other than benefits for loss of time) will be paid:

(i) not more than forty-five (45) days after the insurer's (as defined in IC 27-8-5.7-3) receipt of written proof of loss if the claim is filed by the policyholder; or

(ii) in accordance with IC 27-8-5.7 if the claim is filed by the provider (as defined in IC 27-8-5.7-4); and

(B) subject to due proof of loss, all accrued benefits under the policy for loss of time will be paid not less frequently than monthly during the continuance of the period for which the insurer is liable, and any balance remaining unpaid at the termination of the period for which the insurer is liable will be paid as soon as possible after receipt of the proof of loss.

(13) A provision that benefits for loss of life of the person insured are payable to the beneficiary designated by the person insured. However, if the policy contains conditions pertaining to family status, the beneficiary may be the family member specified by the policy terms. In either case, payment of benefits for loss of life is subject to the provisions of the policy if no designated or specified beneficiary is living at the death of the person insured. All other benefits of the policy are payable to the person insured. The policy may also provide that if any benefit is payable to the estate of a person or to a person who is a minor or otherwise not competent to give a valid release, the insurer may pay the benefit, up to an amount of five thousand dollars ($5,000), to any relative by blood or connection by marriage of the person who is deemed by the insurer to be equitably entitled to the benefit.

(14) A provision that the insurer, at the insurer's expense, has the right and must be allowed the opportunity to:

(A) examine the person of the individual for whom a claim is made under the policy when and as often as the insurer reasonably requires during the pendency of the claim; and

(B) conduct an autopsy in case of death if it is not prohibited by law.

(15) A provision that no action at law or in equity may be brought to recover on the policy less than sixty (60) days after proof of loss is filed in accordance with the requirements of the policy and that no action may be brought at all more than three (3) years after the expiration of the time within which proof of loss is required by the policy.

(16) In the case of a policy insuring debtors, a provision that the insurer will furnish to the policyholder, for delivery to each debtor insured under the policy, a certificate of insurance describing the coverage and specifying that the benefits payable will first be applied to reduce or extinguish the indebtedness.

(17) If the policy provides that hospital or medical expense coverage of a dependent child of a group member terminates upon the child's attainment of the limiting age for dependent children set forth in the policy, a provision that the child's attainment of the limiting age does not terminate the hospital and medical coverage of the child while the child is:

(A) incapable of self-sustaining employment because of a mental, intellectual, or physical disability; and

(B) chiefly dependent upon the group member for support and maintenance.

A provision under this subdivision may require that proof of the child's incapacity and dependency be furnished to the insurer by the group member within one hundred twenty (120) days of the child's attainment of the limiting age and, subsequently, at reasonable intervals during the two (2) years following the child's attainment of the limiting age. The policy may not require proof more than once per year in the time more than two (2) years after the child's attainment of the limiting age. This subdivision does not require an insurer to provide coverage to a child who has a mental, intellectual, or physical disability who does not satisfy the requirements of the group policy as to evidence of insurability or other requirements for coverage under the policy to take effect. In any case, the terms of the policy apply with regard to the coverage or exclusion from coverage of the child.

(18) A provision that complies with the group portability and guaranteed renewability provisions of the federal Health Insurance Portability and Accountability Act of 1996 (P.L.104-191).

(d) Subsection (c)(5), (c)(8), and (c)(13) do not apply to policies insuring the lives of debtors. The standard provisions required under section 3(a) of this chapter for individual accident and sickness insurance policies do not apply to group accident and sickness insurance policies.

(e) If any policy provision required under subsection (c) is in whole or in part inapplicable to or inconsistent with the coverage provided by an insurer under a particular form of policy, the insurer, with the approval of the commissioner, shall delete the provision from the policy or modify the provision in such a manner as to make it consistent with the coverage provided by the policy.

(f) An insurer that issues a policy described in this section shall include in the insurer's enrollment materials information concerning the manner in which an individual insured under the policy may:

(1) obtain a certificate described in subsection (c)(8); and

(2) request the certificate in paper form.

As added by P.L.257-1985, SEC.5. Amended by P.L.165-1986, SEC.1; P.L.23-1993, SEC.154; P.L.185-1996, SEC.14; P.L.91-1998, SEC.11; P.L.207-1999, SEC.4; P.L.233-1999, SEC.10; P.L.14-2000, SEC.58; P.L.162-2001, SEC.4; P.L.125-2005, SEC.3; P.L.127-2006, SEC.3; P.L.99-2007, SEC.193; P.L.173-2007, SEC.25; P.L.117-2015, SEC.38.
Ind. Code § 27-6-8-5 — Indiana Code / Title 27 / Article 6 / Chapter 8 / Section 27-6-8-5
Creation of the association
Status: in_force

Sec. 5. There is created a nonprofit unincorporated legal entity to be known as the Indiana Insurance Guaranty Association (referred to in this chapter as the "association"). All insurers defined as member insurers in section 4(a)(9) of this chapter shall be and remain members of the association as a condition of their authority to transact insurance in this state. The association shall perform its functions under a plan of operation established and approved under section 8 of this chapter and shall exercise its powers through a board of directors established under section 6 of this chapter. For purposes of administration and assessment, the association shall be divided into three (3) separate accounts:

(1) The worker's compensation insurance account.

(2) The automobile insurance account.

(3) The account for all other insurance to which this chapter applies.

Formerly: Acts 1971, P.L.390, SEC.1. As amended by P.L.252-1985, SEC.221; P.L.28-1988, SEC.83; P.L.52-2013, SEC.3; P.L.158-2024, SEC.21; P.L.86-2026, SEC.13.
Ind. Code § 27-13-9-6 — Indiana Code / Title 27 / Article 13 / Chapter 9 / Section 27-13-9-6
"Health plan information card"; indication of benefits and health care services
Status: in_force

Sec. 6. (a) As used in this section, "health plan information card" means a card that:

(1) a health maintenance organization; or

(2) a third party administrator of a self-insured plan;

provides to an individual so that the individual may present the card to establish the eligibility of the individual or the individual's dependents to receive benefits or health care services.

(b) A health plan information card must indicate that the benefits and health care services are provided by:

(1) a health maintenance organization; or

(2) a third party administrator.

(c) Subsection (b) applies only to a health plan information card issued:

(1) initially to an individual as a new enrollee; or

(2) to an individual at the time of the individual’s renewal of enrollment;

in a health maintenance organization after June 30, 2020.

(d) The department of insurance shall adopt rules under IC 4-22-2 to ensure compliance with this section.

As added by P.L.111-2020, SEC.14.
Ind. Code § 27-1-27-14 — Indiana Code / Title 27 / Article 1 / Chapter 27 / Section 27-1-27-14
Disclosure document to be provided before contract is entered into
Status: in_force

Sec. 14. (a) Before an insured enters into a contract with a public adjuster, the public adjuster shall provide to the insured a separate signed and dated disclosure document that states the following:

"Property insurance policies obligate the insured to present a claim to his or her insurer for the insurer's consideration. There are three (3) types of adjusters that could be involved in that process. Here are definitions of the three (3) types of adjusters:

"Company adjuster" means an insurance adjuster who is an employee of an insurer, who represents the interests of the insurer, and who is paid by the insurer. A company adjuster will not charge the insured a fee.

"Independent adjuster" means an insurance adjuster who is hired on a contract basis by an insurer to represent the insurer's interest in the settlement of a claim and who is paid by the insurer. An independent adjuster will not charge the insured a fee.

"Public adjuster" means an insurance adjuster who does not work for any insurer. A public adjuster represents the insured to assist in the preparation, presentation, and settlement of the insured's claim. The insured hires a public adjuster by signing a contract under which the insured agrees to pay the public adjuster a fee or commission based on a percentage of the amount paid by the insurer in settlement of the insured's claim or based on some other method of compensation.".

As added by P.L.226-2023, SEC.9.
Ind. Code § 27-13-23-7 — Indiana Code / Title 27 / Article 13 / Chapter 23 / Section 27-13-23-7
Annual review of HEDIS data
Status: in_force

Sec. 7. (a) Beginning July 1, 1999, the commissioner shall review each health maintenance organization's Health Plan Employer Data and Information Set (HEDIS) data on an annual basis.

(b) The commissioner may contract with an appropriate entity to conduct the reviews required under this section.

As added by P.L.69-1998, SEC.9.
Ind. Code § 27-1-7.5-11 — Indiana Code / Title 27 / Article 1 / Chapter 7.5 / Section 27-1-7.5-11
Court ordered indemnification; determination
Status: in_force

Sec. 11. Unless a corporation's articles of incorporation provide otherwise, a director of the corporation who is a party to a proceeding may apply for indemnification to the court conducting the proceeding or to another court of competent jurisdiction. On receipt of an application, the court, after giving any notice the court considers necessary, may order indemnification if it determines that:

(1) the director is entitled to mandatory indemnification under section 9 of this chapter, in which case the court shall also order the corporation to pay the director's reasonable expenses incurred to obtain court ordered indemnification; or

(2) the director is fairly and reasonably entitled to indemnification in view of all the relevant circumstances, whether or not the director met the standard of conduct set forth in section 8 of this chapter.

As added by P.L.266-1987, SEC.6.
Ind. Code § 27-17-2-5 — Indiana Code / Title 27 / Article 17 / Chapter 2 / Section 27-17-2-5
Exception for certain providers and business entities
Status: in_force

Sec. 5. A provider or a business entity owned by at least one (1) provider that contracts with employers or health plans to provide medical services is not required to register under this chapter.

As added by P.L.73-2006, SEC.3.
Ind. Code § 27-4-4-1 — Indiana Code / Title 27 / Article 4 / Chapter 4 / Section 27-4-4-1
Purpose; legislative declaration
Status: in_force

Sec. 1. (a) The purpose of this chapter is to subject certain insurers to the jurisdiction of courts of this state in suits by or on behalf of the insureds or beneficiaries under insurance contracts.

(b) The general assembly declares that it is a subject of concern that many residents of this state hold policies of insurance issued or delivered in this state by insurers while not authorized to do business in this state, thus presenting to such residents the often insuperable obstacle of resorting to distant forums for the purpose of asserting legal rights under such policies. In furtherance of such state interest, the general assembly provides in this chapter a method of substituted service of process upon such insurers and declares that in so doing it exercises its power to protect its residents and to define, for the purpose of this chapter, what constitutes doing business in this state, and also exercises powers and privileges available to the state by virtue of 15 U.S.C. 1011 et seq., which declares that the business of insurance and every person engaged in the business of insurance is subject to the laws of the several states.

Formerly: Acts 1955, c.203, s.1. As amended by P.L.252-1985, SEC.159; P.L.136-2018, SEC.171.
Ind. Code § 27-7-10-15 — Indiana Code / Title 27 / Article 7 / Chapter 10 / Section 27-7-10-15
Premium taxes and taxes on premiums; liability; report of premiums; policy records
Status: in_force

Sec. 15. (a) A risk retention group is liable for the payment of premium taxes and taxes on premiums of direct business for risks resident or located within Indiana, and shall report to the commissioner of this state the net premiums written for risks resident or located within Indiana. A risk retention group that is chartered and licensed in a state other than Indiana is subject to taxation, and any applicable fines and penalties related thereto, on the same basis as a foreign admitted insurer.

(b) A licensed insurance producer who is utilized under section 30 of this chapter in soliciting, negotiating, or procuring liability insurance from a risk retention group that is chartered and licensed in a state other than Indiana shall report to the commissioner the premiums for direct business for risks resident or located within Indiana that the insurance producer has placed with or on behalf of a risk retention group that is not chartered in Indiana.

(c) A licensed insurance producer who is utilized under section 30 of this chapter in soliciting, negotiating, or procuring liability insurance from a risk retention group that is chartered and licensed in a state other than Indiana shall keep a complete and separate record of all policies procured from each such risk retention group. The record kept under this subsection must be open to examination by the commissioner and must, for each policy and each kind of insurance provided, include the following information:

(1) The limit of liability.

(2) The time period covered.

(3) The effective date.

(4) The name of the risk retention group that issued the policy.

(5) The gross premium charged.

(6) The amount of return premiums, if any.

As added by P.L.162-1988, SEC.2. Amended by P.L.178-2003, SEC.49.
Ind. Code § 27-14.5-2-15 — Indiana Code / Title 27 / Article 14.5 / Chapter 2 / Section 27-14.5-2-15
Proceeding pending against mutual insurance company
Status: in_force

Sec. 15. If a proceeding is pending against a mutual insurance company that is the subject of a plan of reorganization under this chapter:

(1) the proceeding may be continued against the reorganized insurer under its former name after the effective date of the reorganization, as if the reorganization had not occurred; or

(2) the reorganized insurer that succeeds to the mutual insurance company's business may be substituted in the proceeding for the mutual insurance company.

As added by P.L.226-2023, SEC.30.
Ind. Code § 27-7-9-17 — Indiana Code / Title 27 / Article 7 / Chapter 9 / Section 27-7-9-17
Authority to adopt rules
Status: in_force

Sec. 17. In order to establish guidelines and procedures necessary to implement this chapter, the commissioner shall have authority to adopt rules pursuant to IC 4-22-2.

As added by P.L.124-1992, SEC.9.
Ind. Code § 27-8-5.7-7 — Indiana Code / Title 27 / Article 8 / Chapter 5.7 / Section 27-8-5.7-7
Permitted forms
Status: in_force

Sec. 7. A provider shall submit only the following forms for payment by an insurer:

(1) CMS-1500.

(2) CMS-1450 (UB-04).

(3) American Dental Association (ADA) claim form.

As added by P.L.162-2001, SEC.5. Amended by P.L.208-2018, SEC.10.
Ind. Code § 27-19-4-12 — Indiana Code / Title 27 / Article 19 / Chapter 4 / Section 27-19-4-12
Navigator continuing education
Status: in_force

Sec. 12. (a) The commissioner:

(1) in consultation with the secretary, shall develop continuing education requirements for navigators; and

(2) may contract with one (1) or more third party organizations to:

(A) develop continuing education materials to meet the requirements developed under subdivision (1);

(B) administer continuing education programs; and

(C) collect nonrefundable continuing education program fees.

(b) All continuing education materials, programs, and fees referred to in subsection (a)(2) must be approved in advance by the commissioner in consultation with the secretary.

(c) The commissioner may require a navigator to complete specific continuing education requirements, as prescribed by the commissioner in consultation with the secretary, as a prerequisite to the authority to perform specific functions with respect to a health benefit exchange.

As added by P.L.278-2013, SEC.27.
Ind. Code § 27-8-24.2-7 — Indiana Code / Title 27 / Article 8 / Chapter 24.2 / Section 27-8-24.2-7
Comparison to other benefits
Status: in_force

Sec. 7. Except as provided in sections 8 and 9 of this chapter, the coverage required under section 5 of this chapter:

(1) may be subject to; and

(2) may not be more restrictive than;

the provisions that apply to other benefits under the policy of accident and sickness insurance.

As added by P.L.109-2008, SEC.2.
Ind. Code § 27-7-2-40 — Indiana Code / Title 27 / Article 7 / Chapter 2 / Section 27-7-2-40
Confidential data; data sharing with department or worker's compensation board
Status: in_force

Sec. 40. The bureau may collect data from its members under this chapter, including:

(1) claims data;

(2) policy data such as policy number, policy term, and employer and employee identification information; and

(3) proof of coverage data such as employer identification information, classification information, carrier information, agency identification information, premium information, and payroll data.

Unless this chapter specifically states otherwise, all data collected by the bureau from its members is confidential and shall not be disclosed or disseminated to third parties unless consented to by the bureau. To the extent this chapter authorizes the bureau to share the data with the department or the worker's compensation board, the data must remain confidential. The department and the worker's compensation board shall not publish the data or distribute the data to third parties.

As added by P.L.275-2013, SEC.20.
Ind. Code § 27-2-24-12 — Indiana Code / Title 27 / Article 2 / Chapter 24 / Section 27-2-24-12
Subrogation rights of insurer
Status: in_force

Sec. 12. This chapter does not affect an insurer's right of subrogation under a policy of property or casualty insurance to recover payments made from the person that is responsible for the property loss.

As added by P.L.148-2017, SEC.8.
Ind. Code § 27-1-36-36 — Indiana Code / Title 27 / Article 1 / Chapter 36 / Section 27-1-36-36
Action by commissioner after regulatory action level event
Status: in_force

Sec. 36. If a regulatory action level event occurs, the commissioner shall:

(1) require the insurer to prepare an RBC plan or, if applicable, a revised RBC plan;

(2) perform such examination or analysis as the commissioner considers necessary of the assets, liabilities, and operations of the insurer, including a review of the insurer's RBC plan or revised RBC plan; and

(3) after the examination or analysis, issue a corrective order specifying the corrective actions that the commissioner determines are required, taking into account relevant factors with respect to the insurer, based upon the commissioner's examination or analysis of the assets, liabilities, and operations of the insurer, including the results of any sensitivity tests undertaken under the RBC instructions.

As added by P.L.186-1996, SEC.1.
Ind. Code § 27-8-1-8 — Indiana Code / Title 27 / Article 8 / Chapter 1 / Section 27-8-1-8
Annual statement; examination
Status: in_force

Sec. 8. Any corporation, association, or society carrying on the business of life or accident insurance on the assessment plan shall submit annually, on or before February 28, under oath, to the insurance commissioner a detailed statement of assets, liabilities, insurance in force, and number of persons upon whom risks are in force on the preceding December 31, and answer such interrogatories as the commissioner, who shall furnish a blank for the purpose, may, under the provisions of this chapter make in order to ascertain its financial character and condition, and shall pay to the commissioner, upon filing such statement, a fee of ten dollars ($10), and the commissioner shall publish such statement in his annual report. For the purpose of verifying such statement, the commissioner shall, on petition of a majority of the officers or of ten (10) members of such association supported by the affidavit of one (1) or more of the petitioners showing the necessity therefor, institute an examination of its affairs to ascertain its true character and condition.

Formerly: Acts 1883, c.136, s.8; Acts 1891, c.189, s.1. As amended by P.L.252-1985, SEC.271.
Ind. Code § 27-6-8-11.5 — Indiana Code / Title 27 / Article 6 / Chapter 8 / Section 27-6-8-11.5
High net worth insureds; financial information
Status: in_force

Sec. 11.5. (a) The association is not obligated to pay a first party claim by a high net worth insured described in section 4(a)(6)(A) of this chapter.

(b) The association has the right to recover from a high net worth insured described in section 4(a)(6)(B) of this chapter all amounts paid by the association to or on behalf of the high net worth insured, regardless of whether the amounts were paid for indemnity, defense, or otherwise.

(c) The association is not obligated to pay a claim that:

(1) would otherwise be a covered claim;

(2) is an obligation to or on behalf of a person who has a net worth greater than the net worth allowed by the insurance guaranty association law of the state of residence of the claimant at the time specified by the applicable law of the state of residence of the claimant; and

(3) has been denied by the association of the state of residence of the claimant on the basis described in subdivision (2).

(d) The association may also, at its sole discretion and without assumption of any ongoing duty to do so, pay any third party claims or cybersecurity insurance obligations covered by a policy or endorsement of an insolvent company on behalf of a high net worth insured. In that case, the association shall recover from the high net worth insured under this section all amounts paid on its behalf, all allocated claim adjusted expenses relating to the claims, the association's attorney's fees, and all court costs in any action necessary to collect the full amount to the association's reimbursement under this section.

(e) The association shall establish reasonable procedures, subject to the approval of the commissioner, for requesting financial information from insureds:

(1) on a confidential basis; and

(2) in the application of this section.

(f) The procedures established under subsection (e) must provide for sharing of the financial information obtained from insureds with:

(1) any other association that is similar to the association; and

(2) the liquidator for an insolvent insurer;

on the same confidential basis.

(g) If an insured refuses to provide financial information that is:

(1) requested under the procedures established under subsection (e); and

(2) available;

the association may, until the time that the financial information is provided to the association, consider the insured to be a high net worth insured for purposes of subsections (a) and (b).

(h) In an action contesting the applicability of this section to an insured that refuses to provide financial information under the procedures established under subsection (e), the insured bears the burden of proof concerning the insured's net worth at the relevant time. If the insured fails to prove that the insured's net worth at the relevant time was less than the applicable amount set forth in section 4(a)(6)(A) or 4(a)(6)(B) of this chapter, the court shall award to the association the association's full costs, expenses, and reasonable attorney's fees incurred in contesting the claim.

As added by P.L.52-2013, SEC.8. Amended by P.L.158-2024, SEC.22; P.L.86-2026, SEC.16.
Ind. Code § 27-1-16.1-9 — Indiana Code / Title 27 / Article 1 / Chapter 16.1 / Section 27-1-16.1-9
Supervising entity registry
Status: in_force

Sec. 9. (a) A supervising entity shall:

(1) maintain a registry of locations described in section 8(b) of this chapter; and

(2) make the registry available for examination by the commissioner during the supervising entity's regular business hours.

(b) The commissioner shall, at least ten (10) days before the examination is conducted, provide to a supervising entity written notice of an examination described in subsection (a).

As added by P.L.81-2013, SEC.3.
Ind. Code § 27-1-24.5-17 — Indiana Code / Title 27 / Article 1 / Chapter 24.5 / Section 27-1-24.5-17
"Third party"
Status: in_force

Sec. 17. As used in this chapter, "third party" means a person other than a:

(1) pharmacy benefit manager; or

(2) covered individual.

As added by P.L.68-2020, SEC.1.
Ind. Code § 27-13-37-1 — Indiana Code / Title 27 / Article 13 / Chapter 37 / Section 27-13-37-1
Enrollees allowed to choose primary care provider from list
Status: in_force

Sec. 1. (a) A health maintenance organization shall allow each enrollee of the health maintenance organization to choose the enrollee's own primary care provider from a list of participating primary care providers within the health maintenance organization.

(b) The list described in subsection (a) shall be updated semiannually and must include a sufficient number of primary care providers that accept new enrollees. The list must be:

(1) provided to each enrollee annually; and

(2) sent to an enrollee at the enrollee's request.

As added by P.L.69-1998, SEC.15.
Ind. Code § 27-15-14-4 — Indiana Code / Title 27 / Article 15 / Chapter 14 / Section 27-15-14-4
Supplemental requirements for modified conversion
Status: in_force

Sec. 4. The requirements of this chapter are in addition to, and may be combined with, any other filings, approvals, or hearings required by IC 27-1-23 or otherwise by law.

As added by P.L.94-1999, SEC.3.
Ind. Code § 27-13-7-23 — Indiana Code / Title 27 / Article 13 / Chapter 7 / Section 27-13-7-23
Step therapy protocol
Status: in_force

Sec. 23. (a) As used in this section, "group contract" refers to a group contract that provides coverage for prescription drugs.

(b) As used in this section, "health maintenance organization" refers to a health maintenance organization that provides coverage for prescription drugs. The term includes the following:

(1) A limited service health maintenance organization.

(2) A person that administers prescription drug benefits on behalf of a health maintenance organization or a limited service health maintenance organization.

(c) As used in this section, "individual contract" refers to an individual contract that provides coverage for prescription drugs.

(d) As used in this section, "preceding prescription drug" means a prescription drug that, according to a step therapy protocol, must be:

(1) first used to treat an enrollee's condition; and

(2) as a result of the treatment under subdivision (1), determined to be inappropriate to treat the enrollee's condition;

as a condition of coverage under an individual contract or a group contract for succeeding treatment with another prescription drug.

(e) As used in this section, "protocol exception" means a determination by a health maintenance organization that, based on a review of a request for the determination and any supporting documentation:

(1) a step therapy protocol is not medically appropriate for treatment of a particular enrollee's condition; and

(2) the health maintenance organization will:

(A) not require the enrollee's use of a preceding prescription drug under the step therapy protocol; and

(B) provide immediate coverage for another prescription drug that is prescribed for the enrollee.

(f) As used in this section, "step therapy protocol" means a protocol that specifies, as a condition of coverage under an individual contract or a group contract, the order in which certain prescription drugs must be used to treat an enrollee's condition.

(g) As used in this section, "urgent care situation" means an enrollee's injury or condition about which the following apply:

(1) If medical care or treatment is not provided earlier than the time frame generally considered by the medical profession to be reasonable for a nonurgent situation, the injury or condition could seriously jeopardize the enrollee's:

(A) life or health; or

(B) ability to regain maximum function;

based on a prudent layperson's judgment.

(2) If medical care or treatment is not provided earlier than the time frame generally considered by the medical profession to be reasonable for a nonurgent situation, the injury or condition could subject the enrollee to severe pain that cannot be adequately managed, based on the enrollee's treating health care provider's judgment.

(h) A health maintenance organization shall publish on the health maintenance organization's Internet web site, and provide to an enrollee in writing, a procedure for the enrollee's use in requesting a protocol exception. The procedure must include the following provisions:

(1) A description of the manner in which an enrollee may request a protocol exception.

(2) That the health maintenance organization shall make a determination concerning a protocol exception request, or an appeal of a denial of a protocol exception request, not more than:

(A) in an urgent care situation, one (1) business day after receiving the request or appeal; or

(B) in a nonurgent care situation, three (3) business days after receiving the request or appeal.

(3) That a protocol exception will be granted if any of the following apply:

(A) A preceding prescription drug is contraindicated or will likely cause an adverse reaction or physical or mental harm to the enrollee.

(B) A preceding prescription drug is expected to be ineffective, based on both of the following:

(i) The known clinical characteristics of the enrollee.

(ii) Known characteristics of the preceding prescription drug, as found in sound clinical evidence.

(C) The enrollee has previously received:

(i) a preceding prescription drug; or

(ii) another prescription drug that is in the same pharmacologic class or has the same mechanism of action as a preceding prescription drug;

and the prescription drug was discontinued due to lack of efficacy or effectiveness, diminished effect, or an adverse event.

(D) Based on clinical appropriateness, a preceding prescription drug is not in the best interest of the enrollee because the enrollee's use of the preceding prescription drug is expected to:

(i) cause a significant barrier to the enrollee's adherence to or compliance with the enrollee's plan of care;

(ii) worsen a comorbid condition of the enrollee; or

(iii) decrease the enrollee's ability to achieve or maintain reasonable functional ability in performing daily activities.

(4) That when a protocol exception is granted, the health maintenance organization shall notify the enrollee and the enrollee's health care provider of the authorization for coverage of the prescription drug that is the subject of the protocol exception.

(5) That if:

(A) a protocol exception request; or

(B) an appeal of a denied protocol exception request;

results in a denial of the protocol exception, the health maintenance organization shall provide to the enrollee and the treating health care provider notice of the denial, including a detailed, written explanation of the reason for the denial and the clinical rationale that supports the denial.

(6) That the insurer may request a copy of relevant documentation from the insured's medical record in support of a protocol exception.

As added by P.L.19-2016, SEC.5.
Ind. Code § 27-1-51-5 — Indiana Code / Title 27 / Article 1 / Chapter 51 / Section 27-1-51-5
"Health care service"
Status: in_force

Sec. 5. As used in this chapter, "health care service" means a service or good furnished for the purpose of preventing, alleviating, curing, or healing:

(1) human illness;

(2) physical disability; or

(3) injury.

As added by P.L.237-2025, SEC.10.
Ind. Code § 27-15-11-2 — Indiana Code / Title 27 / Article 15 / Chapter 11 / Section 27-15-11-2
Preparation of written plan of operation
Status: in_force

Sec. 2. The converting mutual shall prepare a written plan of operation for the closed block, consistent with the requirements of this article.

As added by P.L.94-1999, SEC.3.
Ind. Code § 27-1-2.3-2.8 — Indiana Code / Title 27 / Article 1 / Chapter 2.3 / Section 27-1-2.3-2.8
"Clean claim"
Status: in_force

Sec. 2.8. As used in this chapter, "clean claim" means a claim for payment for ambulance service:

(1) that is submitted to a health plan by an ambulance service provider; and

(2) about which there is no defect, impropriety, or particular circumstance requiring special treatment that may prevent or delay payment.

As added by P.L.163-2024, SEC.5.
Ind. Code § 27-8-28-2 — Indiana Code / Title 27 / Article 8 / Chapter 28 / Section 27-8-28-2
"Commissioner"
Status: in_force

Sec. 2. As used in this chapter, "commissioner" refers to the insurance commissioner appointed under IC 27-1-1-2.

As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13. Amended by P.L.1-2002, SEC.113.
Ind. Code § 27-8-15-27 — Indiana Code / Title 27 / Article 8 / Chapter 15 / Section 27-8-15-27
Application in conformity with act; compliance
Status: in_force

Sec. 27. (a) This section shall be applied in conformity with the requirements of the federal Patient Protection and Affordable Care Act (P.L. 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (P.L. 111-152), as in effect on September 23, 2010.

(b) A health insurance plan provided by a small employer insurer to a small employer must comply with the following:

(1) The benefits provided by a plan to an eligible employee enrolled in the plan may not be excluded, limited, or denied for more than nine (9) months after the effective date of the coverage because of a preexisting condition of the eligible employee, the eligible employee's spouse, or the eligible employee's dependent.

(2) The plan may not define a preexisting condition, rider, or endorsement more restrictively than as a condition for which medical advice, diagnosis, care, or treatment was recommended or received during the six (6) months immediately preceding the effective date of enrollment in the plan.

As added by P.L.93-1995, SEC.15. Amended by P.L.91-1998, SEC.18; P.L.160-2011, SEC.20.
Ind. Code § 27-7-18-16 — Indiana Code / Title 27 / Article 7 / Chapter 18 / Section 27-7-18-16
Prohibition on rejecting provider based on nonparticipation
Status: in_force

Sec. 16. When entering into a provider network contract with providers, a contracting entity shall not reject a provider as a party to the provider network contract because the provider chooses or has chosen under section 11(b)(1)(A) of this chapter not to participate in third party access.

As added by P.L.17-2024, SEC.19.
Ind. Code § 27-14.5-4-10 — Indiana Code / Title 27 / Article 14.5 / Chapter 4 / Section 27-14.5-4-10
Amendment of articles of incorporation under plan of reorganization
Status: in_force

Sec. 10. (a) Except as otherwise provided in this article and subject to subsection (b), the amendment of the articles of incorporation of a mutual insurance company under a plan under this article must be conducted in compliance with IC 27-1-8.

(b) The commissioner, the attorney general, and the secretary of state shall:

(1) examine; and

(2) if warranted, approve;

the proposed articles of amendment before the amended articles are submitted to the members for approval.

As added by P.L.226-2023, SEC.30.
Ind. Code § 27-8-5.8-2 — Indiana Code / Title 27 / Article 8 / Chapter 5.8 / Section 27-8-5.8-2
"Commissioner" defined
Status: in_force

Sec. 2. As used in this chapter, "commissioner" means the insurance commissioner appointed under IC 27-1-1-2.

As added by P.L.230-2001, SEC.2.
Ind. Code § 27-1-24.5-7 — Indiana Code / Title 27 / Article 1 / Chapter 24.5 / Section 27-1-24.5-7
"Maximum allowable cost"
Status: in_force

Sec. 7. As used in this chapter, "maximum allowable cost" means the maximum amount that a pharmacy benefit manager will reimburse a pharmacy for the cost of a generic drug. The term does not include a dispensing fee or professional fee.

As added by P.L.68-2020, SEC.1. Amended by P.L.32-2021, SEC.76.
Ind. Code § 27-8-19.8-24.8 — Indiana Code / Title 27 / Article 8 / Chapter 19.8 / Section 27-8-19.8-24.8
Applicability of IC 16-39 to release of insured's medical records
Status: in_force

Sec. 24.8. IC 16-39 applies to the release of an insured's medical records under this chapter.

As added by P.L.32-1998, SEC.29.
Ind. Code § 27-1-7-2 — Indiana Code / Title 27 / Article 1 / Chapter 7 / Section 27-1-7-2
Capacity and authority to act; general rights, privileges, and powers; excluded powers
Status: in_force

Sec. 2. (a) Every corporation has the capacity to act that is possessed by natural persons, but has the authority to perform only those acts that are necessary, convenient, or expedient to accomplish the purposes for which it is formed and that are not repugnant to law.

(b) Subject to any limitations or restrictions imposed by law or the articles of incorporation, each corporation has the following general rights, privileges, and powers:

(1) To continue as a corporation, under its corporate name, for the period set forth in its articles of incorporation.

(2) To sue and be sued in its corporate name.

(3) To have a corporate seal and to alter the same at pleasure.

(4) To acquire, own, hold, lease, mortgage, pledge, convey, or otherwise dispose of property, real and personal, tangible and intangible.

(5) To acquire, subscribe for, own, hold, vote, mortgage, lend, pledge, convey, or otherwise dispose of, and to guarantee or otherwise deal in and with, shares or other interests in, or obligations of, any entity, including itself, except as otherwise prohibited or limited by this article.

(6) To be a promoter, partner, member, associate, or manager of any partnership, joint venture, trust, or other entity.

(7) To borrow money, and to issue its notes or debentures to evidence such borrowings, but any debentures so issued shall be subordinate to the rights of policyholders, members, or creditors of such corporations.

(8) To conduct business in this state and elsewhere; to have one (1) or more offices out of this state; to acquire, own, hold and use, and to lease, mortgage, pledge, sell, convey, or otherwise dispose of property, real and personal, tangible and intangible, out of this state.

(9) To appoint such officers and agents as the business of the corporation may require, and to define their duties and fix their compensation.

(10) To lend money, invest and reinvest its funds, and receive and hold real estate and personal property as security for repayment, except as otherwise limited in this title.

(11) To pay pensions and establish and administer pension plans, pension trusts, profit sharing plans, share bonus plans, share option plans, welfare plans, qualified and nonqualified retirement plans, and benefit or incentive plans for any or all of its current or former directors, officers, employees, and agents.

(12) To make donations for the public welfare or for charitable, scientific, or education purposes.

(13) To make bylaws for the government and regulation of its affairs.

(14) To cease doing business and to dissolve and surrender its corporate franchise and authority and license to transact an insurance business in this state.

(15) To do all acts and things necessary, convenient, or expedient to carry out the purposes for which it is formed.

(16) To become a member of any federal home loan bank; to purchase stock in a federal home loan bank, to borrow money or obtain advances from any such bank and to transfer, assign, and pledge property to or with such bank as security for the payment of such loans or advances, to do and perform all acts required of members of a federal home loan bank, and to possess and exercise all rights, powers, and privileges conferred upon such members under the provisions of the act of Congress entitled Federal Home Loan Bank Act.

(c) No corporation shall, by any implication or construction, be deemed to possess the power of carrying on the business of receiving deposits of money, bullion, or foreign coins, or receiving deposits of securities or other personal property from any person or corporation or acting as a safe deposit company, or of issuing bills, notes, or other evidences of debt for circulation as money.

(d) A corporation that is a stock company may establish one (1) or more procedures by which it regulates transactions that would, when consummated, result in a change of control of such corporation.

(e) For purposes of this section "control" means:

(1) for any corporation having one hundred (100) or more shareholders, the beneficial ownership, or the direct or indirect power to direct the voting, of no less than ten percent (10%) of the voting shares of a corporation's outstanding voting shares; or

(2) for any corporation having fewer than one hundred (100) shareholders, the beneficial ownership, or the direct or indirect power to direct the voting, of no less than fifty percent (50%) of the voting shares of the corporation's outstanding voting shares.

(f) A procedure established under this section may be adopted:

(1) in a corporation's original articles of incorporation or bylaws;

(2) by amending the articles of incorporation; or

(3) notwithstanding that a vote of the shareholders would otherwise be required by any other provision of this article or the articles of incorporation for the adoption or implementation of all or any portion of the procedure, by amending the bylaws.

Formerly: Acts 1935, c.162, s.80; Acts 1939, c.63, s.1; Acts 1973, P.L.271, SEC.1. As amended by P.L.266-1987, SEC.1; P.L.136-2018, SEC.148.
Ind. Code § 27-1-12.3-3 — Indiana Code / Title 27 / Article 1 / Chapter 12.3 / Section 27-1-12.3-3
Variable interest rate loans; duties of insurer
Status: in_force

Sec. 3. With respect to variable interest rate loans under section 2 of this chapter, the insurer shall:

(1) notify the policyholder at the time a cash loan is made of the initial rate of interest on the loan;

(2) notify the policyholder as soon as is reasonably practical after a premium loan is made of the initial rate of interest on the loan, except that notice need not be given the policyholder when a further premium loan is added other than the notice required by subdivision (3) of this section;

(3) send to the policyholder reasonable advance notice of any increase in the loan interest rate; and

(4) include in the notices required by this section, whether the rate is fixed or variable and, if variable, the permitted frequency of change.

As added by Acts 1981, P.L.240, SEC.1.
Ind. Code § 27-13-3-1 — Indiana Code / Title 27 / Article 13 / Chapter 3 / Section 27-13-3-1
Satisfaction of requirements
Status: in_force

Sec. 1. After receiving a completed application, the commissioner shall issue a certificate of authority to operate a health maintenance organization to the applicant if:

(1) the application fee is received by the commissioner; and

(2) the commissioner is satisfied that the following requirements are met:

(A) The persons responsible for the conduct of the affairs of the applicant are competent, trustworthy, and have good reputations.

(B) The health maintenance organization will effectively provide or arrange for the provision of the health care services covered in the health maintenance organization's individual and group contracts on a prepaid basis, through insurance or other means, except to the extent of reasonable requirements for copayments and deductibles.

(C) The health maintenance organization complies with IC 27-13-12 through IC 27-13-19.

As added by P.L.26-1994, SEC.25.
Ind. Code § 27-17-2-4 — Indiana Code / Title 27 / Article 17 / Chapter 2 / Section 27-17-2-4
Exception for certain providers providing discounted prices
Status: in_force

Sec. 4. This article does not require a provider that provides discounted prices for medical services to the provider's patients to be registered under this chapter.

As added by P.L.73-2006, SEC.3.
Ind. Code § 27-1-7.5-10 — Indiana Code / Title 27 / Article 1 / Chapter 7.5 / Section 27-1-7.5-10
Advancement of expenses before final disposition; conditions
Status: in_force

Sec. 10. (a) A corporation may pay for or reimburse the reasonable expenses incurred by a director who is a party to a proceeding in advance of final disposition of the proceeding if:

(1) the director furnishes the corporation a written affirmation of the director's good faith belief that the director has met the standard of conduct described in section 8 of this chapter;

(2) the director furnishes the corporation a written undertaking, executed personally or on the director's behalf, to repay the advance if it is ultimately determined that the director did not meet the standard of conduct; and

(3) a determination is made that the facts then known to those making the determination would not preclude indemnification under this chapter.

(b) The undertaking required by subsection (a)(2) must be an unlimited general obligation of the director but need not be secured and may be accepted without reference to financial ability to make repayment.

(c) Determinations and authorizations of payments under this section shall be made in the manner specified in section 12 of this chapter.

As added by P.L.266-1987, SEC.6.
Ind. Code § 27-13-1-33 — Indiana Code / Title 27 / Article 13 / Chapter 1 / Section 27-13-1-33
"Subscriber premiums"
Status: in_force

Sec. 33. "Subscriber premiums" means money or any other thing of value paid or given in consideration to a health maintenance organization, agent, or solicitor on account of or in connection with a contract under which a health maintenance organization provides or arranges for the delivery of health care benefits to enrollees.

As added by P.L.26-1994, SEC.25.
Ind. Code § 27-1-12.5-9 — Indiana Code / Title 27 / Article 1 / Chapter 12.5 / Section 27-1-12.5-9
Allowance for lapse of time and payment of scheduled considerations
Status: in_force

Sec. 9. Under any annuity contract with fixed scheduled considerations, any paid-up annuity, cash surrender or death benefits available at any time, other than on the contract anniversary, shall be calculated with allowance for the lapse of time and the payment of any scheduled considerations beyond the beginning of the contract year in which cessation of payment of considerations under the contract occurs.

As added by Acts 1977, P.L.286, SEC.1.
Ind. Code § 27-16-4-7 — Indiana Code / Title 27 / Article 16 / Chapter 4 / Section 27-16-4-7
Rules
Status: in_force

Sec. 7. The department shall adopt rules under IC 4-22-2 to provide for registration of a PEO without compliance with this chapter and IC 27-16-6 by the commissioner's acceptance of an affidavit or a certification:

(1) provided by a bonded, independent, and qualified assurance organization that has been approved by the commissioner; and

(2) that certifies the qualifications of a professional employer organization.

As added by P.L.245-2005, SEC.7.
Ind. Code § 27-1-3.5-14 — Indiana Code / Title 27 / Article 1 / Chapter 3.5 / Section 27-1-3.5-14
Exemption application; hearing
Status: in_force

Sec. 14. (a) In response to a written application from a domestic insurer, the commissioner may grant an exemption from compliance with this chapter if the commissioner finds, upon review of the application, that compliance with this chapter would constitute a financial or an organizational hardship upon the domestic insurer. An exemption may be granted at any time for a specified period.

(b) Within ten (10) days after the denial of a domestic insurer's written request for an exemption from this chapter, the insurer may, in writing, request a hearing on its application for an exemption. The hearing shall be held under IC 4-21.5.

As added by P.L.244-1989, SEC.2. Amended by P.L.251-1995, SEC.14.
Ind. Code § 27-4-5-3 — Indiana Code / Title 27 / Article 4 / Chapter 5 / Section 27-4-5-3
Injunction
Status: in_force

Sec. 3. Whenever the commissioner believes, from evidence satisfactory to the commissioner, that any insurer is violating or about to violate the provisions of section 2 of this chapter, the commissioner may cause a complaint to be filed in the circuit or superior court to enjoin and restrain such insurer from continuing such violation or engaging in the violation or doing any act in furtherance of the violation. The court shall have jurisdiction of the proceeding and shall have the power to make and enter an order or judgment awarding preliminary or final injunctive relief as in its judgment is proper.

Formerly: Acts 1969, c.194, s.3. As amended by P.L.252-1985, SEC.166; P.L.255-1995, SEC.5; P.L.136-2018, SEC.176.
Ind. Code § 27-1-18-4 — Indiana Code / Title 27 / Article 1 / Chapter 18 / Section 27-1-18-4
Amended certificate of authority
Status: in_force

Sec. 4. (a) Any foreign or alien corporation admitted to do business in this state may alter or enlarge the character of the business which it is authorized to transact in this state under its articles of incorporation or association, and any amendments thereof filed with the department as provided in section 3 of this chapter, by procuring an amended certificate of authority from the department in the manner provided in subsection (b).

(b) Whenever a foreign or alien corporation desires to procure such amended certificate, it shall present to the department at its office, accompanied by the fees prescribed by law, an application for an amended certificate of authority, setting forth the change desired in the kind or kinds of insurance business under its articles of incorporation or association which it intends to thereafter carry on in this state; the application shall be filed in the form prescribed by the department by the president or a vice president and the secretary or an assistant secretary of the corporation, and verified by the oaths of the officers signing the same.

(c) Upon the presentation of such application, accompanied by the corporation's certificate of authority, the department, if it finds that it conforms to law and that the foreign or alien company has fulfilled the requirements set forth in subsection (b) and in section 3 of this chapter, may endorse its approval upon the application, and, in case of the approval of such application and when all fees required by law shall have been paid, shall file one (1) copy of the application in its office, cancel the certificate of authority presented with the application, and issue to the corporation a new certificate of authority, which certificate shall set forth the kind or kinds of business that the corporation is authorized thereafter to transact in this state, which shall be accompanied by one (1) copy of the application bearing the endorsement of the approval of the department.

(d) Upon the issuance of the new certificate of authority by the department, the corporation named in the certificate of authority shall have authority thereafter to transact in this state the kind or kinds of insurance business set forth in such certificate, subject to the terms and conditions prescribed in this article.

Formerly: Acts 1935, c.162, s.237. As amended by P.L.252-1985, SEC.79; P.L.11-2011, SEC.15; P.L.136-2018, SEC.163.
Ind. Code § 27-1-12.8-33 — Indiana Code / Title 27 / Article 1 / Chapter 12.8 / Section 27-1-12.8-33
Accident and sickness insurance contracts
Status: in_force

Sec. 33. The following apply to accident and sickness insurance contracts:

(1) For accident and sickness insurance contracts issued on or after the operative date of the valuation manual, the standard prescribed in the valuation manual is the minimum standard of valuation required under section 20 of this chapter.

(2) For accident and sickness insurance contracts issued before the operative date of the valuation manual, the minimum standard of valuation is the standard adopted by the commissioner in rules adopted under IC 4-22-2.

As added by P.L.276-2013, SEC.10.
Ind. Code § 27-13-7-4 — Indiana Code / Title 27 / Article 13 / Chapter 7 / Section 27-13-7-4
Compliance with requirements; ten day grace period
Status: in_force

Sec. 4. (a) An individual contract must comply with all provisions of section 3(a) of this chapter and provide for a period of ten (10) days during which the individual entering into the contract with the health maintenance organization may:

(1) examine the contract; and

(2) if the individual decides, return the contract to the health maintenance organization and obtain a refund of the premium paid.

(b) If:

(1) services were received during the ten (10) day period referred to in subsection (a); and

(2) the individual returns the contract to receive a refund of the premium paid;

the individual must pay for the services received during the ten (10) day period.

As added by P.L.26-1994, SEC.25.
Ind. Code § 27-1-40-5 — Indiana Code / Title 27 / Article 1 / Chapter 40 / Section 27-1-40-5
Certificate of authority for United States branch; requirements
Status: in_force

Sec. 5. (a) The commissioner shall require a United States branch to do the following before granting the United States branch a certificate of authority to transact insurance business as described in section 3(1) of this chapter:

(1) Comply with this chapter and any other requirement of this title.

(2) Submit the following:

(A) A copy of the current charter and bylaws of the alien company that intends to transact business through the United States branch and any other documents determined by the commissioner to be necessary to provide evidence of the kinds of insurance business that the alien company is authorized to transact. Documents submitted under this clause must be attested to as accurate by the insurance supervisory official in the alien company's domiciliary jurisdiction.

(B) A full statement, subscribed and affirmed as true under penalty of perjury by two (2) officers or equivalent responsible representatives of the alien company in a manner prescribed by the commissioner, of the alien company's financial condition as of the close of the alien company's latest fiscal year, showing the alien company's:

(i) assets;

(ii) liabilities;

(iii) income disbursements;

(iv) business transacted; and

(v) other facts required to be shown in the alien company's annual statement reported to the insurance supervisory official in the alien company's domiciliary jurisdiction.

(C) An English translation, if necessary, of any document submitted under this subdivision.

(3) Submit to an examination of the affairs of the alien company that intends to transact business through the United States branch at the alien company's principal office in the United States. However, the commissioner may accept a report of the insurance supervisory official in the alien company's domiciliary jurisdiction in lieu of the examination required under this subdivision.

(b) The commissioner may at any time hire, at a United States branch's expense, any independent experts that the commissioner considers necessary to implement this chapter with respect to the United States branch.

As added by P.L.173-2007, SEC.20.
Ind. Code § 27-13-7-26 — Indiana Code / Title 27 / Article 13 / Chapter 7 / Section 27-13-7-26
Coverage for pediatric neuropsychiatric disorders
Status: in_force

Sec. 26. (a) An individual contract and a group contract must provide coverage for treatment of:

(1) pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS); and

(2) pediatric acute-onset neuropsychiatric syndrome (PANS);

including treatment with intravenous immunoglobulin therapy.

(b) The coverage required by this section may not be subject to annual or lifetime limitation, deductible, copayment, or coinsurance provisions that are more restrictive than the annual or lifetime limitation, deductible, copayment, or coinsurance provisions that apply generally under the individual contract or group contract.

As added by P.L.130-2020, SEC.16.
Ind. Code § 27-2-8-1 — Indiana Code / Title 27 / Article 2 / Chapter 8 / Section 27-2-8-1
List of motor vehicle insurers agreeable to meeting state standards
Status: in_force

Sec. 1. The insurance commissioner shall annually forward to all departments and divisions of the state requiring the posting of security because of motor vehicle accidents and resultant damage and loss a list of those insurers which are, or which are agreeable to be, examined by the insurance department in the same manner as set out in IC 27-1-3-7 and IC 27-1-3.1, and set up and maintain liabilities and reserves in the same manner as set out in IC 27-1-13-8, and submit a written statement of their financial condition and their operations on the forms as prescribed by the NAIC and adopted in rules adopted under IC 4-22-2 by the insurance commissioner, and in the same manner as set out in IC 27-1-3-7 and IC 27-1-20-21. No certificates or policies shall be accepted by such departments or divisions as such security unless the insurer so filing the certificate or policy shall have met or is agreeable to meeting the requirements as set out above.

Formerly: Acts 1949, c.240, s.1. As amended by P.L.252-1985, SEC.129; P.L.26-1991, SEC.24; P.L.124-2018, SEC.62.
Ind. Code § 27-2-21-16 — Indiana Code / Title 27 / Article 2 / Chapter 21 / Section 27-2-21-16
Requirements for insurer use of credit information
Status: in_force

Sec. 16. (a) An insurer that uses credit information to underwrite or rate risks shall not do the following:

(1) Use an insurance score that is calculated using income, gender, address, ZIP code, ethnic group, religion, marital status, or nationality of the consumer as a factor.

(2) Deny, cancel, or decline to renew a personal insurance policy solely on the basis of credit information.

(3) Base an insured's renewal rate for a personal insurance policy solely on credit information.

(4) Take an adverse action against a consumer solely because the consumer does not have a credit card account.

(5) Consider an absence of credit information or an inability to calculate an insurance score in underwriting or rating a personal insurance policy, unless the insurer does one (1) of the following:

(A) Presents to the commissioner information that the absence or inability relates to the risk for the insurer and treats the consumer as approved by the commissioner.

(B) Treats the consumer as if the consumer had neutral credit information, as defined by the insurer.

(6) Take an adverse action against a consumer based on credit information unless the insurer obtains and uses:

(A) a credit report issued; or

(B) an insurance score calculated;

not more than ninety (90) days before the date the personal insurance policy is first written or the renewal is issued.

(7) Use the following as a negative factor in an insurance scoring methodology or in reviewing credit information for the purpose of underwriting or rating a personal insurance policy:

(A) A credit inquiry:

(i) not initiated by the consumer; or

(ii) requested by the consumer for the consumer's own credit information.

(B) A credit inquiry relating to insurance coverage.

(C) A late payment or a collection account with a medical industry code on the consumer's credit report.

(D) Multiple lender inquiries:

(i) coded by the consumer reporting agency on the consumer's credit report as being from the home mortgage industry; and

(ii) made within thirty (30) days of one another.

(E) Multiple lender inquiries:

(i) coded by the consumer reporting agency on the consumer's credit report as being from the automobile lending industry; and

(ii) made within thirty (30) days of one another.

(b) An insurer that uses credit information to underwrite or rate risks shall, at annual renewal upon the request of an insured or an insured's agent, re-underwrite and re-rate the insured's personal insurance policy based on a current credit report or insurance score unless one (1) of the following applies:

(1) The insurer's treatment of the consumer is otherwise approved by the commissioner.

(2) The insured is in the most favorably priced tier of the insurer, within a group of affiliated insurers.

(3) Credit information was not used for underwriting or rating the insured when the personal insurance policy was initially written.

(4) The insurer reevaluates the insured at least every thirty-six (36) months after a personal insurance policy is issued based on underwriting or rating factors other than credit information.

(5) The insurer has re-underwritten and re-rated the insured's personal insurance policy based on a credit report obtained or an insurance score recalculated less than twelve (12) months before the date of the request by the insured or the insured's agent.

(c) An insurer that uses credit information to underwrite or rate risks may obtain current credit information upon the renewal of a personal insurance policy when renewal occurs more frequently than every thirty-six (36) months if consistent with the insurer's underwriting guidelines.

As added by P.L.201-2003, SEC.1. Amended by P.L.84-2009, SEC.1.
Ind. Code § 27-5.1-1-2 — Indiana Code / Title 27 / Article 5.1 / Chapter 1 / Section 27-5.1-1-2
"Assessment"
Status: in_force

Sec. 2. "Assessment" means an amount or a policyholder's share of an amount that a farm mutual insurance company determines is necessary for any of the following:

(1) To pay the farm mutual insurance company's accrued liabilities.

(2) To meet or defray the farm mutual insurance company's anticipated needs.

(3) To add to or restore the policyholder surplus of the farm mutual insurance company.

As added by P.L.129-2003, SEC.8.
Ind. Code § 27-1-29-27.1 — Indiana Code / Title 27 / Article 1 / Chapter 29 / Section 27-1-29-27.1
Repealed
Status: repealed

As added by P.L.5-1996, SEC.19. Repealed by P.L.177-2011, SEC.5.
Ind. Code § 27-1-45.2-11 — Indiana Code / Title 27 / Article 1 / Chapter 45.2 / Section 27-1-45.2-11
Notice; good faith negotiation
Status: in_force

Sec. 11. (a) If, during any ninety (90) day period, an initiating party submits requests for independent dispute resolutions that, in the aggregate, include twenty-five (25) or more qualified disputes, the health carrier may:

(1) provide written notice to the out of network provider and the facility that includes:

(A) a description of the independent dispute resolution requests that are the basis for the notice, including applicable dates of service;

(B) identification of the party involved, including the name and tax identification number, if known;

(C) the name and contact information of a representative authorized to negotiate on behalf of the health carrier; and

(D) the requirement to participate in a conference and good faith negotiation; and

(2) deliver the notice to the out of network provider and the facility by:

(A) electronic mail; and

(B) certified mail.

(b) If a health carrier provides notice under subsection (a), the health carrier, the out of network provider, and the facility shall engage in good faith efforts to negotiate a resolution not later than thirty (30) days after the notice is provided, including:

(1) at least one (1) conference between authorized representatives; and

(2) a reasonable exchange of information necessary to evaluate and address the conduct described in the notice.

(c) A conference under subsection (b) may not:

(1) adjudicate individual claims;

(2) alter rights or obligations under federal or state law; or

(3) occur more than once per calendar quarter.

As added by P.L.119-2026, SEC.1.
Ind. Code § 27-1-24.2-16 — Indiana Code / Title 27 / Article 1 / Chapter 24.2 / Section 27-1-24.2-16
Prohibited actions
Status: in_force

Sec. 16. (a) Except as provided in section 15 of this chapter, with respect to the provision of pharmacy or pharmacist services under a health plan, an insurer, a pharmacy benefit manager, or any other administrator of pharmacy benefits may not:

(1) prohibit a pharmacy or pharmacist from, or impose a penalty on a pharmacy or pharmacist for:

(A) selling a lower cost alternative to an insured, if a lower cost alternative is available; or

(B) providing information to an insured under subsection (c);

(2) discriminate against any pharmacy or pharmacist that is:

(A) located within the geographic coverage area of the health plan; and

(B) willing to agree to, or accept, terms and conditions established for participation in the insurer's, pharmacy benefit manager's, other administrator's, or health plan's network;

(3) impose limits, including quantity limits or refill frequency limits, on an insured's access to medication from a pharmacy that are more restrictive than those existing for a pharmacy affiliate;

(4) except as provided in subsection (b), require an insured to receive pharmacy or pharmacist services from a pharmacy affiliate, including:

(A) requiring an insured to obtain a specialty drug from a pharmacy affiliate; and

(B) charging less cost sharing to insureds that use pharmacy affiliates than what is charged to insureds that use nonaffiliated pharmacies;

(5) require a pharmacy or pharmacist to enter into an additional contract with an affiliate of the insurer, pharmacy benefit manager, or other administrator of pharmacy benefits as a condition of entering into a contract with this insurer, pharmacy benefit manager, or administrator; or

(6) require a pharmacy or pharmacist to, as a condition of a contract, agree to payment rates for any affiliate of the insurer, pharmacy benefit manager, or other administrator of pharmacy benefits that is not a party to the contract.

(b) Subsection (a)(4):

(1) does not apply to a mail order pharmacy; and

(2) may not be construed to prohibit:

(A) communications to insureds regarding networks and prices if the communication is accurate and includes information about all eligible nonaffiliated pharmacies; or

(B) an insurer, a pharmacy benefit manager, or any other administrator of pharmacy benefits from providing financial incentives for utilizing the network, if the insurer, pharmacy benefit manager, or other administrator complies with this section and section 14 of this chapter.

(c) A pharmacist shall have the right to provide an insured with information regarding lower cost alternatives to assist the insured in making informed decisions.

As added by P.L.189-2025, SEC.1.
Ind. Code § 27-8-28-13 — Indiana Code / Title 27 / Article 8 / Chapter 28 / Section 27-8-28-13
Notice of grievance related information
Status: in_force

Sec. 13. (a) An insurer shall provide, at the request of the insured, covered individual, or legal representative of the insured or covered individual, and upon policy issuance, at each policy renewal, and with any notice of denial of a claim, timely, adequate, and appropriate notice to each insured, covered individual, or legal representative, of:

(1) the grievance procedure required under this chapter;

(2) the external grievance procedure required under IC 27-8-29;

(3) information on how to file:

(A) a grievance under this chapter; and

(B) a request for an external grievance review under IC 27-8-29;

(4) a toll free telephone number through which a covered individual may contact the insurer at no cost to the covered individual to obtain information and to file grievances; and

(5) the address for the Internet web site established by the department under IC 27-1-3-33.

(b) An insurer shall prominently display on all notices to covered individuals the toll free telephone number and the address at which a grievance or request for external grievance review may be filed.

As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13. Amended by P.L.18-2016, SEC.2.
Ind. Code § 27-10-1-2 — Indiana Code / Title 27 / Article 10 / Chapter 1 / Section 27-10-1-2
"All lines fire and casualty insurance producer"
Status: in_force

Sec. 2. "All lines fire and casualty insurance producer" means an insurance producer who holds a valid license issued by the department of insurance to engage in the writing and transacting of all of the following lines and kinds of insurance:

(1) Property insurance.

(2) Casualty insurance.

(3) Surety insurance.

(4) Disability insurance.

(5) Inland marine insurance.

As added by P.L.261-1985, SEC.1. Amended by P.L.178-2003, SEC.80.
Ind. Code § 27-7-14-7 — Indiana Code / Title 27 / Article 7 / Chapter 14 / Section 27-7-14-7
Provision of group motor vehicle insurance policy
Status: in_force

Sec. 7. An insurer that is authorized under IC 27-1-3-20 to:

(1) transact business as a casualty insurance company; and

(2) offer motor vehicle insurance;

may provide a group motor vehicle insurance policy.

As added by P.L.146-2015, SEC.31.
Ind. Code § 27-8-5.5-1 — Indiana Code / Title 27 / Article 8 / Chapter 5.5 / Section 27-8-5.5-1
Definitions
Status: in_force

Sec. 1. As used in this chapter:

(a) "Commissioner" means the insurance commissioner of Indiana.

(b) "Accident and sickness insurance" means any policy or contract of insurance described in classes 1(b), 2(a), 2(b), or 2(l), as defined in IC 27-1-5-1.

As added by Acts 1977, P.L.288, SEC.1.
Ind. Code § 27-5.1-2-37 — Indiana Code / Title 27 / Article 5.1 / Chapter 2 / Section 27-5.1-2-37
Policy cancellation; notice
Status: in_force

Sec. 37. (a) A farm mutual insurance company may cancel, in whole or in part, a policyholder's insurance policy after giving the policyholder written notice of the cancellation as follows:

(1) The written notice must be delivered or mailed to the policyholder at the last known address of the policyholder.

(2) The written notice must specify the effective date of the cancellation.

(3) Upon request of the policyholder, the written notice must be accompanied by a written explanation of the specific reasons for the cancellation.

(b) A farm mutual insurance company shall provide the written notice specified in subsection (a) at least:

(1) ten (10) days before canceling the insurance policy, if the cancellation is for nonpayment of premium;

(2) twenty (20) days before canceling the insurance policy, if the cancellation occurs more than sixty (60) days after the date of issuance of the policy; and

(3) ten (10) days before canceling the insurance policy, if the cancellation occurs less than sixty-one (61) days after the date of issuance of the policy.

(c) If the insurance policy was procured by an independent insurance producer licensed in Indiana, the farm mutual insurance company shall deliver or mail notice of cancellation to the insurance producer not less than ten (10) days before the farm mutual insurance company delivers or mails the notice to the policyholder, unless the obligation to notify the insurance producer is waived in writing by the insurance producer.

As added by P.L.129-2003, SEC.8.
Ind. Code § 27-8-19.8-3 — Indiana Code / Title 27 / Article 8 / Chapter 19.8 / Section 27-8-19.8-3
"Insured" defined
Status: in_force

Sec. 3. As used in this chapter, "insured" refers to an individual whose life is the subject of insurance under a life insurance policy or contract.

As added by P.L.130-1994, SEC.47 and P.L.116-1994, SEC.70. Amended by P.L.32-1998, SEC.2; P.L.223-2005, SEC.4.
Ind. Code § 27-13-10.1-1 — Indiana Code / Title 27 / Article 13 / Chapter 10.1 / Section 27-13-10.1-1
External grievance procedure established
Status: in_force

Sec. 1. A health maintenance organization shall establish and maintain an external grievance procedure for the resolution of grievances regarding the following:

(1) The following determinations made by the health maintenance organization or an agent of the health maintenance organization regarding a service proposed by the treating physician:

(A) An adverse utilization review determination (as defined in IC 27-8-17-8).

(B) An adverse determination of medical necessity.

(C) A determination that a proposed service is experimental or investigational.

(2) The health maintenance organization's decision to rescind an individual contract or a group contract.

As added by P.L.133-1999, SEC.7. Amended by P.L.160-2011, SEC.28.
Ind. Code § 27-8-30-3 — Indiana Code / Title 27 / Article 8 / Chapter 30 / Section 27-8-30-3
Allowing an insurer to report the number of covered children who are prescribed a stimulant medication for the treatment of certain disorders
Status: in_force

Sec. 3. An insurer that issues an accident and sickness insurance policy may report to the drug utilization review board established by IC 12-15-35-19 the number of covered individuals who are:

(1) less than eighteen (18) years of age; and

(2) prescribed a stimulant medication approved by the federal Food and Drug Administration for the treatment of attention deficit disorder or attention deficit hyperactivity disorder.

As added by P.L.107-2002, SEC.29.
Ind. Code § 27-1-25-7 — Indiana Code / Title 27 / Article 1 / Chapter 25 / Section 27-1-25-7
Payment of claims
Status: in_force

Sec. 7. All claims paid by an administrator from funds collected on behalf of an insurer shall be paid:

(1) by draft or check; or

(2) via electronic payment;

as authorized by the insurer.

As added by Acts 1980, P.L.168, SEC.2. Amended by Acts 1982, P.L.165, SEC.5; P.L.160-2003, SEC.11; P.L.130-2020, SEC.5.
Ind. Code § 27-1-7-3 — Indiana Code / Title 27 / Article 1 / Chapter 7 / Section 27-1-7-3
Principal office; change of location
Status: in_force

Sec. 3. Each corporation shall maintain an office or place of business in this state, to be known as the "Principal Office." The post-office address of the principal office shall be stated in the original articles of incorporation at the time of incorporating. Thereafter, the location of the principal office, may be changed at any time or from time to time when authorized by the board of directors by:

(1) filing with the department and secretary of state, on or before the day any change is to take effect, a certificate signed by the president or a vice-president and the secretary or an assistant secretary of the corporation, and verified under oath, stating the change to be made and reciting that such change is made pursuant to authorization by the board of directors; and

(2) notifying each policyholder of the address and telephone number of the new location.

Formerly: Acts 1935, c.162, s.81. As amended by P.L.94-1999, SEC.1.
Ind. Code § 27-13-37.5-2 — Indiana Code / Title 27 / Article 13 / Chapter 37.5 / Section 27-13-37.5-2
Designation of mail order or Internet based pharmacy
Status: in_force

Sec. 2. (a) A health maintenance organization may designate, under an individual contract or a group contract that provides coverage for prescription drugs, a mail order or an Internet based pharmacy to provide prescription drugs to an enrollee.

(b) A health maintenance organization may not require an enrollee to obtain a prescription drug from a pharmacy designated under subsection (a) as a condition of coverage.

As added by P.L.251-2003, SEC.5.
Ind. Code § 27-1-37.1-4 — Indiana Code / Title 27 / Article 1 / Chapter 37.1 / Section 27-1-37.1-4
"Provider"
Status: in_force

Sec. 4. As used in this chapter, "provider" means:

(1) a physician licensed under IC 25-22.5;

(2) a dentist licensed under IC 25-14;

(3) an advanced practice registered nurse licensed under IC 25-23;

(4) a chiropractor licensed under IC 25-10;

(5) a podiatrist licensed under IC 25-29;

(6) an optometrist licensed under IC 25-24; or

(7) a clinical psychologist licensed under IC 25-33.

As added by P.L.196-2001, SEC.1. Amended by P.L.129-2018, SEC.40.
Ind. Code § 27-1-37.5-12 — Indiana Code / Title 27 / Article 1 / Chapter 37.5 / Section 27-1-37.5-12
Claim for which prior authorization was given; denial; resubmission of claim
Status: in_force

Sec. 12. (a) This section applies to a claim for a health care service rendered by a health care provider:

(1) for which:

(A) prior authorization is requested after June 30, 2025; and

(B) a utilization review entity gives prior authorization; and

(2) that is rendered in accordance with the authorization.

(b) The utilization review entity shall not deny the claim described in subsection (a) unless:

(1) the health care provider knowingly and materially misrepresented the health care service in the prior authorization request with the specific intent to deceive and obtain an unlawful payment from the utilization review entity;

(2) the health care service was no longer a covered benefit on the date the health care service was provided;

(3) the health care provider was no longer contracted with the patient's health plan on the date the health care service was provided;

(4) the health care provider failed to meet the utilization review entity's timely filing requirements;

(5) the utilization review entity does not have liability for the claim; or

(6) the patient was not covered under the health plan on the date on which the health care service was rendered.

(c) If:

(1) the claim described in subsection (a) contains an unintentional and inaccurate inconsistency with the request for prior authorization; and

(2) the inconsistency results in denial of the claim;

the health care provider may resubmit the claim with accurate, corrected information.

As added by P.L.77-2018, SEC.2. Amended by P.L.144-2025, SEC.21.
Ind. Code § 27-13-15-2 — Indiana Code / Title 27 / Article 13 / Chapter 15 / Section 27-13-15-2
Contract requirements not met; collection of money owed by health maintenance organization prohibited
Status: in_force

Sec. 2. If:

(1) the contract between a health maintenance organization and a participating provider has not been reduced to writing as required by this chapter; or

(2) the contract fails to contain the provision required by section 1(a)(4) of this chapter;

the participating provider may not collect or attempt to collect from the subscriber or enrollee any sums that are owed by the health maintenance organization.

As added by P.L.26-1994, SEC.25. Amended by P.L.203-2001, SEC.25.
Ind. Code § 27-13-1-7 — Indiana Code / Title 27 / Article 13 / Chapter 1 / Section 27-13-1-7
"Commissioner"
Status: in_force

Sec. 7. "Commissioner" refers to the insurance commissioner appointed under IC 27-1-1-2.

As added by P.L.26-1994, SEC.25.
Ind. Code § 27-7-9-8.4 — Indiana Code / Title 27 / Article 7 / Chapter 9 / Section 27-7-9-8.4
Additional forms of coverage; application to structures
Status: in_force

Sec. 8.4. If coverage for damage due to mine subsidence is added under this chapter as an additional form of coverage to a policy providing the type of insurance described in Class 3(a) of IC 27-1-5-1, the mine subsidence coverage of the policy must apply to structures in the same manner as coverage for other perils under the policy.

As added by P.L.124-1992, SEC.5. Amended by P.L.286-2019, SEC.4.
Ind. Code § 27-8-35.5-1 — Indiana Code / Title 27 / Article 8 / Chapter 35.5 / Section 27-8-35.5-1
"Chronic pain"
Status: in_force

Sec. 1. As used in this chapter, "chronic pain" means pain that:

(1) persists beyond the usual course of an acute disease or healing of an injury; or

(2) may be associated with an acute or chronic pathologic process that causes continuous or intermittent pain for a period of months or years.

As added by P.L.149-2019, SEC.5.
Ind. Code § 27-15-16-3 — Indiana Code / Title 27 / Article 15 / Chapter 16 / Section 27-15-16-3
Hiring professionals necessary to assist commissioner's review
Status: in_force

Sec. 3. (a) The commissioner may, at the expense of a converting mutual that has:

(1) filed an application under this article;

(2) notified the commissioner of its intention to file an application under this article; or

(3) adopted a resolution proposing a simple plan of conversion under this article;

hire accountants, actuaries, attorneys, financial advisors, investment bankers, and other experts that are necessary to assist the commissioner in reviewing all matters under this article.

(b) The commissioner may at any time require the converting mutual to deposit an amount of money with the department in anticipation of expenses to be incurred by the commissioner under this section.

As added by P.L.94-1999, SEC.3.
Ind. Code § 27-1-23-2.6 — Indiana Code / Title 27 / Article 1 / Chapter 23 / Section 27-1-23-2.6
Primary and subsidiary companies
Status: in_force

Sec. 2.6. (a) As used in this section, "entity" means:

(1) a sole proprietorship;

(2) a corporation;

(3) a limited liability company;

(4) a partnership;

(5) an association;

(6) a joint stock company;

(7) a mutual fund;

(8) a joint venture;

(9) a trust;

(10) a joint tenancy;

(11) an unincorporated organization; or

(12) a similar entity.

(b) As used in this section, "primary company" means a domestic insurance company that beneficially owns more than fifty percent (50%) of one (1) or more subsidiary companies.

(c) As used in this section, "subsidiary company" means an entity of which more than fifty percent (50%) is beneficially owned by an insurance company.

(d) As used in this section, "total investment of the primary company" means the total of:

(1) a direct investment by a primary company in an asset; plus

(2) the primary company's proportionate share of an investment made by a subsidiary company of the primary company.

The primary company's proportionate share must be determined by multiplying the amount of the subsidiary company's investment by the percentage of the primary company's ownership interest in the subsidiary company.

(e) A primary company may, independently or in cooperation with another person, organize or acquire one (1) or more subsidiary companies.

(f) A subsidiary company of a primary company may conduct business of any kind, and the authority to conduct the business is not limited because of the status of the subsidiary company as a subsidiary company of the primary company.

(g) In addition to investments in common stock, preferred stock, debt obligations, and other securities as permitted under IC 27-1-12-2 or IC 27-1-13-3, a primary company to which this section applies may, directly or through one (1) or more subsidiary companies, also do the following:

(1) Invest in common stock, preferred stock, debt obligations, and other securities of one (1) or more subsidiary companies, amounts that in total do not exceed the lesser of ten percent (10%) of the primary company's admitted assets or fifty percent (50%) of the primary company's surplus as regards policyholders, if, after the investments, the primary company's surplus as regards policyholders is reasonable in relation to the primary company's outstanding liabilities and adequate to the primary company's financial needs. In calculating the amount of investments permitted under this subdivision:

(A) investments, whether made directly or through one (1) or more subsidiary companies, in domestic or foreign insurance subsidiary companies and health maintenance organizations must be excluded; and

(B) to the extent that expenditures relate to an investment other than an investment described in clause (A), the following must be included:

(i) Total net money or other consideration expended and obligations assumed in the acquisition or formation of a subsidiary company, including all organizational expenses and contributions to capital and surplus of the subsidiary company, whether or not represented by the purchase of capital stock or issuance of other securities.

(ii) All amounts expended in acquiring additional common stock, preferred stock, debt obligations, and other securities and all contributions to the capital or surplus of a subsidiary company subsequent to the subsidiary company's acquisition or formation.

(2) Notwithstanding subdivision (1), invest an amount in common stock, preferred stock, debt obligations, and other securities of one (1) or more subsidiary companies engaged or organized to engage exclusively in the ownership and management of assets authorized as investments for the primary company, if the subsidiary company agrees to limit the subsidiary company's investment in an asset so that, when combined with the investments of the primary company, the total investment of the primary company will not exceed the investment limitations described in subdivision (1) or in any applicable provision of IC 27-1-12-2 or IC 27-1-13-3.

(3) Notwithstanding subdivision (1), with the prior approval of the commissioner, invest a greater amount in common stock, preferred stock, debt obligations, or other securities of one (1) or more subsidiary companies, if, after the investment, the primary company's surplus as regards policyholders is reasonable in relation to the primary company's outstanding liabilities and adequate to the primary company's financial needs.

(h) Investments that are made under this section in common stock, preferred stock, debt obligations, or other securities of a subsidiary company are not subject to restrictions or prohibitions under IC 27-1-12-2 or IC 27-1-13-3 that otherwise apply to investments of primary companies.

(i) Before a primary company to which this section applies makes an investment described in subsection (g), a primary company shall make a determination regarding whether the proposed investment meets the applicable requirements by determining the applicable investment limitations as though the investment has been made, considering:

(1) the currently outstanding principal balance on previous investments in debt obligations; and

(2) the value of previous investments in equity securities as of the day that the investments in equity securities were made;

net of any return of capital invested.

(j) If a primary company ceases to control a subsidiary company, the primary company shall dispose of any investment in the subsidiary company made under this section not more than:

(1) three (3) years from the time of the cessation of control; or

(2) the period determined appropriate by the commissioner;

unless the investment meets the requirements for investment under any applicable provision of IC 27-1-12-2 or IC 27-1-13-3 and the primary company has notified the commissioner that the investment meets the requirements.

(k) A primary company, at the time of establishing a subsidiary company, must possess:

(1) assets of not less than twenty-five million dollars ($25,000,000); or

(2) not less than three million five hundred thousand dollars ($3,500,000) of:

(A) combined capital and surplus in the case of a stock company; and

(B) surplus in the case of a mutual company.

(l) The department has the power to:

(1) conduct periodic examinations of a subsidiary company;

(2) require reports that reflect the effect of the condition and operation of a subsidiary company on the financial condition of a primary company; and

(3) make additional examinations or require other reports with respect to a subsidiary company that are necessary to carry out the purposes of this section.

A noninsurance subsidiary company shall annually furnish the department financial statements that are prepared under generally accepted accounting principles and certified by an independent certified public accountant and the department may rely on the statements. If a subsidiary company conducts the business of the subsidiary company in a manner that clearly tends to impair the capital or surplus fund of the primary company, or otherwise makes the operation of the primary company financially unsafe, the department may act under IC 27-1-3-19 with respect to the primary company.

(m) A primary company and a subsidiary company shall, in all respects, stand before the law as separate and distinct companies and neither company is liable to the creditors, policyholders, or stockholders of the other company, acts or omissions of an officer, director, stockholder, or member of either company notwithstanding.

(n) The board of directors and officers of a primary company and a subsidiary company may be identical. However, the affairs of each company shall be carried on separate and distinct from the other company.

(o) A foreign subsidiary company shall be treated in the same manner as other foreign companies, except that the treatment may be withheld or suspended with respect to a subsidiary company that is domiciled in a state that does not treat a:

(1) primary company; or

(2) subsidiary company;

that is domiciled in Indiana in a manner equal to a foreign or domestic company doing business in the other state.

(p) Interests in a subsidiary company that are owned by a primary company must be registered in the name of the primary company except for shares that are required under Indiana law to be registered in the name of another person.

As added by P.L.126-2001, SEC.3.
Ind. Code § 27-7-3.6-4 — Indiana Code / Title 27 / Article 7 / Chapter 3.6 / Section 27-7-3.6-4
Reversions to state general fund prohibited
Status: in_force

Sec. 4. Money in the fund at the end of a state fiscal year does not revert to the state general fund.

As added by P.L.171-2006, SEC.5.
Ind. Code § 27-4-4-7 — Indiana Code / Title 27 / Article 4 / Chapter 4 / Section 27-4-4-7
Construction
Status: in_force

Sec. 7. This chapter is declared to be in addition and supplemental to other laws of the state of Indiana and shall be construed accordingly.

Formerly: Acts 1955, c.203, s.7. As amended by P.L.252-1985, SEC.163.
Ind. Code § 27-1-1.5-5 — Indiana Code / Title 27 / Article 1 / Chapter 1.5 / Section 27-1-1.5-5
In effect date of references in IC 27; document maintenance by department of insurance
Status: in_force

Sec. 5. (a) Except as otherwise provided in this title or as reported under section 1 of this chapter, a reference:

(1) in this title; and

(2) to a document not described this chapter;

is a reference to the document as in effect on January 1, 2018.

(b) The department shall maintain, as a public record:

(1) an electronic version on the department's Internet web site; and

(2) a paper copy;

of each document to which there is a reference in this title, including each version of a document that is amended over time.

As added by P.L.124-2018, SEC.1.
Ind. Code § 27-1-3.5-13 — Indiana Code / Title 27 / Article 1 / Chapter 3.5 / Section 27-1-3.5-13
Independent audit work papers and communications; review by department examiners
Status: in_force

Sec. 13. (a) A domestic insurer required to file an audited financial report under this chapter shall require its independent auditor to make available for review by department examiners:

(1) all work papers prepared in the conduct of the independent auditor's examination; and

(2) any record of significant communications related to the audit between the independent auditor and the insurer that took place at:

(A) the offices of the insurer;

(B) the department;

(C) the offices of the independent auditor; or

(D) any other reasonable place designated by the commissioner.

The insurer shall require the independent auditor to retain the audit work papers and communications until the department has filed a report on the examination covering the period of the audit but not later than seven (7) years after the date of the audit report.

(b) Department examiners, in conducting a review of an independent auditor's work papers, may make and retain copies of the work papers and communications. A review of an independent auditor's work papers and communications shall be considered an investigation and all work papers and communications obtained or copied during the course of that investigation are confidential under IC 27-1-3.1-15.

As added by P.L.244-1989, SEC.2. Amended by P.L.251-1995, SEC.13.
Ind. Code § 27-8-13-2 — Indiana Code / Title 27 / Article 8 / Chapter 13 / Section 27-8-13-2
"Medicare supplement insurance solicitation" defined
Status: in_force

Sec. 2. As used in this chapter, "Medicare supplement insurance solicitation" means a meeting between an insurance producer and another individual at which the insurance producer discusses the possible issuance of a medicare supplement policy to the other individual.

As added by P.L.275-1987, SEC.2. Amended by P.L.178-2003, SEC.69.
Ind. Code § 27-7-18-1 — Indiana Code / Title 27 / Article 7 / Chapter 18 / Section 27-7-18-1
"Contracting entity"
Status: in_force

Sec. 1. As used in this chapter, "contracting entity" means a dental carrier, a third party administrator, or another person that enters into a provider network contract with providers for the delivery of dental services in the ordinary course of business.

As added by P.L.17-2024, SEC.19.
Ind. Code § 27-1-22-10 — Indiana Code / Title 27 / Article 1 / Chapter 22 / Section 27-1-22-10
Insurers acting in concert
Status: in_force

Sec. 10. Subject to and in compliance with all other provisions of this chapter, two (2) or more insurers may act in concert with each other and with others with respect to any matters within the purview of this chapter and are authorized to act in concert between or among themselves to the same extent as if they constituted a single insurer.

Formerly: Acts 1967, c.133, s.10. As amended by P.L.252-1985, SEC.113.
Ind. Code § 27-1-12-37 — Indiana Code / Title 27 / Article 1 / Chapter 12 / Section 27-1-12-37
Group life insurance; eligible policyholders; regulations
Status: in_force

Sec. 37. Except as provided in section 38 of this chapter, no policy of group life insurance may be delivered in Indiana unless it conforms to one (1) of the following descriptions:

(1) A policy issued to an employer or to the trustees of a fund established by an employer (which employer or trustees must be deemed the policyholder) to insure employees of the employer for the benefit of persons other than the employer, subject to the following requirements:

(A) The employees eligible for insurance under the policy must be all of the employees of the employer, or all of any class or classes of employees. The policy may provide that the term "employees" includes the employees of one (1) or more subsidiary corporations and the employees, individual proprietors, and partners of one (1) or more affiliated corporations, limited liability companies, proprietorships, or partnerships if the business of the employer and of the affiliated corporations, proprietorships, limited liability companies, or partnerships is under common control. The policy may provide that the term "employees" includes the individual proprietor or partners if the employer is an individual proprietorship or partnership. The policy may provide that the term "employees" may include retired employees, former employees, and directors of a corporate employer. A policy issued to insure the employees of a public body may provide that the term "employees" includes elected or appointed officials.

(B) The premium for the policy must be paid either from the employer's funds, from funds contributed by the insured employees, or from both sources of funds. Except as provided in clause (C), a policy on which no part of the premium is to be derived from funds contributed by the insured employees must insure all eligible employees, except those who reject the coverage in writing.

(C) An insurer may exclude or limit the coverage on any person as to whom evidence of individual insurability is not satisfactory to the insurer.

(2) A policy issued to a creditor or its parent holding company or to a trustee or trustees or agent designated by two (2) or more creditors (which creditor, holding company, affiliate, trustee, trustees, or agent must be deemed the policyholder) to insure debtors of the creditor, or creditors, subject to the following requirements:

(A) The debtors eligible for insurance under the policy must be all of the debtors of the creditor or creditors, or all of any class or classes of debtors. The policy may provide that the term "debtors" includes:

(i) borrowers of money or purchasers or lessees of goods, services, or property for which payment is arranged through a credit transaction;

(ii) the debtors of one (1) or more subsidiary corporations; and

(iii) the debtors of one (1) or more affiliated corporations, proprietorships, limited liability companies, or partnerships if the business of the policyholder and of the affiliated corporations, proprietorships, limited liability companies, or partnerships is under common control.

(B) The premium for the policy must be paid either from the creditor's funds, from charges collected from the insured debtors, or from both sources of funds. Except as provided in clause (C), a policy on which no part of the premium is to be derived from the funds contributed by insured debtors specifically for their insurance must insure all eligible debtors.

(C) An insurer may exclude any debtors as to whom evidence of individual insurability is not satisfactory to the insurer.

(D) The amount of the insurance on the life of any debtor may at no time exceed the greater of the scheduled or actual amount of unpaid indebtedness to the creditor.

(E) The insurance may be payable to the creditor or any successor to the right, title, and interest of the creditor. Each payment under this clause must reduce or extinguish the unpaid indebtedness of the debtor to the extent of the payment, and any excess of the insurance must be payable to the estate of the insured.

(F) Notwithstanding clauses (A) through (E), insurance on agricultural credit transaction commitments may be written up to the amount of the loan commitment on a nondecreasing or level term plan, and insurance on educational credit transaction commitments may be written up to the amount of the loan commitment less the amount of any repayments made on the loan.

(3) A policy issued to a labor union or similar employee organization (which organization must be deemed to be the policyholder) to insure members of the union or organization for the benefit of persons other than the union or organization or any of its officials, representatives, or agents, subject to the following requirements:

(A) The members eligible for insurance under the policy must be all of the members of the union or organization, or all of any class or classes of members.

(B) The premium for the policy must be paid either from funds of the union or organization, from funds contributed by the insured members specifically for their insurance, or from both sources of funds. Except as provided in clause (C), a policy on which no part of the premium is to be derived from funds contributed by the insured members specifically for their insurance must insure all eligible members, except those who reject the coverage in writing.

(C) An insurer may exclude or limit the coverage on any person as to whom evidence of individual insurability is not satisfactory to the insurer.

(4) A policy issued to a trust or to one (1) or more trustees of a fund established or adopted by two (2) or more employers, or by one (1) or more labor unions or similar employee organizations, or by one (1) or more employers and one (1) or more labor unions or similar employee organizations (which trust or trustees must be deemed the policyholder) to insure employees of the employers or members of the unions or organizations for the benefit of persons other than the employers or the unions or organizations, subject to the following requirements:

(A) The persons eligible for insurance must be all of the employees of the employers or all of the members of the unions or organizations, or all of any class or classes of employees or members. The policy may provide that the term "employees" includes the employees of one (1) or more subsidiary corporations and the employees, individual proprietors, and partners of one (1) or more affiliated corporations, proprietorships, limited liability companies, or partnerships if the business of the employer and of the affiliated corporations, proprietorships, limited liability companies, or partnerships is under common control. The policy may provide that the term "employees" includes the individual proprietor or partners if the employer is an individual proprietorship or partnership. The policy may provide that the term "employees" includes retired employees, former employees, and directors of a corporate employer. The policy may provide that the term "employees" includes the trustees or their employees, or both, if their duties are principally connected with the trusteeship.

(B) The premium for the policy must be paid from funds contributed by the employer or employers of the insured persons, by the union or unions or similar employee organizations, or by both, from funds contributed by the insured persons, or from both the insured persons and one (1) or more employers, unions, or similar employee organizations. Except as provided in clause (C), a policy on which no part of the premium is to be derived from funds contributed by the insured persons, specifically for their insurance must insure all eligible persons, except those who reject the coverage in writing.

(C) An insurer may exclude or limit the coverage on any person as to whom evidence of individual insurability is not satisfactory to the insurer.

(5) A policy issued to an association, a trust, or one (1) or more trustees of a fund established, created, or maintained for the benefit of members of one (1) or more associations. The association or associations must have at the outset a minimum of one hundred (100) persons; must have been organized and maintained in good faith for purposes other than that of obtaining insurance; must have been in active existence for at least two (2) years; and must have a constitution and bylaws that provide that the association or associations hold regular meetings not less than annually to further purposes of the members, that, except for credit unions, the association or associations collect dues or solicit contributions from members, and that the members have voting privileges and representation on the governing board and committees. The policy must be subject to the following requirements:

(A) The policy may insure members or employees of the association or associations, employees of members, one (1) or more of the preceding, or all of any class or classes of members, employees, or employees of members for the benefit of persons other than the employee's employer.

(B) The premium for the policy must be paid from funds contributed by the association or associations, by employer members, or by both, from funds contributed by the covered persons, or from both the covered persons and the association, associations, or employer members.

(C) Except as provided in clause (D), a policy on which no part of the premium is to be derived from funds contributed by the covered persons specifically for the insurance must insure all eligible persons, except those who reject such coverage in writing.

(D) An insurer may exclude or limit the coverage on any person as to whom evidence of individual insurability is not satisfactory to the insurer.

(6) A policy issued to a credit union or to one (1) or more trustees or an agent designated by two (2) or more credit unions (which credit union, trustee, trustees, or agent must be deemed the policyholder) to insure members of the credit union or credit unions for the benefit of persons other than the credit union or credit unions, trustee, trustees, or agent, or any of their officials, subject to the following requirements:

(A) The members eligible for insurance must be all of the members of the credit union or credit unions, or all of any class or classes of members.

(B) The premium for the policy shall be paid by the policyholder from the credit union's funds and, except as provided in clause (C), must insure all eligible members.

(C) An insurer may exclude or limit the coverage on any member as to whom evidence of individual insurability is not satisfactory to the insurer.

As added by P.L.254-1985, SEC.1. Amended by P.L.19-1986, SEC.46; P.L.8-1993, SEC.413.
Ind. Code § 27-1-36-9.3 — Indiana Code / Title 27 / Article 1 / Chapter 36 / Section 27-1-36-9.3
"Health insurer"
Status: in_force

Sec. 9.3. As used in this chapter, "health insurer" means the following:

(1) A health maintenance organization.

(2) A limited service health maintenance organization.

(3) An insurer that makes one (1) or more of the types of insurance described in Class 1(b) or Class 2(a) of IC 27-1-5-1.

(4) An insurer that files a health Annual Statement Blank in accordance with the applicable Annual Statement Instructions.

As added by P.L.276-2013, SEC.20. Amended by P.L.124-2018, SEC.57.
Ind. Code § 27-1-46-10 — Indiana Code / Title 27 / Article 1 / Chapter 46 / Section 27-1-46-10
"Provider facility"
Status: in_force

Sec. 10. (a) As used in this chapter, "provider facility" means any of the following:

(1) A hospital licensed under IC 16-21-2.

(2) An ambulatory outpatient surgical center licensed under IC 16-21-2.

(3) A birthing center licensed under IC 16-21-2.

(4) Except for an urgent care facility, a facility that provides diagnostic services to the medical profession or the general public, including outpatient facilities.

(5) A laboratory where clinical pathology tests are carried out on specimens to obtain information about the health of a patient.

(6) A facility where radiologic and electromagnetic images are made to obtain information about the health of a patient.

(7) An infusion center that administers intravenous medications.

(b) The term does not include the following:

(1) A private mental health institution licensed under IC 12-25.

(2) A Medicare certified, freestanding rehabilitation hospital.

As added by P.L.93-2020, SEC.12. Amended by P.L.9-2022, SEC.49; P.L.36-2022, SEC.11; P.L.179-2022(ss), SEC.43.
Ind. Code § 27-2-10-7 — Indiana Code / Title 27 / Article 2 / Chapter 10 / Section 27-2-10-7
Exemption of sale of registered securities or securities in closely held corporation
Status: in_force

Sec. 7. The provisions of sections 1, 2, and 3 of this chapter shall not apply to transactions in equity securities of a domestic stock insurance company if:

(a) such securities shall be registered, or shall be required to be registered, pursuant to section 12 of the Securities Exchange Act of 1934 (15 U.S.C. 78l); or

(b) such domestic stock insurance company shall not have any class of its equity securities held of record by one hundred (100) or more persons on the last business day of the year next preceding the year in which equity securities of the company would be subject to the provisions of sections 1, 2, and 3 of this chapter except for the provisions of this subdivision.

Formerly: Acts 1965, c.5, s.7. As amended by P.L.252-1985, SEC.135; P.L.3-1989, SEC.153; P.L.124-2018, SEC.63.
Ind. Code § 27-1-27-17 — Indiana Code / Title 27 / Article 1 / Chapter 27 / Section 27-1-27-17
Principles applying to public adjuster contracts
Status: in_force

Sec. 17. The following apply to a contract between an insured and a public adjuster:

(1) An insured is not required to hire a public adjuster to help the insured meet the insured's obligations under a policy, but has a right to do so.

(2) The public adjuster is not a representative or employee of the insurer.

(3) The salary, fee, commission, or other consideration to be paid to the public adjuster is the obligation of the insured, not of the insurer, except when the insured has assigned the insured's rights to the public adjuster.

As added by P.L.226-2023, SEC.12.
Ind. Code § 27-15-14-1 — Indiana Code / Title 27 / Article 15 / Chapter 14 / Section 27-15-14-1
Qualifications for modified conversion; waivers or modifications of notice requirements
Status: in_force

Sec. 1. (a) If a domestic mutual insurance company:

(1) is insolvent, as defined in IC 27-9-1-2(o);

(2) does not meet the minimum surplus requirements of IC 27-1-6-15; or

(3) in the judgment of the commissioner, is in a hazardous financial condition;

its board of directors may adopt, and the commissioner may approve, any plan of conversion and amendment to the articles of incorporation that, on the effective date of the conversion, would provide for the former mutual to have paid-in capital stock and surplus in an amount not less than the minimum requirements of IC 27-1-6-14(c) and IC 27-1-6-14(e) and an RBC level greater than its company action RBC level.

(b) The commissioner may allow waivers or material modifications of the requirement to give any notices to members and policyholders, to obtain member approval of the proposed plan of conversion or amendment to the articles of incorporation of the converting mutual, or to distribute consideration to members if the value of a converting mutual described in subsection (a) does not in the judgment of the commissioner warrant any such notices, approvals, or distribution under the circumstances, including the expenses involved in a distribution of consideration.

As added by P.L.94-1999, SEC.3. Amended by P.L.72-2016, SEC.27.
Ind. Code § 27-13-22-5 — Indiana Code / Title 27 / Article 13 / Chapter 22 / Section 27-13-22-5
Benefit payments to health maintenance organization; contract provisions
Status: in_force

Sec. 5. Under a contract between an insurer or a hospital and a health maintenance organization under section 4 of this chapter, the insurer or hospital may make benefit payments to the health maintenance organization for health care services for which the health maintenance organization is liable.

As added by P.L.26-1994, SEC.25.
Ind. Code § 27-11-8-4 — Indiana Code / Title 27 / Article 11 / Chapter 8 / Section 27-11-8-4
Examination of societies transacting or applying for admission to transact business in Indiana; expenses
Status: in_force

Sec. 4. (a) The commissioner or any person the commissioner may appoint may examine any domestic, foreign, or alien society transacting or applying for admission to transact business in Indiana in the same manner as authorized for examination of domestic, foreign, or alien insurers. Requirements of notice and an opportunity to respond before findings are made public as provided in the laws regulating insurers shall also be applicable to the examination of societies.

(b) The expense of each examination and of each valuation, including compensation and actual expense of examiners, shall be paid by the society examined or whose certificates are valued, upon statements furnished by the commissioner.

As added by P.L.262-1985, SEC.1.
Ind. Code § 27-17-9-1 — Indiana Code / Title 27 / Article 17 / Chapter 9 / Section 27-17-9-1
Application; exemption
Status: in_force

Sec. 1. This chapter does not apply to a person that is exempt from registration under IC 27-17-2.

As added by P.L.73-2006, SEC.3.
Ind. Code § 27-4-3-3 — Indiana Code / Title 27 / Article 4 / Chapter 3 / Section 27-4-3-3
Violations; license suspension; public hearing; appeal
Status: in_force

Sec. 3. For violation of any provision of this chapter, the license of the offending company or insurance producer to transact the business of insurance within the state of Indiana shall be suspended for a period of three (3) years. Whenever information of any such violation shall come to the knowledge of the commissioner of insurance, the commissioner shall issue an order fixing a day certain, not more than thirty (30) nor less than twenty (20) days from the making thereof, upon which the offender shall appear and show cause why such penalty should not be enforced, such order specifying with reasonable certainty the violation charged, and if, after hearing, the commissioner shall determine that the company or insurance producer is guilty of such violation, the commissioner shall forthwith suspend the license of the offender for a period of three (3) years. Such hearing shall be public, and at any such hearing any person or corporation having lodged information of such violation with the commissioner shall be entitled to be present and submit evidence. Within thirty (30) days after the suspension of any such license, the insurance producer or company whose license has been suspended may appeal from the ruling of the commissioner of insurance to the circuit or superior court of the county in which the insurance producer resides or in which such company has its principal place of business, and if such company be a foreign insurance company then such appeal may be taken by such company to the circuit or superior court of Marion County.

Formerly: Acts 1937, c.46, s.3. As amended by P.L.252-1985, SEC.158; P.L.178-2003, SEC.38.
Ind. Code § 27-1-27-7 — Indiana Code / Title 27 / Article 1 / Chapter 27 / Section 27-1-27-7
Repealed
Status: repealed

As added by P.L.257-1983, SEC.1. Amended by P.L.7-1987, SEC.142. Repealed by P.L.146-2015, SEC.26.
Ind. Code § 27-1-29.1-15 — Indiana Code / Title 27 / Article 1 / Chapter 29.1 / Section 27-1-29.1-15
Single or installment payments; limits
Status: in_force

Sec. 15. An amount payable under section 13 of this chapter that is no more than ten thousand dollars ($10,000) may be paid in a single, immediate payment. An amount payable under section 13 of this chapter that is greater than ten thousand dollars ($10,000) shall be paid:

(1) in installments under section 18(c) of this chapter; or

(2) under a structured settlement negotiated under section 18(d) of this chapter.

As added by P.L.272-1987, SEC.7.
Ind. Code § 27-4-10-3 — Indiana Code / Title 27 / Article 4 / Chapter 10 / Section 27-4-10-3
"Dental provider"
Status: in_force

Sec. 3. As used in this chapter, "dental provider" means:

(1) a dentist licensed under IC 25-14; or

(2) a dental office that provides billing and administrative services for one (1) or more dentists licensed under IC 25-14 who provide dental care through the dental office.

As added by P.L.31-2021, SEC.4.
Ind. Code § 27-1-25.1-3 — Indiana Code / Title 27 / Article 1 / Chapter 25.1 / Section 27-1-25.1-3
"Person"
Status: in_force

Sec. 3. As used in this chapter, "person" refers to a person described in IC 27-1-25-1(a)(15).

As added by P.L.160-2003, SEC.22.
Ind. Code § 27-6-8-17 — Indiana Code / Title 27 / Article 6 / Chapter 8 / Section 27-6-8-17
Stay of proceedings; reopening of default judgments
Status: in_force

Sec. 17. (Stay of Proceedings; Reopening of Default Judgments) All proceedings in which the insolvent insurer is a party or is obligated to defend a party in court in this state shall be stayed for up to six (6) months and such additional time thereafter as may be determined by the court from the date the insolvency is determined or an ancillary proceeding is instituted in the state whichever is later to permit proper defense by the association of all pending causes of action. As to any covered claims arising from a judgment under any decision, verdict or finding based on the default of the insolvent insurer or its failure to defend an insured, the association either on its own behalf or on behalf of such insured may apply to have the judgment, order, decision, verdict or finding set aside by the same court or administrator that made the judgment, order, decision, verdict or findings and shall be permitted to defend against the claim on the merits.

Formerly: Acts 1971, P.L.390, SEC.1; Acts 1973, P.L.279, SEC.2.
Ind. Code § 27-1-19-1 — Indiana Code / Title 27 / Article 1 / Chapter 19 / Section 27-1-19-1
Authority to reorganize as domestic company
Status: in_force

Sec. 1. Any foreign life insurance company authorized to do business in this state, and empowered by the laws of the state, territory or insular possession of the United States, or the District of Columbia under which it was incorporated to reincorporate, is hereby authorized to reorganize under the laws of this state by compliance with the provisions of this chapter and thereafter be a new corporation of this state under this article.

Formerly: Acts 1935, c.162, s.240. As amended by P.L.252-1985, SEC.81.
Ind. Code § 27-1-51-11 — Indiana Code / Title 27 / Article 1 / Chapter 51 / Section 27-1-51-11
Terms of health insurance coverage
Status: in_force

Sec. 11. An insurer and an administrator may not directly or indirectly:

(1) set;

(2) alter;

(3) implement; or

(4) condition;

the terms of health insurance coverage, including the benefit design, based in part or entirely on information about the availability or amount of financial or product assistance available for a prescription drug.

As added by P.L.237-2025, SEC.10.
Ind. Code § 27-13-23-8 — Indiana Code / Title 27 / Article 13 / Chapter 23 / Section 27-13-23-8
Filing examination reports of other states
Status: in_force

Sec. 8. A health maintenance organization shall file a copy of any examination report filed by the insurance commissioner of another state during the preceding calendar year with the annual statement required under IC 27-13-8-1.

As added by P.L.203-2001, SEC.29.
Ind. Code § 27-1-24.5-22 — Indiana Code / Title 27 / Article 1 / Chapter 24.5 / Section 27-1-24.5-22
Required information; appeals process; auditing procedures
Status: in_force

Sec. 22. (a) A pharmacy benefit manager shall do the following:

(1) Identify to contracted:

(A) pharmacy services administrative organizations; or

(B) pharmacies if the pharmacy benefit manager contracts directly with pharmacies;

the sources used by the pharmacy benefit manager to calculate the drug product reimbursement paid for covered drugs available under the pharmacy health plan administered by the pharmacy benefit manager.

(2) Establish an appeal process for contracted pharmacies, pharmacy services administrative organizations, or group purchasing organizations to appeal and resolve disputes concerning the maximum allowable cost pricing.

(3) Update and make available to pharmacies:

(A) at least every seven (7) days; or

(B) in a different time frame if contracted between a pharmacy benefit manager and a pharmacy;

the pharmacy benefit manager's maximum allowable cost list.

(4) Determine that a prescription drug:

(A) is not obsolete;

(B) is generally available for purchase by pharmacies in Indiana from a national or regional wholesaler licensed in Indiana; and

(C) is not:

(i) temporarily unavailable;

(ii) listed on a drug shortage list; or

(iii) unable to be lawfully substituted;

before the prescription drug is placed or continued on a maximum allowable cost list.

(b) The appeal process required by subsection (a)(2) must include the following:

(1) The right to appeal a claim not to exceed sixty (60) days following the initial filing of the claim.

(2) The investigation and resolution of a filed appeal by the pharmacy benefit manager in a time frame determined by the commissioner.

(3) If an appeal is denied, a requirement that the pharmacy benefit manager do the following:

(A) Provide the reason for the denial.

(B) Provide the appealing contracted pharmacy, pharmacy services administrative organization, or group purchasing organization with the national drug code number of the prescription drug that is available from a national or regional wholesaler operating in Indiana.

(4) If an appeal is approved, a requirement that the pharmacy benefit manager do the following:

(A) Change the maximum allowable cost of the drug for the pharmacy that filed the appeal as of the initial date of service that the appealed drug was dispensed.

(B) Adjust the maximum allowable cost of the drug for the appealing pharmacy and for all other contracted pharmacies in the same network of the pharmacy benefit manager that filled a prescription for patients covered under the same health plan beginning on the initial date of service the appealed drug was dispensed.

(C) Notify each pharmacy in the pharmacy benefit manager's network that the maximum allowable cost for the drug has been adjusted as a result of an approved appeal.

(D) Adjust the drug product reimbursement for contracted pharmacies that resubmit claims to reflect the adjusted maximum allowable cost, if applicable.

(E) Allow the appealing pharmacy and all other contracted pharmacies in the network that filled the prescriptions for patients covered under the same health plan to reverse and resubmit claims and receive payment based on the adjusted maximum allowable cost from the initial date of service the appealed drug was dispensed.

(F) Make retroactive price adjustments in the next payment cycle unless otherwise agreed to by the pharmacy.

(5) The establishment of procedures for auditing submitted claims by a contracted pharmacy in a manner established by administrative rules under IC 4-22-2 by the department. The auditing procedures:

(A) may not use extrapolation or any similar methodology;

(B) may not allow for recovery by a pharmacy benefit manager of a submitted claim due to clerical or other error where the patient has received the drug for which the claim was submitted;

(C) must allow for recovery by a contracted pharmacy for underpayments by the pharmacy benefit manager; and

(D) may only allow for the pharmacy benefit manager to recover overpayments on claims that are actually audited and discovered to include a recoverable error.

(c) The department must approve the manner in which a pharmacy benefit manager may respond to an appeal filed under this section. The department shall establish a process for a pharmacy benefit manager to obtain approval from the department under this section.

As added by P.L.68-2020, SEC.1. Amended by P.L.32-2021, SEC.79; P.L.196-2021, SEC.24.
Ind. Code § 27-7-6-3 — Indiana Code / Title 27 / Article 7 / Chapter 6 / Section 27-7-6-3
"Renewal" or "to renew" defined
Status: in_force

Sec. 3. "Renewal" or "to renew" means the issuance and delivery by an insurer of a policy replacing at the end of the policy period a policy previously issued and delivered by the same insurer insuring the same insured, or the issuance and delivery of a certificate or notice extending the term of a policy beyond its policy period or term; provided, however, that any policy with a policy period or term of six (6) months or less and any policy with no fixed expiration date shall for the purposes of this chapter be considered as if written for a policy period or term of six (6) months; and provided further, that any policy written for a term longer than one (1) year shall for the purposes of this chapter be considered as if written for successive policy periods or terms of one (1) year, and such policy may be terminated by the insurer at the expiration of any annual period upon giving twenty (20) days notice of cancellation prior to such anniversary date, and such cancellation shall not be subject to any other provisions of this chapter.

Formerly: Acts 1969, c.332, s.3. As amended by P.L.252-1985, SEC.265.
Ind. Code § 27-8-15-25 — Indiana Code / Title 27 / Article 8 / Chapter 15 / Section 27-8-15-25
Availability of information and documentation to commissioner; disclosure by commissioner
Status: in_force

Sec. 25. A small employer insurer shall make the information and documentation described in section 23 of this chapter available to the commissioner upon request. The information is proprietary and trade secret information and is not subject to disclosure by the commissioner to a person outside of the department except as agreed to by the insurer or as ordered by a court with jurisdiction.

As added by P.L.127-1992, SEC.1.
Ind. Code § 27-6-6-7 — Indiana Code / Title 27 / Article 6 / Chapter 6 / Section 27-6-6-7
Annual financial report; examination; acceptance of examination of another state
Status: in_force

Sec. 7. Such attorney shall, within the time limited for filing the annual statement by insurance companies transacting the same kind of business, make a report under oath to the insurance department for each calendar year showing the financial condition of affairs at the office where such contracts are issued and shall furnish such additional information and reports as may be required. The business affairs, records, and assets of any such organization shall be subject to examination by the insurance department at any reasonable time, and such examination shall be at the expense of the organization examined. Where the principal office of the attorney is located in another state, the insurance department may in lieu of the examination provided for in this section, accept a certified copy of the report of examination made by the insurance department of the state where the principal office is located.

Formerly: Acts 1919, c.102, s.7; Acts 1963, c.315, s.3; Acts 1967, c.232, s.6.
Ind. Code § 27-15-8-2 — Indiana Code / Title 27 / Article 15 / Chapter 8 / Section 27-15-8-2
Factors in determination of forms and amount
Status: in_force

Sec. 2. The amount and the form or forms of consideration to be distributed to a class, category, or group of eligible members may differ from the amount and form or forms of consideration to be distributed to another class, category, or group of eligible members. The choice of the amount and form or forms of consideration to be distributed to a class or category of eligible members may take into account such factors as the type of policies with respect to which the consideration is being distributed, the country or state of residence or tax status of the eligible members, the length of time the eligible members have been members of the converting mutual, or other appropriate factors or circumstances described in the plan of conversion.

As added by P.L.94-1999, SEC.3.
Ind. Code § 27-5.1-2-43 — Indiana Code / Title 27 / Article 5.1 / Chapter 2 / Section 27-5.1-2-43
Administrative rules
Status: in_force

Sec. 43. The commissioner may adopt rules under IC 4-22-2 to implement this article.

As added by P.L.129-2003, SEC.8.
Ind. Code § 27-1-12-16 — Indiana Code / Title 27 / Article 1 / Chapter 12 / Section 27-1-12-16
Proceeds of life insurance; definition; payment to trustees
Status: in_force

Sec. 16. (A) The terms "proceeds" and "proceeds of life insurance" and similar phrases used in this section mean and include any and all benefits payable by the insurer by reason of the death of the insured under any "life insurance," "policy of life insurance," "insurance policy," "policy," or "annuity contract" providing for benefits on the death of the insured, including individual ordinary life policies, certificates issued under a group policy, annuity contracts, and accident or health policies.

(B) Proceeds of life insurance policies heretofore made payable to a trustee or trustees named as beneficiary or hereafter to be named beneficiary under an inter vivos trust shall be paid directly to the trustee or trustees and held and disposed of by the trustee or trustees as provided in the trust agreement or declaration of trust in writing made and in existence on the date of death of the insured, whether or not such trust or declaration of trust is amendable or revocable or both, or whether it may have been amended, and notwithstanding the reservation of any or all rights of ownership under the insurance policy or annuity contract; subject, however, to a valid assignment of any part of the proceeds. It is not necessary to the validity of such trust agreement or declaration of trust that it be funded or have a corpus other than the right, which need not be irrevocable, of the trustee or trustees named therein to receive such proceeds as beneficiary.

(C) A policy of life insurance or annuity contract may designate as beneficiary a trustee or trustees named or to be named by will if the designation is made in accordance with the provisions of the policy or contract whether or not the will is in existence at the time of the designation. The company shall, within sixty days after receipt at its home office of proof of probate of the will, pay the proceeds of such insurance or contract to the trustee or trustees designated in the insurance policy or annuity contract, subject to a valid assignment of any part thereof and any other provisions of the policy or contract, unless prior to the actual payment by the company it shall have received at its home office written notice of the filing or pendency of (1) objection to the probate of said will, or (2) a suit to contest the validity of said will or of the testamentary trust or trusts created therein to which such proceeds are payable, or (3) petition for the construction of that part of the testamentary trust designating the trustee or trustees: Provided, however, That if the company makes any payment or payments of proceeds to such trustee or trustees in accordance with the terms of the policy or contract before receipt at the home office of such written notice, said trustee or trustees shall give full acquittance therefor to the company and such payment shall fully discharge the company from all claims and liability to the extent thereof. Provided, further, That if such written notice is received by the company, payment by it of any unpaid proceeds may be delayed during the pendency of said objections, suit, or petition for construction for not to exceed one (1) year from the date of death of insured, and thereafter the company may pay any and all unpaid proceeds due by reason of the death of the insured to the clerk of the court wherein the probate proceeding is pending by depositing them with such clerk who, as such clerk, shall give full acquittance to the company for all proceeds so paid and the company shall be fully discharged from any and all liability and claims by or on behalf of any other person or persons whomsoever to the extent of the amount so paid and deposited. The clerk shall thereafter hold and disburse said proceeds in accordance with the order of said court to the party or parties and in the amount or amounts provided in said order upon receiving proper receipts therefor; all Provided, however, That the procedure provided for herein shall not preclude the company from interpleading or being interpleaded in any appropriate proceeding or filing a bill of interpleader in any court of competent jurisdiction.

(d) If no claim to proceeds is made by any trustee designated as the beneficiary in any policy of insurance or annuity contract within one year after the death of the insured or if satisfactory evidence is furnished the insurance company within the one-year period showing that there is or will be no trustee qualified to receive the proceeds, payment may be made by the insurance company to those thereafter entitled.

(e) The proceeds of insurance collected by the trustee or trustees are not part of the testator's estate and are not subject to the debts of the insured or to transfer, inheritance, or estate taxes to any greater extent than if the proceeds were payable to some named beneficiary or beneficiaries other than to the estate of the insured or executor or administrator thereof.

(f) This section applies to all trustee designations of a beneficiary or beneficiaries by an insured dying after June 15, 1967, regardless of when made, naming a trustee or trustees of a trust or trusts established by will.

If any provision of this section or the application thereof to any person or circumstance is held invalid, the invalidity shall not affect other provisions or applications of this section which can be given effect without the invalid provision or application.

Formerly: Acts 1935, c.162, s.155b; Acts 1967, c.127, s.4.
Ind. Code § 27-2-27-9 — Indiana Code / Title 27 / Article 2 / Chapter 27 / Section 27-2-27-9
"Information system"
Status: in_force

Sec. 9. As used in this chapter, "information system" means either of the following:

(1) A discrete set of electronic information resources organized for the collection, processing, maintenance, use, sharing, dissemination, or disposition of nonpublic information.

(2) Any specialized system, such as industrial or process control systems, telephone switching systems, private exchange systems, and environmental control systems.

As added by P.L.130-2020, SEC.10.
Ind. Code § 27-1-2-1 — Indiana Code / Title 27 / Article 1 / Chapter 2 / Section 27-1-2-1
Citation
Status: in_force

Sec. 1. IC 27-1-2 through IC 27-1-20 shall be known and may be cited as the Indiana Insurance Law.

Formerly: Acts 1935, c.162, s.1. As amended by P.L.252-1985, SEC.3.
Ind. Code § 27-1-27-18 — Indiana Code / Title 27 / Article 1 / Chapter 27 / Section 27-1-27-18
If insurer pays policy limit within five business days
Status: in_force

Sec. 18. (a) This section applies notwithstanding the terms of a written contract between an insured and a public adjuster.

(b) If the insurer, not more than five (5) business days after the date on which the insured's loss is reported to the insurer, either pays or commits in writing to pay to the insured the policy limit of the insurance policy covering the insured:

(1) the public adjuster shall not receive a commission consisting of or based on a percentage of the total amount paid by the insurer to resolve the claim of the insured;

(2) the public adjuster shall inform the insured that the loss recovery amount might not be increased by the insurer; and

(3) the public adjuster is entitled only to reasonable compensation from the insured for services provided by the public adjuster on behalf of the insured, based on:

(A) the time spent by the public adjuster on the claim; and

(B) the expenses incurred by the public adjuster before the claim is paid or the insured receives a written commitment from the insurer to pay the claim.

As added by P.L.226-2023, SEC.13.
Ind. Code § 27-17-10-4 — Indiana Code / Title 27 / Article 17 / Chapter 10 / Section 27-17-10-4
Suspension; specifications; rescind or modify; reinstatement
Status: in_force

Sec. 4. (a) If the department suspends the registration of a discount medical card program organization, the department must specify in the order of suspension the:

(1) period during which the suspension is in effect; and

(2) conditions that must be met by the discount medical card program organization before the registration is reinstated.

(b) An order of suspension may be rescinded or modified by further order of the department before the expiration of the suspension period specified under subsection (a).

(c) The department may not reinstate a suspended registration unless reinstatement is requested by the discount medical card program organization.

(d) The department may not reinstate a suspended registration if the department determines that the circumstances for which the suspension occurred continue to exist or are likely to recur.

As added by P.L.73-2006, SEC.3.
Ind. Code § 27-13-36-8 — Indiana Code / Title 27 / Article 13 / Chapter 36 / Section 27-13-36-8
Guidelines for establishing reasonable periods for appointments
Status: in_force

Sec. 8. (a) Each health maintenance organization shall establish guidelines for establishing reasonable periods of time within which an enrollee must be given an appointment with a participating provider, except as provided in section 9 of this chapter regarding emergency services.

(b) The guidelines described in subsection (a) must include appointment scheduling guidelines based on the type of health care services most often requested, including the following:

(1) Prenatal care appointments.

(2) Well-child visits and immunizations.

(3) Routine physicals.

(4) Adult preventive services.

(5) Urgent visits.

As added by P.L.69-1998, SEC.14.
Ind. Code § 27-2-23-3 — Indiana Code / Title 27 / Article 2 / Chapter 23 / Section 27-2-23-3
"Account owner"
Status: in_force

Sec. 3. As used in this chapter, "account owner" means an Indiana resident who is the owner of a retained asset account.

As added by P.L.90-2014, SEC.1.
Ind. Code § 27-1-24.2-10 — Indiana Code / Title 27 / Article 1 / Chapter 24.2 / Section 27-1-24.2-10
"Pharmacy"
Status: in_force

Sec. 10. As used in this chapter, "pharmacy" has the meaning set forth in IC 25-26-13-2.

As added by P.L.189-2025, SEC.1.
Ind. Code § 27-1-8-7 — Indiana Code / Title 27 / Article 1 / Chapter 8 / Section 27-1-8-7
Submission of articles of amendment to attorney general
Status: in_force

Sec. 7. In the event the department approves the articles of amendment, they shall then be submitted to the attorney general for the state of Indiana who shall examine said articles. And his approval, if given, shall be evidenced in the manner provided in IC 27-1-6-9, and he shall return the same to the department.

Formerly: Acts 1935, c.162, s.107. As amended by P.L.252-1985, SEC.35.
Ind. Code § 27-17-1-6 — Indiana Code / Title 27 / Article 17 / Chapter 1 / Section 27-17-1-6
"Discount medical card program organization"
Status: in_force

Sec. 6. (a) "Discount medical card program organization" means a person that:

(1) negotiates and enters into provider agreements;

(2) in exchange for consideration, provides cardholders with a right of access to the discounted prices available under the provider agreements entered into under subdivision (1); and

(3) determines the charge to cardholders for the discount prices.

(b) The term does not include the following:

(1) An insurance company, or an affiliate (as defined in IC 27-1-12-2) of an insurance company, that is regulated under this title.

(2) A health maintenance organization, or an affiliate (as defined in IC 27-1-12-2) of a health maintenance organization, that is regulated under this title.

(3) A limited service health maintenance organization, or an affiliate (as defined in IC 27-1-12-2) of a limited service health maintenance organization, that is regulated under this title.

As added by P.L.73-2006, SEC.3.
Ind. Code § 27-1-3-33 — Indiana Code / Title 27 / Article 1 / Chapter 3 / Section 27-1-3-33
Publication of grievance related information on Internet
Status: in_force

Sec. 33. The department shall develop, post, and maintain on the department's Internet web site information concerning the internal and external grievance procedures for accident and sickness insurance policies and health maintenance organization contracts. The department shall include on the web site:

(1) information concerning the process that a consumer should follow in filing an internal grievance or an external grievance; and

(2) a telephone number for the department where consumers may call to obtain additional information.

As added by P.L.18-2016, SEC.1.
Ind. Code § 27-1-24.2-8 — Indiana Code / Title 27 / Article 1 / Chapter 24.2 / Section 27-1-24.2-8
"National drug code number"
Status: in_force

Sec. 8. As used in this chapter, "national drug code number" means the unique national drug code number that identifies:

(1) a specific approved drug;

(2) the manufacturer of the drug; and

(3) the package presentation of the drug.

As added by P.L.189-2025, SEC.1.
Ind. Code § 27-7-17-7 — Indiana Code / Title 27 / Article 7 / Chapter 17 / Section 27-7-17-7
"Eligible group"
Status: in_force

Sec. 7. As used in this chapter, "eligible group" means two (2) or more persons who are engaged in a common enterprise, or have an economic, educational, or social affinity or relationship, including the following:

(1) An entity engaged in the business of providing travel or travel services, including tour operators, lodging providers, vacation property owners, hotels and resorts, travel clubs, travel agencies, property managers, cultural exchange programs, and common carriers or the operator, owner, or lessor of a means of transportation of passengers, including airlines, cruise lines, railroads, steamship companies, and public bus carriers, wherein with regard to any particular travel or type of travel or travelers, all members or customers of the group must have a common exposure to risk attendant in such travel.

(2) A college, school, or other institution of learning, covering students, teachers, employees, or volunteers.

(3) An employer covering any group of employees, volunteers, contractors, board of directors, dependents, or guests.

(4) A sports team, camp, or sponsor thereof, covering participants, members, campers, employees, officials, supervisors, or volunteers.

(5) A religious, charitable, recreational, educational, or civic organization, or branch thereof, covering any group of members, participants, or volunteers.

(6) A financial institution or financial institution vendor, or parent holding company, trustee, or agent of or designated by one (1) or more financial institutions or financial institution vendors, including account holders, credit card holders, debtors, guarantors, or purchasers.

(7) Any incorporated or unincorporated association, including labor unions, having a common interest, constitution, and bylaws and organized and maintained in good faith for purposes other than obtaining insurance for members or participants of such association covering its members.

(8) A trust or the trustees of a fund established, created, or maintained for the benefit of and covering members, employees, or customers, subject to the commissioner's permitting the use of a trust and the state's premium tax provisions in section 14 of this chapter of one (1) or more associations meeting the requirements of subdivision (7).

(9) An entertainment production company covering any group of participants, volunteers, audience members, contestants, or workers.

(10) A volunteer fire department, ambulance, rescue, police, court, or any first aid, civil defense, or other such volunteer group.

(11) A preschool, day care institution for children or adults, or senior citizen club.

(12) An automobile or truck rental or leasing company covering a group of individuals who may become renters, lessees, or passengers defined by their travel status on the rented or leased vehicles. The common carrier, operator, owner, or lessor of a means of transportation or the automobile or truck rental or leasing company is the policyholder under a policy to which this chapter applies.

(13) Any other group for which the commissioner has determined that the members are engaged in a common enterprise or have an economic, educational, or social affinity or relationship, and that issuance of a policy would not be contrary to the public interest.

As added by P.L.19-2022, SEC.5. Amended by P.L.23-2026, SEC.264.
Ind. Code § 27-13-36-3 — Indiana Code / Title 27 / Article 13 / Chapter 36 / Section 27-13-36-3
Adequate number of services and providers within reasonable proximity of subscribers
Status: in_force

Sec. 3. (a) The provisions of this section do not apply until July 1, 1999.

(b) Each health maintenance organization shall demonstrate to the department that the health maintenance organization offers an adequate number of:

(1) acute care hospital services;

(2) primary care providers; and

(3) other appropriate providers;

that are located within a reasonable proximity of subscribers of the health maintenance organization. Compliance with the National Committee on Quality Assurance standards or guidelines is sufficient to meet the requirements of this subsection.

(c) If a health maintenance organization provides coverage for:

(1) specialty medical services, including physical therapy, occupational therapy, and rehabilitation services;

(2) mental and behavioral care services; or

(3) pharmacy services;

the health maintenance organization shall demonstrate to the department that the offered services are located within a reasonable proximity of subscribers of the health maintenance organization. Compliance with the National Committee on Quality Assurance standards or guidelines is sufficient to meet the requirements of this subsection.

As added by P.L.69-1998, SEC.14. Amended by P.L.124-2018, SEC.100.
Ind. Code § 27-1-15.6-34 — Indiana Code / Title 27 / Article 1 / Chapter 15.6 / Section 27-1-15.6-34
Hearings
Status: in_force

Sec. 34. All hearings held under this chapter are governed by IC 4-21.5-3. The commissioner may appoint members of the commissioner's staff to act as hearing officers for purposes of hearings held under this chapter.

As added by P.L.132-2001, SEC.3.
Ind. Code § 27-14.5-5-8 — Indiana Code / Title 27 / Article 14.5 / Chapter 5 / Section 27-14.5-5-8
Membership interest in mutual insurance holding company is not a security
Status: in_force

Sec. 8. A membership interest in a mutual insurance holding company does not constitute a security under Indiana law.

As added by P.L.226-2023, SEC.30.
Ind. Code § 27-8-9-10 — Indiana Code / Title 27 / Article 8 / Chapter 9 / Section 27-8-9-10
Garage liability policy as owner's only coverage; permittee's coverage primary
Status: in_force

Sec. 10. (a) This section applies if the only motor vehicle insurance coverage provided by the owner of the motor vehicle is under a garage liability policy.

(b) Notwithstanding section 7 of this chapter, any coverage available to the permittee is primary.

(c) Recovery may not be made under the garage liability policy until the limits of all coverage available to the permittee have been exhausted.

As added by P.L.226-1993, SEC.6.
Ind. Code § 27-1-45.2-4 — Indiana Code / Title 27 / Article 1 / Chapter 45.2 / Section 27-1-45.2-4
"Health carrier"
Status: in_force

Sec. 4. (a) As used in this chapter, "health carrier" means an entity:

(1) that is subject to this title and the administrative rules adopted under this title; and

(2) that enters into a contract to:

(A) provide health care services;

(B) deliver health care services;

(C) arrange for health care services; or

(D) pay for or reimburse any of the cost of health care services.

(b) The term includes the following:

(1) An insurer (as defined in IC 27-1-2-3(x)) that issues a policy of accident and sickness insurance (as defined in IC 27-8-5-1(a)).

(2) A health maintenance organization (as defined in IC 27-13-1-19).

(3) An administrator (as defined in IC 27-1-25-1(a)) that is licensed under IC 27-1-25.

(4) A state employee health plan offered under IC 5-10-8.

(5) A short term insurance plan (as defined in IC 27-8-5.9-3).

(6) Any other entity that provides a plan of health insurance, health benefits, or health care services.

(c) The term does not include:

(1) an insurer that issues a policy of accident and sickness insurance;

(2) a limited service health maintenance organization (as defined in IC 27-13-34-4); or

(3) an administrator;

that only provides coverage for, or processes claims for, dental or vision care services.

As added by P.L.119-2026, SEC.1.
Ind. Code § 27-7-18-12 — Indiana Code / Title 27 / Article 7 / Chapter 18 / Section 27-7-18-12
Prohibition on altering rights or status
Status: in_force

Sec. 12. A contracting entity that is a party to a provider network contract with a provider that chooses under section 11(b)(1)(A) of this chapter not to participate in third party access shall not alter the provider's rights or status under the provider network contract because of the provider's choice not to participate in third party access.

As added by P.L.17-2024, SEC.19.
Ind. Code § 27-6-9-1 — Indiana Code / Title 27 / Article 6 / Chapter 9 / Section 27-6-9-1
Actuary
Status: in_force

Sec. 1. As used in this chapter, "actuary" means a person who is a member in good standing of the American Academy of Actuaries.

As added by P.L.26-1991, SEC.26.
Ind. Code § 27-19-2-15 — Indiana Code / Title 27 / Article 19 / Chapter 2 / Section 27-19-2-15
"Public health insurance program"
Status: in_force

Sec. 15. (a) "Public health insurance program" refers to health coverage provided under a state or federal government program.

(b) The term includes the following:

(1) Medicaid (42 U.S.C. 1396 et seq.).

(2) The healthy Indiana plan established by IC 12-15-44.5-3.

(3) The children's health insurance program established under IC 12-17.6.

As added by P.L.278-2013, SEC.27. Amended by P.L.213-2015, SEC.254; P.L.30-2016, SEC.43.
Ind. Code § 27-8-15-8.5 — Indiana Code / Title 27 / Article 8 / Chapter 15 / Section 27-8-15-8.5
"Eligible employee"
Status: in_force

Sec. 8.5. (a) As used in this chapter, "eligible employee" means an employee:

(1) who is employed to work at least thirty (30) hours each week; and

(2) who meets an applicable waiting period required by a small employer before gaining coverage under a health insurance policy.

(b) The term includes:

(1) a sole proprietor;

(2) a partner in a partnership; and

(3) an owner of an S corporation;

regardless of whether the sole proprietor, partner, or owner is included as an employee for purposes of taxation of a small employer.

(c) The term does not include:

(1) an employee who works on a temporary or substitute basis; or

(2) a seasonal employee.

As added by P.L.93-1995, SEC.10. Amended by P.L.11-2011, SEC.33.
Ind. Code § 27-1-33-7 — Indiana Code / Title 27 / Article 1 / Chapter 33 / Section 27-1-33-7
Placement of business with an insurer; contract; contents
Status: in_force

Sec. 7. A person, a firm, an association, or a corporation acting in the capacity of an MGA may not place business with an insurer unless there is in force a written contract between the parties. A contract required by this section must set forth the responsibilities of each party and, where both parties share responsibility for a particular function, specify the division of those responsibilities. The contract must, at a minimum, contain provisions that state the following:

(1) The insurer may terminate the contract for cause upon written notice to the MGA and may suspend the underwriting authority of the MGA during the pendency of any dispute regarding the cause for termination.

(2) The MGA will:

(A) render accounts to the reinsurer detailing all transactions; and

(B) remit all funds due under the contract to the insurer on not less than a monthly basis.

(3) All funds collected for the account of an insurer will be held by the MGA in a fiduciary capacity in a bank that is a member of the Federal Reserve System. This account shall be used for all payments on behalf of the insurer. The MGA may retain not more than three (3) months estimated claims payments and allocated loss adjustment expenses.

(4) Separate records of business written by the MGA shall be maintained. The insurer shall have access and right to copy all accounts and records related to its business in a form usable by the insurer, and the commissioner shall have access to all books, bank accounts, and records of the MGA in a form usable to the commissioner.

(5) The contract may not be assigned in whole or part by the MGA.

(6) Appropriate underwriting guidelines, including the following:

(A) The maximum annual premium volume.

(B) The basis of the rates to be charged.

(C) The types of risks which may be written.

(D) Maximum limits of liability.

(E) Applicable exclusions.

(F) Territorial limitations.

(G) Policy cancellation provisions.

(H) The maximum policy period.

(7) The insurer has the right to cancel or nonrenew any policy of insurance subject to the applicable laws and regulations concerning the cancellation and nonrenewal of insurance policies.

(8) If the contract permits the MGA to settle claims on behalf of the insurer, the following apply:

(A) All claims must be reported to the company in a timely manner.

(B) A copy of the claim file will be sent to the insurer at its request or as soon as it becomes known that the claim:

(i) has the potential to exceed an amount determined by the commissioner or exceeds the limit set by the company, whichever is less;

(ii) involves a coverage dispute;

(iii) may exceed the MGA's claims settlement authority;

(iv) is open for more than six (6) months; or

(v) is closed by payment of an amount set by the commissioner or an amount set by the company, whichever is less.

(C) All claim files will be the joint property of the insurer and MGA. However, upon an order of liquidation of the insurer, those files shall become the sole property of the insurer or its estate. The MGA shall have reasonable access to and the right to copy the files on a timely basis.

(D) Any settlement authority granted to the MGA may be terminated for cause upon the insurer's written notice to the MGA or upon the termination of the contract. The insurer may suspend the settlement authority during the pendency of any dispute regarding the cause for termination.

(9) Where electronic claims files are in existence, the contract must address the timely transmission of the data in those files.

(10) If the contract provides for a sharing of interim profits by the MGA, and the MGA has the authority to determine the amount of the interim profits by establishing loss reserves or controlling claim payments, or in any other manner, interim profits will not be paid to the MGA:

(A) until one (1) year after the profits are earned, for property insurance business, and five (5) years after the profits are earned on casualty business; and

(B) until the profits have been verified pursuant to section 8 of this chapter.

(11) An MGA may not do any of the following:

(A) Bind reinsurance or retrocessions on behalf of the insurer, except that the MGA may bind facultative reinsurance contracts pursuant to obligatory facultative agreements if the contract with the insurer contains reinsurance underwriting guidelines, including, for both reinsurance assumed and ceded, a list of reinsurers with which the automatic agreements are in effect, the coverages and amounts or percentages that may be reinsured, and commission schedules.

(B) Commit the insurer to participate in insurance or reinsurance syndicates.

(C) Appoint any producer without assuring that the producer is lawfully licensed to transact the type of insurance for which the producer is appointed.

(D) Without prior approval of the insurer, pay or commit the insurer to pay a claim over a specified amount, net of reinsurance, which may not exceed one percent (1%) of the insurer's policyholder's surplus as of December 31 of the last completed calendar year before the payment or commitment.

(E) Collect any payment from a reinsurer or commit the insurer to any claim settlement with a reinsurer without prior approval of the insurer. If prior approval is given, a report must be promptly forwarded to the insurer.

(F) Permit its subproducer to serve on the insurer's board of directors.

(G) Jointly employ an individual who is employed with the insurer, unless the MGA and the insurer are affiliated in an insurance holding company system.

(H) Appoint a sub-MGA.

As added by P.L.1-1992, SEC.148. Amended by P.L.186-1997, SEC.9.
Ind. Code § 27-6-8-12 — Indiana Code / Title 27 / Article 6 / Chapter 8 / Section 27-6-8-12
Prevention of insolvencies
Status: in_force

Sec. 12. To aid in the detection and prevention of insurer insolvencies:

(1) Every member insurer shall file with the NAIC for use in their Early Warning System on or before March 1 of each year a financial statement of the same type and content as required by IC 27-1-20-21.

(2) It shall be the duty of the commissioner:

(A) To notify the commissioners of all of the other states, territories of the United States, and the District of Columbia in which a member insurer is licensed to do business when he takes any of the following actions against a member insurer:

(i) revocation of license;

(ii) suspension of license;

(iii) makes any formal order that such company restrict its premium writing, obtain additional contributions to surplus, withdraw from the state, reinsure all or any part of its business, or an increase in capital, surplus, or any other account for the security of policyholders or creditors. Such notice shall be mailed to all commissioners within thirty (30) days following the action taken or the date on which such action occurs.

(B) To report to the board of directors when he has taken any of the actions set forth in (A) of this paragraph or has received a report from any other commissioner indicating that any such action has been taken in another state. Such report to the board of directors shall contain all significant details of the action taken or the report received from another commissioner.

(C) To report to the board of directors when he has reasonable cause to believe from any examination, whether completed or in process, of any member company, that such company may be insolvent or in a financial condition hazardous to the policyholders or the public.

(3) The commissioner may seek the advice and recommendations of the board of directors concerning any matter affecting his duties and responsibilities regarding the financial condition of member companies and companies seeking admission to transact insurance business in this state.

(4) The board of directors may, upon majority vote, make reports and recommendations to the commissioner upon any matter germane to the solvency, liquidation, rehabilitation, or conservation of any member insurer or germane to the solvency of any company seeking to do an insurance business in this state. Such reports and recommendations shall not be considered public documents.

(5) The board of directors may, upon majority vote, request that the commissioner order an examination of any member insurer which the board in good faith believes may be in a financial condition hazardous to the policyholders or the public. Within thirty (30) days of the receipt of such request, the commissioner shall begin such examination. The examination may be conducted as a NAIC examination or may be conducted by such persons as the commissioner designates provided such persons are qualified insurance accountants or actuaries. The cost of such examination shall be paid by the association and the examination report shall be treated as are other examination reports. In no event shall such examination report be released to the board of directors prior to its release to the public, but this shall not preclude the commissioner from complying with subsection (1). The commissioner shall notify the board of directors when the examination is completed. The request for an examination shall be kept on file by the commissioner but it shall not be open to public inspection prior to the release of the examination report to the public.

(6) The board of directors may, upon majority vote, make recommendations to the commissioner for the detection and prevention of insurer insolvencies.

Formerly: Acts 1971, P.L.390, SEC.1. As amended by Acts 1977, P.L.281, SEC.8; P.L.163-1988, SEC.5; P.L.124-2018, SEC.66.
Ind. Code § 27-1-43.2-6 — Indiana Code / Title 27 / Article 1 / Chapter 43.2 / Section 27-1-43.2-6
"Road hazard"
Status: in_force

Sec. 6. (a) As used in this chapter, "road hazard" means a hazard encountered by a motor vehicle in normal driving conditions.

(b) "Road hazard" includes the following:

(1) A pothole.

(2) A rock.

(3) Wood debris.

(4) Metal parts.

(5) Glass.

(6) Plastic.

(7) A curb.

(8) A composite scrap.

As added by P.L.129-2014, SEC.10.
Ind. Code § 27-7-3-7 — Indiana Code / Title 27 / Article 7 / Chapter 3 / Section 27-7-3-7
Deposits; title insurance fund
Status: in_force

Sec. 7. Every company described in section 3 of this chapter, before engaging in business, shall deposit with the department the sum of fifty thousand dollars ($50,000) either out of its capital or surplus. The deposit shall be known as the title insurance fund and must be deposited in securities of the kind and character designated by IC 27-1-13-3(b).

Formerly: Acts 1937, c.104, s.7. As amended by P.L.252-1985, SEC.253; P.L.159-1986, SEC.5; P.L.161-1986, SEC.2; P.L.184-1996, SEC.3.
Ind. Code § 27-7-1-5 — Indiana Code / Title 27 / Article 7 / Chapter 1 / Section 27-7-1-5
Investments
Status: in_force

Sec. 5. Any such Lloyds as may be thus authorized to do business in this state shall not invest its funds except in accordance with the laws of this state relative to the investment of the funds of domestic stock insurance companies doing a similar business, except in such securities as may be held by said Lloyds as a guaranty for the payment of any subscription.

Formerly: Acts 1919, c.177, s.5.
Ind. Code § 27-9-3.1-8 — Indiana Code / Title 27 / Article 9 / Chapter 3.1 / Section 27-9-3.1-8
"Repurchase agreement"
Status: in_force

Sec. 8. As used in this chapter, "repurchase agreement" has the meaning set forth in the Federal Deposit Insurance Act (12 U.S.C. 1821).

As added by P.L.11-2011, SEC.36.
Ind. Code § 27-1-25.5-4 — Indiana Code / Title 27 / Article 1 / Chapter 25.5 / Section 27-1-25.5-4
"Pharmacy benefit manager"
Status: in_force

Sec. 4. As used in this chapter, "pharmacy benefit manager" has the meaning set forth in IC 27-1-24.5-12.

As added by P.L.69-2025, SEC.1.
Ind. Code § 27-13-2-9 — Indiana Code / Title 27 / Article 13 / Chapter 2 / Section 27-13-2-9
Prohibited names
Status: in_force

Sec. 9. (a) A health maintenance organization established under this article may not:

(1) use as a part of its corporate name the words "United States", "Federal", "government", "official", or any word that would imply that the company is an administrative agency of the state of Indiana or of the United States, or that it is subject to supervision of any department other than the department of insurance; or

(2) take or assume a corporate name the same as, or confusingly similar to, an existing name of any other insurance company or other entity licensed or regulated under IC 27, unless at the same time:

(A) the other company changes its corporate name or withdraws from transacting business in Indiana; and

(B) the written consent of the other company, signed and verified under oath by its secretary, is filed with the department.

(b) This section does not affect the right of any health maintenance organization that:

(1) exists under the laws of Indiana as of July 1, 2001;

(2) exists under the laws of Indiana as of July 1, 2001, and thereafter reorganizes or reincorporates under this article; or

(3) is authorized to transact business in Indiana as of July 1, 2001;

to continue the use of its corporate name.

As added by P.L.203-2001, SEC.17.
Ind. Code § 27-16-2-2 — Indiana Code / Title 27 / Article 16 / Chapter 2 / Section 27-16-2-2
"Administrative fee"
Status: in_force

Sec. 2. (a) "Administrative fee" means the fee charged to a client by a professional employer organization for professional employer services.

(b) The term does not include any amount charged to a client by a professional employer organization for wages and salaries, benefits, worker's compensation, payroll taxes, withholding, or other assessments paid by a professional employer organization to or on behalf of a covered employee.

As added by P.L.245-2005, SEC.7.
Ind. Code § 27-7-9-5 — Indiana Code / Title 27 / Article 7 / Chapter 9 / Section 27-7-9-5
"Structure"
Status: in_force

Sec. 5. As used in this chapter, "structure" means any dwelling, building, or fixture permanently fixed to real property. The term does not include land, trees, crops, or other plants.

As added by P.L.164-1986, SEC.1. Amended by P.L.124-1992, SEC.3; P.L.101-2016, SEC.3.
Ind. Code § 27-11-8-1 — Indiana Code / Title 27 / Article 11 / Chapter 8 / Section 27-11-8-1
Standards for valuation of certificates; maintenance of excess reserves on certificates
Status: in_force

Sec. 1. (a) Standards of valuation for certificates issued before January 1, 1987, shall be those provided by the laws applicable on December 31, 1985.

(b) The minimum standards of valuation for certificates issued after December 31, 1986, shall be based on the following tables:

(1) For certificates of life insurance─the Commissioner's 1941 Standard Ordinary Mortality Table, the Commissioner's 1941 Standard Industrial Mortality Table, the Commissioner's 1958 Standard Ordinary Mortality Table, the Commissioner's 1980 Standard Ordinary Mortality Table, the Commissioner's 2017 Standard Mortality Table, or any more recent table made applicable to life insurers and approved by the commissioner in rules adopted under IC 4-22-2.

(2) For annuity and pure endowment certificates, total and permanent disability benefits, accidental death benefits, and noncancellable accident and health benefits─such tables as are authorized for use by life insurers in this state.

(c) All of the above shall be under valuation methods and standards (including interest assumptions) in accordance with the laws of this state applicable to life insurers issuing policies containing like benefits.

(d) The commissioner may accept other standards for valuation if the commissioner finds that the reserves produced will not be less in the aggregate than reserves computed in accordance with the minimum valuation standard prescribed in this section. The commissioner may vary the standards of mortality applicable to all benefit contracts on substandard lives or other extra hazardous lives by any society authorized to do business in this state.

(e) Any society, with the consent of the commissioner of the state of domicile of the society and under the conditions, if any, that the commissioner may impose, may establish and maintain reserves on its certificates in excess of the reserves required thereunder, but the contractual rights of any benefit member shall not be affected thereby.

As added by P.L.262-1985, SEC.1. Amended by P.L.124-2018, SEC.86.
Ind. Code § 27-1-1.5-6 — Indiana Code / Title 27 / Article 1 / Chapter 1.5 / Section 27-1-1.5-6
Application of chapter; definitions
Status: in_force

Sec. 6. The references in this chapter and the definitions in this chapter apply throughout this title.

As added by P.L.124-2018, SEC.1.
Ind. Code § 27-8-10-12 — Indiana Code / Title 27 / Article 8 / Chapter 10 / Section 27-8-10-12
Repealed
Status: repealed

As added by P.L.193-2003, SEC.9. Repealed by P.L.51-2004, SEC.10.
Ind. Code § 27-8-24.3-7 — Indiana Code / Title 27 / Article 8 / Chapter 24.3 / Section 27-8-24.3-7
Insurer may adjust premiums
Status: in_force

Sec. 7. This chapter does not prohibit an insurer from adjusting premiums of an individual applying for or covered by an insurance policy described in Class 1(a) of IC 27-1-5-1 on the basis that the individual has a physical or mental condition or medical claims history.

As added by P.L.188-1996, SEC.2.
Ind. Code § 27-1-35-5 — Indiana Code / Title 27 / Article 1 / Chapter 35 / Section 27-1-35-5
"Controlled insurer" defined
Status: in_force

Sec. 5. As used in this chapter, "controlled insurer" means a licensed insurer that is controlled, directly or indirectly, by a producer.

As added by P.L.130-1994, SEC.36 and P.L.116-1994, SEC.47.
Ind. Code § 27-2-17-2 — Indiana Code / Title 27 / Article 2 / Chapter 17 / Section 27-2-17-2
"Department" defined
Status: in_force

Sec. 2. As used in this chapter, "department" means the department of insurance of Indiana.

As added by P.L.130-1994, SEC.37 and P.L.116-1994, SEC.48.
Ind. Code § 27-13-36.2-1 — Indiana Code / Title 27 / Article 13 / Chapter 36.2 / Section 27-13-36.2-1
"Clean claim" defined
Status: in_force

Sec. 1. As used in this chapter, "clean claim" means a claim submitted by a provider for payment for health care services provided to an enrollee that has no defect, impropriety, or particular circumstance requiring special treatment preventing payment.

As added by P.L.162-2001, SEC.6.
Ind. Code § 27-13-1-24 — Indiana Code / Title 27 / Article 13 / Chapter 1 / Section 27-13-1-24
"Participating provider"
Status: in_force

Sec. 24. "Participating provider" means a provider who, under an express or implied contract with:

(1) the health maintenance organization; or

(2) a contractor of the health maintenance organization or any subcontractor of a contractor of the health maintenance organization;

has agreed to provide health care services to enrollees with an expectation of directly or indirectly receiving payment, other than copayment or deductible, from the health maintenance organization.

As added by P.L.26-1994, SEC.25. Amended by P.L.195-1996, SEC.1.
Ind. Code § 27-1-45.2-5 — Indiana Code / Title 27 / Article 1 / Chapter 45.2 / Section 27-1-45.2-5
"Independent dispute resolution"
Status: in_force

Sec. 5. As used in this chapter, "independent dispute resolution" means the federal independent dispute resolution process established under 42 U.S.C. 300gg-111 and 45 CFR Part 149, Subpart F.

As added by P.L.119-2026, SEC.1.
Ind. Code § 27-1-3.1-17 — Indiana Code / Title 27 / Article 1 / Chapter 3.1 / Section 27-1-3.1-17
Liability of commissioner, authorized representative, or examiner; attorney's fees
Status: in_force

Sec. 17. (a) No cause of action shall arise nor shall any liability be imposed against the commissioner, the commissioner's authorized representatives or any examiner appointed by the commissioner for any statements made or conduct performed in good faith while carrying out the provisions of this chapter.

(b) No cause of action may arise, and no liability be imposed against any person for the act of communicating or delivering information or data to the commissioner or the commissioner's authorized representative or examiner pursuant to an examination made under this chapter, if that act of communication or delivery is performed in good faith and without fraudulent intent or the intent to deceive.

(c) This section does not abrogate or modify in any way any common law or statutory privilege or immunity enjoyed by any person identified in subsection (a).

(d) A person identified in subsection (a) is entitled to an award of attorney's fees and costs if that person is the prevailing party in a civil cause of action for libel, slander or any other relevant tort arising out of that person's activities in carrying out the provisions of this chapter and if the court finds the action was frivolous, unreasonable, groundless, or litigated in bad faith.

As added by P.L.26-1991, SEC.5.
Ind. Code § 27-8-29-15.5 — Indiana Code / Title 27 / Article 8 / Chapter 29 / Section 27-8-29-15.5
Information from independent review organization
Status: in_force

Sec. 15.5. Upon the request of a covered individual who is notified under section 15(d) of this chapter that the independent review organization has made a determination, the independent review organization shall provide to the covered individual all information reasonably necessary to enable the covered individual to understand the:

(1) effect of the determination on the covered individual; and

(2) manner in which the insurer may be expected to respond to the determination.

As added by P.L.173-2007, SEC.42.
Ind. Code § 27-1-27-12 — Indiana Code / Title 27 / Article 1 / Chapter 27 / Section 27-1-27-12
Disclosure by public adjuster of financial interests
Status: in_force

Sec. 12. (a) Before entering into a contract with an insured, a public adjuster shall provide to the insured a written disclosure concerning any direct or indirect financial interest that the public adjuster has with any other party that is or will be involved in any aspect of the insured's claim, other than by receiving a salary, fee, commission, or other consideration that will be established in the written contract with the insured.

(b) The direct or indirect financial interests that a public adjuster must disclose to an insured under subsection (a) includes any ownership by the public adjuster of, or any compensation that the public adjuster can expect to be received from, any:

(1) construction firm;

(2) salvage firm;

(3) lawyer or law firm;

(4) building appraisal firm; or

(5) board up company;

or any other firm that provides estimates for work, or performs any work in conjunction with the insured loss to which the contract between the public adjuster and the insured applies.

As added by P.L.226-2023, SEC.7.
Ind. Code § 27-2-27-29 — Indiana Code / Title 27 / Article 2 / Chapter 27 / Section 27-2-27-29
Private right of action
Status: in_force

Sec. 29. This chapter does not create a private right of action against any person.

As added by P.L.130-2020, SEC.10.
Ind. Code § 27-1-22-8 — Indiana Code / Title 27 / Article 1 / Chapter 22 / Section 27-1-22-8
Rating organizations; definitions; license; services to subscribers; rules; cooperation
Status: in_force

Sec. 8. (a) A rating organization is an individual, partnership, corporation, limited liability company, or unincorporated association other than an insurer located within or without this state, who or which has as its primary object and purpose the making and filing of rates, rating plans, rating systems, or rules relating thereto, and who or which may also examine policies, daily reports, binders, renewal certificates, endorsements, and other evidences of insurance or the cancellation thereof for any member or subscriber requesting such auditing service.

(b) Such a rating organization shall make application to the commissioner for license as a rating organization for such kinds of insurance, or subdivisions, or classes of risk, or parts or combination of any of the foregoing as are specified in its application and shall file therewith:

(1) a copy of its constitution, its articles of agreement or association or its certificate of incorporation, and of its bylaws, rules, and regulations governing the conduct of its business;

(2) a list of its members and subscribers;

(3) the name and address of a resident of this state upon whom notices or orders of the commissioner or process affecting such rating organization may be served; and

(4) a statement of its qualifications as a rating organization.

(c) If the commissioner finds that the applicant is competent, trustworthy, and otherwise qualified to act as a rating organization, and that its constitution, its articles of agreement or association, or its certificate of incorporation, and its bylaws, rules, and regulations governing the conduct of its business conform to the requirements of law, he shall issue a license specifying the kinds of insurance, or subdivisions, or classes of risk, or parts or combinations of any of the foregoing for which the applicant is authorized to act as a rating organization. Every such application shall be granted or denied in whole or in part by the commissioner within sixty (60) days of the date of its filing with him. Licenses issued pursuant to this section shall remain in effect for three (3) years unless sooner suspended or revoked by the commissioner. The fee for the license is seventy-five dollars ($75). Licenses issued pursuant to this section may be suspended or revoked by the commissioner, after hearing upon notice, in the event the rating organization ceases to meet the requirements of this subsection. Every rating organization shall notify the commissioner promptly of every change in:

(1) its constitution, its articles of agreement or association, or its certificate of incorporation, and its bylaws, rules, and regulations governing the conduct of its business;

(2) its list of members and subscribers; and

(3) the name and address of the resident of this state designated by it upon whom notices or orders of the commissioner or process affecting such rating organization may be served.

(d) Subject to rules and regulations which have been approved by the commissioner as reasonable, each rating organization shall permit any insurer, not a member, to be a subscriber to its services for any one (1) or more of the kinds of insurance, subdivisions, or classes of risk or parts or combinations of any of the foregoing for which it is authorized to act as an organization. Notice of proposed changes in such rules and regulations shall be given to subscribers. Each rating organization shall furnish its services without discrimination to its members and subscribers. The reasonableness of any rule or regulation in its application to subscribers, or the refusal of any rating organization to admit an insurer as a subscriber, shall, at the request of any subscriber or any such insurer, be reviewed by the commissioner at a hearing held upon at least ten (10) days written notice to such rating organization and to such subscriber or insurer. If the commissioner finds that such rule or regulation is unreasonable in its application to subscribers, he shall order that such rule or regulation shall not be applicable to subscribers. If the rating organization fails to grant or reject an insurer's application for subscribership within thirty (30) days after it was made, the insurer may request a review by the commissioner as if the application had been rejected. If the commissioner finds that the insurer has been refused admittance to the rating organization as a subscriber without justification, he shall order the rating organization to admit the insurer as a subscriber. If he finds that the action of the rating organization was justified, he shall make an order affirming its action.

(e) No rating organization shall adopt any rule the effect of which would be to prohibit or regulate the payment of dividends or savings allowed or returned by insurers to their policyholders or members.

(f) Cooperation among rating organizations or among rating organizations and insurers in ratemaking or in other matters within the scope of this chapter is hereby authorized, provided the filings resulting from such cooperation are subject to all the provisions of this chapter which are applicable to filing generally. The commissioner may review such cooperative activities and practices and if, after a hearing, he finds that any such activity or practice is unfair or unreasonable, or otherwise inconsistent with the provisions of this chapter, he may issue a written order specifying in what respects such activity or practice is unfair or unreasonable or otherwise inconsistent with the provisions of this chapter and requiring the discontinuance of such activity or practice.

(g) Any rating organization may subscribe for or purchase actuarial, technical, or other services, and such services shall be available to all members and subscribers without discrimination.

(h) A member of a rating organization means an insurer entitled to participate in its management and electing to exercise its right to so participate.

Formerly: Acts 1967, c.133, s.8. As amended by P.L.252-1985, SEC.111; P.L.31-1988, SEC.14; P.L.8-1993, SEC.415.
Ind. Code § 27-2-20-4 — Indiana Code / Title 27 / Article 2 / Chapter 20 / Section 27-2-20-4
Private right of action not created
Status: in_force

Sec. 4. This chapter does not create a private right of action against any person.

As added by P.L.203-2001, SEC.6.
Ind. Code § 27-8-4-7 — Indiana Code / Title 27 / Article 8 / Chapter 4 / Section 27-8-4-7
Filing of documents; disapproval of form of policy; effect; withdrawal of approval; review
Status: in_force

Sec. 7. (a) All policies, certificates of insurance, notices of proposed insurance, applications for insurance, endorsements, and riders delivered or issued for delivery in this state and the schedules of premium rates pertaining thereto shall be filed with the commissioner.

(b) The commissioner shall, within thirty (30) days after the filing of any such policies, certificates of insurance, notices of proposed insurance, applications for insurance, endorsements, and riders, disapprove any such form if the benefits provided therein are not reasonable in relation to the premium charge, or if it contains provisions which are unjust, unfair, inequitable, misleading, deceptive, or encourage misrepresentation of the coverage, or are contrary to any provision of this title or of a rule promulgated under this title.

(c) If the commissioner notifies the insurer that the form is disapproved, it shall be unlawful thereafter for such insurer to issue or use such form. In such notice, the commissioner shall specify the reason for his disapproval and state that a hearing will be granted within twenty (20) days after request in writing by the insurer. No such policy, certificate of insurance, notice of proposed insurance, nor any application, endorsement, or rider, shall be issued or used until the expiration of thirty (30) days after it has been so filed, unless the commissioner shall give his prior written approval thereto.

(d) The commissioner may, at any time after a hearing held not less than twenty (20) days after written notice to the insurer, withdraw his approval of any such form on any ground set forth in subsection (b). The written notice of such hearing shall state the reason for the proposed withdrawal.

(e) It shall be unlawful for the insurer to issue such forms or use them after the effective date of such withdrawal.

(f) If a group policy of credit life insurance or credit accident and health insurance:

(1) has been delivered by an insurer in this state before July 6, 1961; or

(2) has been or is delivered by an insurer in another state before or after July 6, 1961;

such insurer shall be required to file only the group certificate and notice of proposed insurance delivered or issued for delivery in this state as specified in sections 6(b) and 6(d) of this chapter, and such forms shall be approved by the commissioner if they conform with the requirements specified in sections 6(b) and 6(d) and if the schedules of premium rates applicable to the insurance evidenced by such certificate or notice are not in excess of the insurer's schedules of premium rates on file with the commissioner; provided, however, that the premium rate in effect on group policies existing on July 6, 1961, may be continued until the first policy anniversary date following the date this section becomes operative as provided in section 12 of this chapter.

(g) Any order or final determination of the commissioner under the provisions of this section shall be subject to judicial review.

Formerly: Acts 1961, c.47, s.7. As amended by P.L.252-1985, SEC.299.
Ind. Code § 27-8-25-1 — Indiana Code / Title 27 / Article 8 / Chapter 25 / Section 27-8-25-1
"Care method"
Status: in_force

Sec. 1. As used in this chapter, "care method" means the use of a particular drug or device in a particular manner.

As added by P.L.109-2009, SEC.3.
Ind. Code § 27-8-4-6 — Indiana Code / Title 27 / Article 8 / Chapter 4 / Section 27-8-4-6
Policy or certificate; delivery; rejection of risk; to another insurer; credit for lower premium
Status: in_force

Sec. 6. (a) All credit life insurance and credit accident and health insurance shall be evidenced by an individual policy, or in the case of group insurance by a certificate of insurance, which individual policy of group certificate of insurance shall be delivered to the debtor.

(b) Each individual policy or group certificate of credit life insurance or credit accident and health insurance shall, in addition to other requirements of law, set forth:

(1) the name and home office address of the insurer;

(2) the name or names of the debtor or in the case of a certificate under a group policy, the identity by name or otherwise of the debtor;

(3) the premium or amount of payment, if any, by the debtor separately for credit life insurance and credit accident and health insurance;

(4) a description of the coverage, including the amount and term of the coverage;

(5) any exceptions, limitations, and restrictions; and

(6) that the benefits shall be paid to the creditor to reduce or extinguish the unpaid indebtedness and, wherever the amount of insurance may exceed the unpaid indebtedness, that any such excess shall be payable to a beneficiary, other than the creditor, named by the debtor or to the debtor's estate.

(c) Said individual policy or group certificate of insurance shall be delivered to the insured debtor at the time the indebtedness is incurred except as provided in this chapter.

(d) If said individual policy or group certificate of insurance is not delivered to the debtor at the time the indebtedness is incurred, a copy of the application for such policy or a notice of proposed insurance, signed by the debtor and setting forth:

(1) the name and home office address of the insurer;

(2) the name or names of the debtor;

(3) the premium or amount of payment by the debtor, if any, separately for credit life insurance and credit accident and health insurance; and

(4) the amount, term, and a brief description of the coverage provided;

shall be delivered to the debtor at the time such indebtedness is incurred. The copy of the application for, or notice of proposed insurance, shall also refer exclusively to insurance coverage, and shall be separate and apart from the loan, sale, or other credit statement of account, instrument, or agreement, unless the information required by this subsection is prominently set forth in the loan, sale, or other credit statement of account, instrument, or agreement. Upon acceptance of the insurance by the insurer and within thirty (30) days of the date upon which the indebtedness is incurred, the insurer shall cause the individual policy or group certificate of insurance to be delivered to the debtor. Said application or notice of proposed insurance shall state that upon acceptance by the insurer, the insurance shall become effective as provided in section 5 of this chapter.

(e) If the named insurer does not accept the risk, then and in such event the debtor shall receive a policy or certificate of insurance, if one (1) can be obtained from another insurer, setting forth the name and home office address of the substituted insurer and the amount of the premium to be charged, and if the amount of premium is less than that set forth in the notice of proposed insurance an appropriate refund shall be made.

Formerly: Acts 1961, c.47, s.6. As amended by P.L.252-1985, SEC.298; P.L.255-1995, SEC.8; P.L.136-2018, SEC.193.
Ind. Code § 27-8-10-10 — Indiana Code / Title 27 / Article 8 / Chapter 10 / Section 27-8-10-10
Eligibility guidelines
Status: in_force

Sec. 10. Before January 1, 1996, the board of directors of the association shall establish eligibility guidelines for the issuance of an association policy under this chapter to prohibit an:

(1) employer;

(2) insurance producer; or

(3) insurance broker;

from placing in or referring to the association an individual who works for an employer who offers employees an employee welfare benefit plan (as defined in 29 U.S.C. 1002).

As added by P.L.93-1995, SEC.9. Amended by P.L.178-2003, SEC.64.
Ind. Code § 27-7-17-3 — Indiana Code / Title 27 / Article 7 / Chapter 17 / Section 27-7-17-3
"Aggregator site"
Status: in_force

Sec. 3. As used in this chapter, "aggregator site" means an Internet web site that provides access to information regarding insurance products from more than one (1) insurer, including product and insurer information, for use in comparison shopping.

As added by P.L.19-2022, SEC.5.
Ind. Code § 27-1-16.1-6 — Indiana Code / Title 27 / Article 1 / Chapter 16.1 / Section 27-1-16.1-6
"Self-storage rental agreement"
Status: in_force

Sec. 6. As used in this chapter, "self-storage rental agreement" means a written agreement containing the terms and conditions governing the use of storage space provided by a self-storage facility.

As added by P.L.81-2013, SEC.3.