Tenn. Code Ann. § 56-9-324 — TN Code / Title 56 / Chapter 9 / Section 56-9-324
Proof of claim - Form - Information to be included in form
Status: in_force

(a) Proof of claim shall consist of a statement, signed by the claimant, that includes all of the following that are applicable: (1) The particulars of the claim including the consideration given for it; (2) The identity and amount of the security on the claim; (3) The payments made on the debt, if any; (4) That the sum claimed is justly owing and that there is no setoff, counterclaim or defense to the claim; (5) Any right of priority of payment or other specific right asserted by the claimant; (6) A copy of the written instrument which is the foundation of the claim; and (7) The name and address of the claimant and the attorney who represents the claimant, if any. (b) No claim need be considered or allowed if it does not contain all the information in subsection (a) that may be applicable. The liquidator may require that a prescribed form be used, and may require that other information and documents be included. (c) At any time the liquidator may request the claimant to present information or evidence supplementary to that required under subsection (a) and may take testimony under oath, require production of affidavits or depositions, or otherwise obtain additional information or evidence. (d) No judgment or order against an insured or the insurer entered after the date of filing of a successful petition for liquidation, and no judgment or order against an insured or the insurer entered at any time by default or by collusion, need be considered as evidence of liability or of the quantum of damages. No judgment or order against an insured or the insurer entered within four (4) months before the filing of the petition need be considered as evidence of liability or of the quantum of damages. (e) All claims of a guaranty association or foreign guaranty association shall be in the form and contain the substantiation that may be agreed to by the association and the liquidator. Acts 1991, ch. 142, § 4.
(a) Proof of claim shall consist of a statement, signed by the claimant, that includes all of the following that are applicable: (1) The particulars of the claim including the consideration given for it; (2) The identity and amount of the security on the claim; (3) The payments made on the debt, if any; (4) That the sum claimed is justly owing and that there is no setoff, counterclaim or defense to the claim; (5) Any right of priority of payment or other specific right asserted by the claimant; (6) A copy of the written instrument which is the foundation of the claim; and (7) The name and address of the claimant and the attorney who represents the claimant, if any.
(1) The particulars of the claim including the consideration given for it;
(2) The identity and amount of the security on the claim;
(3) The payments made on the debt, if any;
(4) That the sum claimed is justly owing and that there is no setoff, counterclaim or defense to the claim;
(5) Any right of priority of payment or other specific right asserted by the claimant;
(6) A copy of the written instrument which is the foundation of the claim; and
(7) The name and address of the claimant and the attorney who represents the claimant, if any.
(b) No claim need be considered or allowed if it does not contain all the information in subsection (a) that may be applicable. The liquidator may require that a prescribed form be used, and may require that other information and documents be included.
(c) At any time the liquidator may request the claimant to present information or evidence supplementary to that required under subsection (a) and may take testimony under oath, require production of affidavits or depositions, or otherwise obtain additional information or evidence.
(d) No judgment or order against an insured or the insurer entered after the date of filing of a successful petition for liquidation, and no judgment or order against an insured or the insurer entered at any time by default or by collusion, need be considered as evidence of liability or of the quantum of damages. No judgment or order against an insured or the insurer entered within four (4) months before the filing of the petition need be considered as evidence of liability or of the quantum of damages.
(e) All claims of a guaranty association or foreign guaranty association shall be in the form and contain the substantiation that may be agreed to by the association and the liquidator.
Acts 1991, ch. 142, § 4.
Tenn. Code Ann. § 56-7-2350 — TN Code / Title 56 / Chapter 7 / Section 56-7-2350
Maternity benefits - Minimum standards of coverage
Status: in_force

(a) The general assembly finds that Tennesseans are increasingly concerned that mothers and newborns receive proper medical care prior to hospital discharge. The general assembly further finds that the lack of proper medical care jeopardizes the health, safety and well-being of the mothers and newborns and may result in serious, costly repercussions not only for the mothers and newborns but also for the entire state. The general assembly, therefore, finds and declares the existence of an immediate and substantial threat to the public health, safety and welfare. The general assembly acknowledges and endorses the recently promulgated emergency rules of the departments of finance and administration and commerce and insurance to timely address these important concerns. (b) In accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, the departments are authorized to promulgate permanent rules establishing minimum standards of coverage for maternity benefits offered by insurers. The rules will establish standards sufficient to protect and promote the health, safety and well-being of both the post-partum mother and the newborn and recognize the relationship between the mother and physician. Acts 1996, ch. 964, § 1.
(a) The general assembly finds that Tennesseans are increasingly concerned that mothers and newborns receive proper medical care prior to hospital discharge. The general assembly further finds that the lack of proper medical care jeopardizes the health, safety and well-being of the mothers and newborns and may result in serious, costly repercussions not only for the mothers and newborns but also for the entire state. The general assembly, therefore, finds and declares the existence of an immediate and substantial threat to the public health, safety and welfare. The general assembly acknowledges and endorses the recently promulgated emergency rules of the departments of finance and administration and commerce and insurance to timely address these important concerns.
(b) In accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, the departments are authorized to promulgate permanent rules establishing minimum standards of coverage for maternity benefits offered by insurers. The rules will establish standards sufficient to protect and promote the health, safety and well-being of both the post-partum mother and the newborn and recognize the relationship between the mother and physician.
Acts 1996, ch. 964, § 1.
Tenn. Code Ann. § 56-37-118 — TN Code / Title 56 / Chapter 37 / Section 56-37-118
Privacy or confidentiality of shared information
Status: in_force

In order to promote more effective regulation and reduce regulatory burden through supervisory information sharing: (1) The requirements under any federal or state law regarding the privacy or confidentiality of any information or material provided to a multi-state automated licensing system, and any privilege arising under federal or state law, including the rules of any federal or state court, with respect to such information or material, continue to apply to the information or material after it has been disclosed to a multi-state automated licensing system. The information or material may be shared with all state and federal regulatory officials with premium finance company oversight authority without the loss of privilege or confidentiality protections provided by federal or state law, including the protection available under § 45-1-120 ; (2) For purposes of subdivision (1), the commissioner may enter into agreements or sharing agreements with other governmental agencies, the Conference of State Bank Supervisors, or other associations representing governmental agencies, as established by rule, regulation, or order of the commissioner; (3) Information or material that is subject to a privilege or confidentiality protection under subdivision (1) shall not be subject to: (A) Disclosure under any federal or state law governing disclosure to the public of information held by an officer or agency of the federal government or the respective state; or (B) Subpoena or discovery or admission into evidence in any private civil action or administrative process, unless the person to whom such information or material pertains, in the person's discretion, waives any applicable privilege held by a multi-state automated licensing system, in whole or in part; (4) This section supersedes any inconsistent provisions of title 10, chapter 7, part 5, pertaining to the records open to public inspection; and (5) This section does not apply with respect to information or material relating to publicly adjudicated disciplinary and enforcement actions against persons subject to this chapter that is included in a multi-state automated licensing system for access by the public. Added by 2017 Tenn. Acts, ch. 122,s 14, eff. 7/1/2018.
In order to promote more effective regulation and reduce regulatory burden through supervisory information sharing:
(1) The requirements under any federal or state law regarding the privacy or confidentiality of any information or material provided to a multi-state automated licensing system, and any privilege arising under federal or state law, including the rules of any federal or state court, with respect to such information or material, continue to apply to the information or material after it has been disclosed to a multi-state automated licensing system. The information or material may be shared with all state and federal regulatory officials with premium finance company oversight authority without the loss of privilege or confidentiality protections provided by federal or state law, including the protection available under § 45-1-120 ;
(2) For purposes of subdivision (1), the commissioner may enter into agreements or sharing agreements with other governmental agencies, the Conference of State Bank Supervisors, or other associations representing governmental agencies, as established by rule, regulation, or order of the commissioner;
(3) Information or material that is subject to a privilege or confidentiality protection under subdivision (1) shall not be subject to: (A) Disclosure under any federal or state law governing disclosure to the public of information held by an officer or agency of the federal government or the respective state; or (B) Subpoena or discovery or admission into evidence in any private civil action or administrative process, unless the person to whom such information or material pertains, in the person's discretion, waives any applicable privilege held by a multi-state automated licensing system, in whole or in part;
(A) Disclosure under any federal or state law governing disclosure to the public of information held by an officer or agency of the federal government or the respective state; or
(B) Subpoena or discovery or admission into evidence in any private civil action or administrative process, unless the person to whom such information or material pertains, in the person's discretion, waives any applicable privilege held by a multi-state automated licensing system, in whole or in part;
(4) This section supersedes any inconsistent provisions of title 10, chapter 7, part 5, pertaining to the records open to public inspection; and
(5) This section does not apply with respect to information or material relating to publicly adjudicated disciplinary and enforcement actions against persons subject to this chapter that is included in a multi-state automated licensing system for access by the public.
Added by 2017 Tenn. Acts, ch. 122,s 14, eff. 7/1/2018.
Tenn. Code Ann. § 56-7-2354 — TN Code / Title 56 / Chapter 7 / Section 56-7-2354
Coverage for early detection of prostrate cancer
Status: in_force

(a) As used in this section: (1) "Cost sharing requirement" means a deductible, coinsurance, copayment, or a maximum limitation on the application of a deductible, coinsurance, copayment, or other out-of-pocket expense; (2) "Health benefit plan": (A) Means a hospital or medical expense policy; health, hospital, or medical service corporation contract; policy or agreement entered into by a health insurer; or health maintenance organization contract offered by an employer; (B) Includes a state insurance plan set out in title 8, chapter 27; a policy or contract for health insurance coverage provided under the TennCare medical assistance program or a successor program provided for in title 71, chapter 5; and a policy or contract for health insurance coverage provided under the CoverKids program or a successor program provided for in title 71, chapter 3; and (C) Does not include policies or certificates covering only accident, credit, dental, disability income, long-term care, hospital indemnity, medicare supplement, as defined in § 1882(g)(1) of the Social Security Act ( 42 U.S.C. § 1395ss(g)(1) ), specified disease, or vision care; other limited benefit health insurance; coverage issued as a supplement to liability insurance; workers' compensation insurance; automobile medical payment insurance; or insurance that is statutorily required to be contained in any liability insurance policy or equivalent self insurance; and (3) "Men with a family history of prostate cancer" means men who have a first-degree relative: (A) Who was diagnosed with prostate cancer; (B) Who developed prostate cancer; (C) Whose death was a result of prostate cancer; (D) Who has been diagnosed with a cancer known to be associated with an increased risk of prostate cancer; or (E) Who has a genetic alteration known to be associated with an increased risk of prostate cancer. (b) A health benefit plan shall provide, upon the recommendation of a physician, coverage for the early detection of prostate cancer for: (1) Men forty (40) to forty-nine (49) years of age who are at a high risk of developing prostate cancer, including African-American men and men with a family history of prostate cancer; (2) Men fifty (50) years of age and older; and (3) Other men, if a physician determines that early detection for prostate cancer is medically necessary. (c) (1) Except as provided in subdivision (c)(2), a health benefit plan that provides coverage for the early detection of prostate cancer must provide such coverage without imposing a cost sharing requirement on the enrollee. (2) If compliance with subdivision (c)(1) would result in a high deductible health benefit plan with a health savings account becoming ineligible under § 223 of the Internal Revenue Code ( 26 U.S.C. § 223 ), then subdivision (c)(1) applies to such plans only after the plan enrollee has satisfied the minimum deductible required under § 223 of the Internal Revenue Code, except with respect to items or services that are deemed preventive care pursuant to § 223(c)(2)(C) of the Internal Revenue Code. (d) Notwithstanding subsection (b), a policy or contract for health insurance coverage provided under the TennCare medical assistance program or a successor program provided for in title 71, chapter 5, or the CoverKids program or a successor program provided for in title 71, chapter 3, must provide coverage pursuant to this section when determined to be medically necessary pursuant to § 71-5-144 . Amended by 2024 Tenn. Acts, ch. 1003,s 2, eff. 7/1/2024. Acts 1997 , ch. 443, § 1.
(a) As used in this section: (1) "Cost sharing requirement" means a deductible, coinsurance, copayment, or a maximum limitation on the application of a deductible, coinsurance, copayment, or other out-of-pocket expense; (2) "Health benefit plan": (A) Means a hospital or medical expense policy; health, hospital, or medical service corporation contract; policy or agreement entered into by a health insurer; or health maintenance organization contract offered by an employer; (B) Includes a state insurance plan set out in title 8, chapter 27; a policy or contract for health insurance coverage provided under the TennCare medical assistance program or a successor program provided for in title 71, chapter 5; and a policy or contract for health insurance coverage provided under the CoverKids program or a successor program provided for in title 71, chapter 3; and (C) Does not include policies or certificates covering only accident, credit, dental, disability income, long-term care, hospital indemnity, medicare supplement, as defined in § 1882(g)(1) of the Social Security Act ( 42 U.S.C. § 1395ss(g)(1) ), specified disease, or vision care; other limited benefit health insurance; coverage issued as a supplement to liability insurance; workers' compensation insurance; automobile medical payment insurance; or insurance that is statutorily required to be contained in any liability insurance policy or equivalent self insurance; and (3) "Men with a family history of prostate cancer" means men who have a first-degree relative: (A) Who was diagnosed with prostate cancer; (B) Who developed prostate cancer; (C) Whose death was a result of prostate cancer; (D) Who has been diagnosed with a cancer known to be associated with an increased risk of prostate cancer; or (E) Who has a genetic alteration known to be associated with an increased risk of prostate cancer.
(1) "Cost sharing requirement" means a deductible, coinsurance, copayment, or a maximum limitation on the application of a deductible, coinsurance, copayment, or other out-of-pocket expense;
(2) "Health benefit plan": (A) Means a hospital or medical expense policy; health, hospital, or medical service corporation contract; policy or agreement entered into by a health insurer; or health maintenance organization contract offered by an employer; (B) Includes a state insurance plan set out in title 8, chapter 27; a policy or contract for health insurance coverage provided under the TennCare medical assistance program or a successor program provided for in title 71, chapter 5; and a policy or contract for health insurance coverage provided under the CoverKids program or a successor program provided for in title 71, chapter 3; and (C) Does not include policies or certificates covering only accident, credit, dental, disability income, long-term care, hospital indemnity, medicare supplement, as defined in § 1882(g)(1) of the Social Security Act ( 42 U.S.C. § 1395ss(g)(1) ), specified disease, or vision care; other limited benefit health insurance; coverage issued as a supplement to liability insurance; workers' compensation insurance; automobile medical payment insurance; or insurance that is statutorily required to be contained in any liability insurance policy or equivalent self insurance; and
(A) Means a hospital or medical expense policy; health, hospital, or medical service corporation contract; policy or agreement entered into by a health insurer; or health maintenance organization contract offered by an employer;
(B) Includes a state insurance plan set out in title 8, chapter 27; a policy or contract for health insurance coverage provided under the TennCare medical assistance program or a successor program provided for in title 71, chapter 5; and a policy or contract for health insurance coverage provided under the CoverKids program or a successor program provided for in title 71, chapter 3; and
(C) Does not include policies or certificates covering only accident, credit, dental, disability income, long-term care, hospital indemnity, medicare supplement, as defined in § 1882(g)(1) of the Social Security Act ( 42 U.S.C. § 1395ss(g)(1) ), specified disease, or vision care; other limited benefit health insurance; coverage issued as a supplement to liability insurance; workers' compensation insurance; automobile medical payment insurance; or insurance that is statutorily required to be contained in any liability insurance policy or equivalent self insurance; and
(3) "Men with a family history of prostate cancer" means men who have a first-degree relative: (A) Who was diagnosed with prostate cancer; (B) Who developed prostate cancer; (C) Whose death was a result of prostate cancer; (D) Who has been diagnosed with a cancer known to be associated with an increased risk of prostate cancer; or (E) Who has a genetic alteration known to be associated with an increased risk of prostate cancer.
(A) Who was diagnosed with prostate cancer;
(B) Who developed prostate cancer;
(C) Whose death was a result of prostate cancer;
(D) Who has been diagnosed with a cancer known to be associated with an increased risk of prostate cancer; or
(E) Who has a genetic alteration known to be associated with an increased risk of prostate cancer.
(b) A health benefit plan shall provide, upon the recommendation of a physician, coverage for the early detection of prostate cancer for: (1) Men forty (40) to forty-nine (49) years of age who are at a high risk of developing prostate cancer, including African-American men and men with a family history of prostate cancer; (2) Men fifty (50) years of age and older; and (3) Other men, if a physician determines that early detection for prostate cancer is medically necessary.
(1) Men forty (40) to forty-nine (49) years of age who are at a high risk of developing prostate cancer, including African-American men and men with a family history of prostate cancer;
(2) Men fifty (50) years of age and older; and
(3) Other men, if a physician determines that early detection for prostate cancer is medically necessary.
(c) (1) Except as provided in subdivision (c)(2), a health benefit plan that provides coverage for the early detection of prostate cancer must provide such coverage without imposing a cost sharing requirement on the enrollee. (2) If compliance with subdivision (c)(1) would result in a high deductible health benefit plan with a health savings account becoming ineligible under § 223 of the Internal Revenue Code ( 26 U.S.C. § 223 ), then subdivision (c)(1) applies to such plans only after the plan enrollee has satisfied the minimum deductible required under § 223 of the Internal Revenue Code, except with respect to items or services that are deemed preventive care pursuant to § 223(c)(2)(C) of the Internal Revenue Code.
(1) Except as provided in subdivision (c)(2), a health benefit plan that provides coverage for the early detection of prostate cancer must provide such coverage without imposing a cost sharing requirement on the enrollee.
(2) If compliance with subdivision (c)(1) would result in a high deductible health benefit plan with a health savings account becoming ineligible under § 223 of the Internal Revenue Code ( 26 U.S.C. § 223 ), then subdivision (c)(1) applies to such plans only after the plan enrollee has satisfied the minimum deductible required under § 223 of the Internal Revenue Code, except with respect to items or services that are deemed preventive care pursuant to § 223(c)(2)(C) of the Internal Revenue Code.
(d) Notwithstanding subsection (b), a policy or contract for health insurance coverage provided under the TennCare medical assistance program or a successor program provided for in title 71, chapter 5, or the CoverKids program or a successor program provided for in title 71, chapter 3, must provide coverage pursuant to this section when determined to be medically necessary pursuant to § 71-5-144 .
Amended by 2024 Tenn. Acts, ch. 1003,s 2, eff. 7/1/2024.
Acts 1997 , ch. 443, § 1.
Tenn. Code Ann. § 56-51-111 — TN Code / Title 56 / Chapter 51 / Section 56-51-111
Language used in contracts and marketing materials
Status: in_force

All prepaid limited health services contracts, marketing materials, and literature must disclose in boldfaced type the name of the organization and disclose that the organization is a prepaid limited health service organization licensed under this chapter. Acts 2000, ch. 948, § 11.
All prepaid limited health services contracts, marketing materials, and literature must disclose in boldfaced type the name of the organization and disclose that the organization is a prepaid limited health service organization licensed under this chapter.
Acts 2000, ch. 948, § 11.
Tenn. Code Ann. § 56-4-105 — TN Code / Title 56 / Chapter 4 / Section 56-4-105
Refund of erroneously paid amounts
Status: in_force

(a) With respect to any revenues or receipts collected by the department, any other law to the contrary notwithstanding, the amounts determined to have been erroneously paid may be refunded by the procedure developed by the commissioner of finance and administration and approved by the comptroller of the treasury. (b) The procedure shall provide that no refund shall be made unless within three (3) years from December 31 of the year in which the erroneous payment was made, the refund is either requested by the claimant or made by the state on its own motion. Acts 1984, ch. 633, § 1.
(a) With respect to any revenues or receipts collected by the department, any other law to the contrary notwithstanding, the amounts determined to have been erroneously paid may be refunded by the procedure developed by the commissioner of finance and administration and approved by the comptroller of the treasury.
(b) The procedure shall provide that no refund shall be made unless within three (3) years from December 31 of the year in which the erroneous payment was made, the refund is either requested by the claimant or made by the state on its own motion.
Acts 1984, ch. 633, § 1.
Tenn. Code Ann. § 56-7-2903 — TN Code / Title 56 / Chapter 7 / Section 56-7-2903
[For postponed repeal effective 6/30/2025, see T.C.A. 56-7-2916] Creation of Access Tennessee health insurance program - Board of directors - Advisory committee - Funding plan and plan of operation - Promulgation of rules - Errors and omissions by commissioner or board members
Status: in_force

(a) There is created a nonprofit entity known as Access Tennessee to operate a program to provide health insurance coverage pursuant to this part. The program shall be known as the Access Tennessee health insurance program. (b) Access Tennessee shall operate the program subject to the supervision and control of a board of directors composed of fourteen (14) members. The commissioner shall, within ninety (90) days after July 1, 2006, give notice to all insurers of the time and place for the initial organizational meeting of the board. The board shall consist of the following members: (1) The commissioner of finance and administration or the commissioner's designee; (2) The commissioner of health or the commissioner's designee; (3) The commissioner of mental health and substance abuse services or the commissioner's designee; (4) One (1) representative of the Tennessee Hospital Association, selected by the commissioner; (5) One (1) representative of the Tennessee Medical Association, selected by the commissioner; (6) One (1) member involved primarily as a producer in the business of health insurance, selected by the commissioner; (7) One (1) member of the general public, selected by the commissioner; (8) One (1) member selected by the speaker of the house of representatives; (9) One (1) member selected by the speaker of the senate; (10) One (1) representative of an employer of greater than or equal to five hundred (500) employees that is self-insured, selected by the commissioner; (11) One (1) representative of an employer of less than five hundred (500) employees that is commercially insured, selected by the commissioner; (12) One (1) representative of a hospital medical service corporation, selected by the commissioner, unless, pursuant to subsection (d), no such representative is able to serve, in which case this position shall be filled by a representative of another insurer; (13) One (1) representative of an insurer other than a hospital medical service corporation, selected by the commissioner, unless, pursuant to subsection (d), no such representative is able to serve, in which case this position shall be filled by a representative of another insurer; and (14) The commissioner of disability and aging or the commissioner's designee. (c) The commissioner and the speakers of the senate and the house of representatives, in making appointments to the board, shall strive to ensure that the membership of the board is representative of the state's geographic and demographic composition, with appropriate attention to the representation of women and minorities. (d) No individual representing an entity selected to administer the program, pursuant to § 56-7-2909 , or its affiliates shall serve on the board. Any appointed board member who represents an entity or affiliate that has the intention of serving as administrator of the program shall be prohibited from serving as the administrator, unless the board member provides written notice to the board of the entity's or affiliate's intent to bid on the contract for administrator. The notice shall be delivered to the board at least six (6) months prior to the release of any request for proposal (RFP) seeking to select or renew an administrator. In the event the notice is delivered, the board member shall simultaneously resign the board member's membership on the board. (e) The commissioner shall, on an annual basis, designate one (1) member of the board to serve as chair and one (1) member of the board to serve as vice chair. (f) The board members selected pursuant to subdivisions (b)(4), (5) and (6) shall serve for an original term of one (1) year. The board members selected pursuant to subdivisions (b)(8), (9), (12) and (13) shall serve for an original term of two (2) years. The board members selected pursuant to subdivisions (b)(7), (10) and (11) shall serve for an original term of three (3) years. Thereafter, all board members selected pursuant to subdivisions (b)(4) - (11) shall serve for a term of three (3) years. Board members appointed pursuant to subdivisions (b)(12) and (13) shall not be appointed to the board until after Access Tennessee awards an initial contract to an administrator of the program. (g) Board members shall receive no compensation, but shall be reimbursed for all travel expenses in accordance with state travel regulations. (h) Vacancies in the board shall be filled by the appropriate appointing authority. Board members may be removed by their respective appointing authority for cause. (i) In order to assist the board, there shall be an advisory committee consisting of five (5) representatives of insurers that offer health insurance coverage in this state who shall be selected by the commissioner. The advisory committee may provide advice on insurance related issues, including, but not limited to, benefit design and market impact of the plans created and offered by Access Tennessee. (j) The board, on an annual basis, shall submit to the commissioner a funding plan and a plan for operation of the program and any amendments necessary or suitable to assure the fair, reasonable, and efficient administration of the program and its financial solvency, based upon timely and accurate actuarial assumptions. The plan of operation is effective upon approval, in writing, by the commissioner. (k) The commissioner shall approve the funding plan and the plan of operation if the commissioner determines that the plans assure the financial solvency of the program, the efficient administration of the program, and compliance with this part. (l) If the board fails to submit a suitable plan of operation within one hundred eighty (180) days after the appointment of the board or at any time thereafter fails to submit suitable amendments to the plan of operation, then the commissioner may initiate actions necessary or advisable to effectuate this part. The actions continue in effect until modified by the commissioner or superseded by a plan of operation submitted by the board and approved by the commissioner. To the extent that the actions include the promulgation of rules to effectuate this part, the rules must be promulgated as emergency rules pursuant to § 4-5-208 . (m) The plan of operation shall: (1) Establish procedures for operation of the program; (2) Establish procedures for selecting an administrator, in accordance with § 56-7-2909 ; (3) Establish procedures to create a fund, under management of the board, for administrative expenses; (4) Establish procedures for the handling, accounting, and auditing of assets, moneys and claims of the program and the program administrator; (5) Develop and implement a program to publicize the existence of the program, the eligibility requirements, and procedures for enrollment, and to maintain public awareness of the program; (6) Establish procedures under which applicants and participants may have grievances reviewed by a grievance committee appointed by the board. The grievances shall be reported to the board after completion of the review. The board shall retain all written complaints regarding the plan for at least three (3) years; (7) Establish procedures to implement the requirements of § 56-7-2909(g) ; and (8) Provide for other matters as may be necessary and proper for the execution of the board's powers, duties and obligations under this part. (n) The funding plan shall: (1) Establish premium rates for the upcoming year, pursuant to § 56-7-2911(a) ; (2) Establish an assessment rate for insurers and insurance arrangements, pursuant to § 56-7-2911(a)(2) ; provided, however, that the total amount of the assessments authorized under § 56-7-2911(a)(2) for a fiscal year shall not exceed the amount appropriated by the state to the program for that same fiscal year; and (3) Identify other available funds for the program, including any legislative appropriations and federal funding. (o) There shall be no liability on the part of, and no cause of action of any nature shall arise against, the commissioner or the board members, or any of their employees or agents, for any omission or any action taken by them within the scope of their duties arising from this part, except for willful, malicious or criminal acts or omissions done for personal gain. Amended by 2024 Tenn. Acts, ch. 688,s 144, eff. 7/1/2024. Amended by 2022 Tenn. Acts, ch. 662, Secs.s 1, s 2, s 3 eff. 3/16/2022. Amended by 2015 Tenn. Acts, ch. 185, s 3, eff. 4/22/2015. Acts 2006, ch. 867, § 3; 2006, ch. 894, §§ 2, 14; 2010 , ch. 1100, §§ 96, 97; 2012 , ch. 575, § 2.
(a) There is created a nonprofit entity known as Access Tennessee to operate a program to provide health insurance coverage pursuant to this part. The program shall be known as the Access Tennessee health insurance program.
(b) Access Tennessee shall operate the program subject to the supervision and control of a board of directors composed of fourteen (14) members. The commissioner shall, within ninety (90) days after July 1, 2006, give notice to all insurers of the time and place for the initial organizational meeting of the board. The board shall consist of the following members: (1) The commissioner of finance and administration or the commissioner's designee; (2) The commissioner of health or the commissioner's designee; (3) The commissioner of mental health and substance abuse services or the commissioner's designee; (4) One (1) representative of the Tennessee Hospital Association, selected by the commissioner; (5) One (1) representative of the Tennessee Medical Association, selected by the commissioner; (6) One (1) member involved primarily as a producer in the business of health insurance, selected by the commissioner; (7) One (1) member of the general public, selected by the commissioner; (8) One (1) member selected by the speaker of the house of representatives; (9) One (1) member selected by the speaker of the senate; (10) One (1) representative of an employer of greater than or equal to five hundred (500) employees that is self-insured, selected by the commissioner; (11) One (1) representative of an employer of less than five hundred (500) employees that is commercially insured, selected by the commissioner; (12) One (1) representative of a hospital medical service corporation, selected by the commissioner, unless, pursuant to subsection (d), no such representative is able to serve, in which case this position shall be filled by a representative of another insurer; (13) One (1) representative of an insurer other than a hospital medical service corporation, selected by the commissioner, unless, pursuant to subsection (d), no such representative is able to serve, in which case this position shall be filled by a representative of another insurer; and (14) The commissioner of disability and aging or the commissioner's designee.
(1) The commissioner of finance and administration or the commissioner's designee;
(2) The commissioner of health or the commissioner's designee;
(3) The commissioner of mental health and substance abuse services or the commissioner's designee;
(4) One (1) representative of the Tennessee Hospital Association, selected by the commissioner;
(5) One (1) representative of the Tennessee Medical Association, selected by the commissioner;
(6) One (1) member involved primarily as a producer in the business of health insurance, selected by the commissioner;
(7) One (1) member of the general public, selected by the commissioner;
(8) One (1) member selected by the speaker of the house of representatives;
(9) One (1) member selected by the speaker of the senate;
(10) One (1) representative of an employer of greater than or equal to five hundred (500) employees that is self-insured, selected by the commissioner;
(11) One (1) representative of an employer of less than five hundred (500) employees that is commercially insured, selected by the commissioner;
(12) One (1) representative of a hospital medical service corporation, selected by the commissioner, unless, pursuant to subsection (d), no such representative is able to serve, in which case this position shall be filled by a representative of another insurer;
(13) One (1) representative of an insurer other than a hospital medical service corporation, selected by the commissioner, unless, pursuant to subsection (d), no such representative is able to serve, in which case this position shall be filled by a representative of another insurer; and
(14) The commissioner of disability and aging or the commissioner's designee.
(c) The commissioner and the speakers of the senate and the house of representatives, in making appointments to the board, shall strive to ensure that the membership of the board is representative of the state's geographic and demographic composition, with appropriate attention to the representation of women and minorities.
(d) No individual representing an entity selected to administer the program, pursuant to § 56-7-2909 , or its affiliates shall serve on the board. Any appointed board member who represents an entity or affiliate that has the intention of serving as administrator of the program shall be prohibited from serving as the administrator, unless the board member provides written notice to the board of the entity's or affiliate's intent to bid on the contract for administrator. The notice shall be delivered to the board at least six (6) months prior to the release of any request for proposal (RFP) seeking to select or renew an administrator. In the event the notice is delivered, the board member shall simultaneously resign the board member's membership on the board.
(e) The commissioner shall, on an annual basis, designate one (1) member of the board to serve as chair and one (1) member of the board to serve as vice chair.
(f) The board members selected pursuant to subdivisions (b)(4), (5) and (6) shall serve for an original term of one (1) year. The board members selected pursuant to subdivisions (b)(8), (9), (12) and (13) shall serve for an original term of two (2) years. The board members selected pursuant to subdivisions (b)(7), (10) and (11) shall serve for an original term of three (3) years. Thereafter, all board members selected pursuant to subdivisions (b)(4) - (11) shall serve for a term of three (3) years. Board members appointed pursuant to subdivisions (b)(12) and (13) shall not be appointed to the board until after Access Tennessee awards an initial contract to an administrator of the program.
(g) Board members shall receive no compensation, but shall be reimbursed for all travel expenses in accordance with state travel regulations.
(h) Vacancies in the board shall be filled by the appropriate appointing authority. Board members may be removed by their respective appointing authority for cause.
(i) In order to assist the board, there shall be an advisory committee consisting of five (5) representatives of insurers that offer health insurance coverage in this state who shall be selected by the commissioner. The advisory committee may provide advice on insurance related issues, including, but not limited to, benefit design and market impact of the plans created and offered by Access Tennessee.
(j) The board, on an annual basis, shall submit to the commissioner a funding plan and a plan for operation of the program and any amendments necessary or suitable to assure the fair, reasonable, and efficient administration of the program and its financial solvency, based upon timely and accurate actuarial assumptions. The plan of operation is effective upon approval, in writing, by the commissioner.
(k) The commissioner shall approve the funding plan and the plan of operation if the commissioner determines that the plans assure the financial solvency of the program, the efficient administration of the program, and compliance with this part.
(l) If the board fails to submit a suitable plan of operation within one hundred eighty (180) days after the appointment of the board or at any time thereafter fails to submit suitable amendments to the plan of operation, then the commissioner may initiate actions necessary or advisable to effectuate this part. The actions continue in effect until modified by the commissioner or superseded by a plan of operation submitted by the board and approved by the commissioner. To the extent that the actions include the promulgation of rules to effectuate this part, the rules must be promulgated as emergency rules pursuant to § 4-5-208 .
(m) The plan of operation shall: (1) Establish procedures for operation of the program; (2) Establish procedures for selecting an administrator, in accordance with § 56-7-2909 ; (3) Establish procedures to create a fund, under management of the board, for administrative expenses; (4) Establish procedures for the handling, accounting, and auditing of assets, moneys and claims of the program and the program administrator; (5) Develop and implement a program to publicize the existence of the program, the eligibility requirements, and procedures for enrollment, and to maintain public awareness of the program; (6) Establish procedures under which applicants and participants may have grievances reviewed by a grievance committee appointed by the board. The grievances shall be reported to the board after completion of the review. The board shall retain all written complaints regarding the plan for at least three (3) years; (7) Establish procedures to implement the requirements of § 56-7-2909(g) ; and (8) Provide for other matters as may be necessary and proper for the execution of the board's powers, duties and obligations under this part.
(1) Establish procedures for operation of the program;
(2) Establish procedures for selecting an administrator, in accordance with § 56-7-2909 ;
(3) Establish procedures to create a fund, under management of the board, for administrative expenses;
(4) Establish procedures for the handling, accounting, and auditing of assets, moneys and claims of the program and the program administrator;
(5) Develop and implement a program to publicize the existence of the program, the eligibility requirements, and procedures for enrollment, and to maintain public awareness of the program;
(6) Establish procedures under which applicants and participants may have grievances reviewed by a grievance committee appointed by the board. The grievances shall be reported to the board after completion of the review. The board shall retain all written complaints regarding the plan for at least three (3) years;
(7) Establish procedures to implement the requirements of § 56-7-2909(g) ; and
(8) Provide for other matters as may be necessary and proper for the execution of the board's powers, duties and obligations under this part.
(n) The funding plan shall: (1) Establish premium rates for the upcoming year, pursuant to § 56-7-2911(a) ; (2) Establish an assessment rate for insurers and insurance arrangements, pursuant to § 56-7-2911(a)(2) ; provided, however, that the total amount of the assessments authorized under § 56-7-2911(a)(2) for a fiscal year shall not exceed the amount appropriated by the state to the program for that same fiscal year; and (3) Identify other available funds for the program, including any legislative appropriations and federal funding.
(1) Establish premium rates for the upcoming year, pursuant to § 56-7-2911(a) ;
(2) Establish an assessment rate for insurers and insurance arrangements, pursuant to § 56-7-2911(a)(2) ; provided, however, that the total amount of the assessments authorized under § 56-7-2911(a)(2) for a fiscal year shall not exceed the amount appropriated by the state to the program for that same fiscal year; and
(3) Identify other available funds for the program, including any legislative appropriations and federal funding.
(o) There shall be no liability on the part of, and no cause of action of any nature shall arise against, the commissioner or the board members, or any of their employees or agents, for any omission or any action taken by them within the scope of their duties arising from this part, except for willful, malicious or criminal acts or omissions done for personal gain.
Amended by 2024 Tenn. Acts, ch. 688,s 144, eff. 7/1/2024.
Amended by 2022 Tenn. Acts, ch. 662, Secs.s 1, s 2, s 3 eff. 3/16/2022.
Amended by 2015 Tenn. Acts, ch. 185, s 3, eff. 4/22/2015.
Acts 2006, ch. 867, § 3; 2006, ch. 894, §§ 2, 14; 2010 , ch. 1100, §§ 96, 97; 2012 , ch. 575, § 2.
Tenn. Code Ann. § 56-7-804 — TN Code / Title 56 / Chapter 7 / Section 56-7-804
Policies protecting trustees, mortgagees, assignees and like parties
Status: in_force

When any person, as trustee, mortgagee, assignee, or otherwise, possesses or has any fire insurance policy on realty made payable to the person, or other person as that person's interest may appear, then the insurance as to the interest of the trustee, mortgagee, assignee or other person named in the policy shall not be invalidated by an act or neglect of the mortgagor owner of the property so insured, nor by any foreclosure or other proceedings or notice of sale relating to the property, nor by change in title or ownership of the property, nor by occupation of the premises for purposes more hazardous than are permitted by the policy; provided, that, in case the mortgagor or owner neglects to pay any premium due under the policy, the mortgagee, trustee, assignee, or other person shall on demand, pay the premium; and provided, further, that the mortgagee, trustee, assignee, or other person shall notify the insurance company of any change of ownership or occupancy or increase of hazard that comes to the knowledge of the mortgagee, trustee, assignee, or other person, and, unless permitted by the policy, it shall be noted on the policy, and the mortgagee, trustee, assignee, or other person shall, on demand, pay the premium for the increased hazard for the term of the use of the property, or otherwise the policy shall be null and void; and provided, further, that in the event the insurer concludes to cancel its policy under its terms, then ten (10) days' notice of the determination shall be given to the mortgagee, trustee, assignee, or other person so interested. Acts 1925, ch. 123, § 1; Shan. Supp., § 3348a1b1; Code 1932, § 6175; T.C.A. (orig. ed.), § 56-1140.
When any person, as trustee, mortgagee, assignee, or otherwise, possesses or has any fire insurance policy on realty made payable to the person, or other person as that person's interest may appear, then the insurance as to the interest of the trustee, mortgagee, assignee or other person named in the policy shall not be invalidated by an act or neglect of the mortgagor owner of the property so insured, nor by any foreclosure or other proceedings or notice of sale relating to the property, nor by change in title or ownership of the property, nor by occupation of the premises for purposes more hazardous than are permitted by the policy; provided, that, in case the mortgagor or owner neglects to pay any premium due under the policy, the mortgagee, trustee, assignee, or other person shall on demand, pay the premium; and provided, further, that the mortgagee, trustee, assignee, or other person shall notify the insurance company of any change of ownership or occupancy or increase of hazard that comes to the knowledge of the mortgagee, trustee, assignee, or other person, and, unless permitted by the policy, it shall be noted on the policy, and the mortgagee, trustee, assignee, or other person shall, on demand, pay the premium for the increased hazard for the term of the use of the property, or otherwise the policy shall be null and void; and provided, further, that in the event the insurer concludes to cancel its policy under its terms, then ten (10) days' notice of the determination shall be given to the mortgagee, trustee, assignee, or other person so interested.
Acts 1925, ch. 123, § 1; Shan. Supp., § 3348a1b1; Code 1932, § 6175; T.C.A. (orig. ed.), § 56-1140.
Tenn. Code Ann. § 56-32-117 — TN Code / Title 56 / Chapter 32 / Section 56-32-117
Rehabilitation, liquidation, conservation or supervision of HMOs
Status: in_force

(a) Any rehabilitation, liquidation, conservation or supervision of an HMO shall be deemed to be the rehabilitation, liquidation, conservation or supervision of an insurance company and shall be conducted under the supervision of the commissioner pursuant to chapter 9 of this title. The commissioner may apply for an order directing the commissioner to rehabilitate, liquidate, conserve or supervise an HMO upon any one (1) or more grounds set out in chapter 9 of this title, or when in the commissioner's opinion the continued operation of the HMO would be hazardous either to the enrollees or to the people of this state. Enrollees shall have the same priority in the event of liquidation or rehabilitation as the law provides to policyholders of an insurer. (b) A claim by a health care provider for an uncovered expenditure has the same priority as an enrollee; provided, that the provider of services agrees not to assert the claim against any enrollee of the HMO. (c) (1) For the purposes of supervision, rehabilitation, or liquidation of HMOs that participate in the TennCare program under Title XIX of the federal Social Security Act ( 42 U.S.C. § 1396 et seq.), or any successor to the TennCare program, and in addition to the powers and duties set forth in this chapter, the department or the chancery court shall have the power to examine and investigate the affairs of every person, entity, HMO, an affiliate of the parent of the HMO, or an affiliate of the HMO, in order to determine whether the person, entity, HMO, an affiliate of the parent of the HMO, or an affiliate of the HMO, is operating in accordance with this chapter and title 71, chapter 5. For purposes of this subdivision (c)(1), "affiliate" means any entity that exercises control over or is controlled by the HMO, directly or indirectly through: (A) Equity ownership of voting securities; (B) Common managerial control; or (C) Collusive participation by the management of the HMO and affiliate in the management of the HMO or the affiliate. (2) For purposes of subdivision (c)(1), "person" includes an individual, insurer, company, association, organization, Lloyds, society, reciprocal insurer or interinsurance exchange, partnership, syndicate, business trust, corporation, agent, general agent, broker, solicitor, service representative, adjuster, and every legal entity. Acts 1986, ch. 713, § 17; 1999, ch. 322, §§ 4, 7; 2000, ch. 708, §§ 1, 7; T.C.A. § 56-32-217.
(a) Any rehabilitation, liquidation, conservation or supervision of an HMO shall be deemed to be the rehabilitation, liquidation, conservation or supervision of an insurance company and shall be conducted under the supervision of the commissioner pursuant to chapter 9 of this title. The commissioner may apply for an order directing the commissioner to rehabilitate, liquidate, conserve or supervise an HMO upon any one (1) or more grounds set out in chapter 9 of this title, or when in the commissioner's opinion the continued operation of the HMO would be hazardous either to the enrollees or to the people of this state. Enrollees shall have the same priority in the event of liquidation or rehabilitation as the law provides to policyholders of an insurer.
(b) A claim by a health care provider for an uncovered expenditure has the same priority as an enrollee; provided, that the provider of services agrees not to assert the claim against any enrollee of the HMO.
(c) (1) For the purposes of supervision, rehabilitation, or liquidation of HMOs that participate in the TennCare program under Title XIX of the federal Social Security Act ( 42 U.S.C. § 1396 et seq.), or any successor to the TennCare program, and in addition to the powers and duties set forth in this chapter, the department or the chancery court shall have the power to examine and investigate the affairs of every person, entity, HMO, an affiliate of the parent of the HMO, or an affiliate of the HMO, in order to determine whether the person, entity, HMO, an affiliate of the parent of the HMO, or an affiliate of the HMO, is operating in accordance with this chapter and title 71, chapter 5. For purposes of this subdivision (c)(1), "affiliate" means any entity that exercises control over or is controlled by the HMO, directly or indirectly through: (A) Equity ownership of voting securities; (B) Common managerial control; or (C) Collusive participation by the management of the HMO and affiliate in the management of the HMO or the affiliate. (2) For purposes of subdivision (c)(1), "person" includes an individual, insurer, company, association, organization, Lloyds, society, reciprocal insurer or interinsurance exchange, partnership, syndicate, business trust, corporation, agent, general agent, broker, solicitor, service representative, adjuster, and every legal entity.
(1) For the purposes of supervision, rehabilitation, or liquidation of HMOs that participate in the TennCare program under Title XIX of the federal Social Security Act ( 42 U.S.C. § 1396 et seq.), or any successor to the TennCare program, and in addition to the powers and duties set forth in this chapter, the department or the chancery court shall have the power to examine and investigate the affairs of every person, entity, HMO, an affiliate of the parent of the HMO, or an affiliate of the HMO, in order to determine whether the person, entity, HMO, an affiliate of the parent of the HMO, or an affiliate of the HMO, is operating in accordance with this chapter and title 71, chapter 5. For purposes of this subdivision (c)(1), "affiliate" means any entity that exercises control over or is controlled by the HMO, directly or indirectly through: (A) Equity ownership of voting securities; (B) Common managerial control; or (C) Collusive participation by the management of the HMO and affiliate in the management of the HMO or the affiliate.
(A) Equity ownership of voting securities;
(B) Common managerial control; or
(C) Collusive participation by the management of the HMO and affiliate in the management of the HMO or the affiliate.
(2) For purposes of subdivision (c)(1), "person" includes an individual, insurer, company, association, organization, Lloyds, society, reciprocal insurer or interinsurance exchange, partnership, syndicate, business trust, corporation, agent, general agent, broker, solicitor, service representative, adjuster, and every legal entity.
Acts 1986, ch. 713, § 17; 1999, ch. 322, §§ 4, 7; 2000, ch. 708, §§ 1, 7; T.C.A. § 56-32-217.
Tenn. Code Ann. § 56-47-106 — TN Code / Title 56 / Chapter 47 / Section 56-47-106
Restitution
Status: in_force

(a) A person convicted of a violation of § 56-47-103 shall be ordered to make monetary restitution for any financial loss or damages sustained by an injured employee or any other person as a result of the violation. Financial loss or damage shall include, but is not necessarily limited to, loss of earnings, out-of-pocket and other expenses, paid deductible amounts under an insurance policy, insurer claim payments, costs reasonably attributed to investigations and recovery efforts by owners, insurers, insurance professionals, law enforcement and other public authorities, and costs of prosecution. (b) When restitution is ordered, the court shall determine its extent and methods. Restitution may be imposed in addition to a fine and, if ordered, any other penalty, but not in lieu thereof. The court shall determine whether restitution, if ordered, shall be paid in a single payment or installments and shall fix a period of time within which payment of restitution is to be made in full. Acts 1996, ch. 944, § 48.
(a) A person convicted of a violation of § 56-47-103 shall be ordered to make monetary restitution for any financial loss or damages sustained by an injured employee or any other person as a result of the violation. Financial loss or damage shall include, but is not necessarily limited to, loss of earnings, out-of-pocket and other expenses, paid deductible amounts under an insurance policy, insurer claim payments, costs reasonably attributed to investigations and recovery efforts by owners, insurers, insurance professionals, law enforcement and other public authorities, and costs of prosecution.
(b) When restitution is ordered, the court shall determine its extent and methods. Restitution may be imposed in addition to a fine and, if ordered, any other penalty, but not in lieu thereof. The court shall determine whether restitution, if ordered, shall be paid in a single payment or installments and shall fix a period of time within which payment of restitution is to be made in full.
Acts 1996, ch. 944, § 48.
Tenn. Code Ann. § 56-31-105 — TN Code / Title 56 / Chapter 31 / Section 56-31-105
Board of directors
Status: in_force

A vision service plan corporation shall consist of a board of directors of such number, grouped in such reasonable classes, as the bylaws of the corporation, as approved by the commissioner, provide. Acts 1969, ch. 118, § 5; T.C.A., § 56-3705.
A vision service plan corporation shall consist of a board of directors of such number, grouped in such reasonable classes, as the bylaws of the corporation, as approved by the commissioner, provide.
Acts 1969, ch. 118, § 5; T.C.A., § 56-3705.
Tenn. Code Ann. § 56-49-105 — TN Code / Title 56 / Chapter 49 / Section 56-49-105
Premium rates
Status: in_force

(a) Premiums for creditor-placed insurance coverage may be calculated based on: (1) An amount not exceeding the net debt even though the coverage may limit the insurer's liability to the net debt, actual cash value or cost of repair; or (2) Other premium calculation methods that more closely reflect the exposure of each item insured and approximate the premium calculation method of the coverage required by the credit agreement. (b) An insurer shall not write creditor-placed insurance for which the premium rate differs from that determined by the schedules of the insurer on file with the commissioner. The premium or amount charged to the debtor for creditor-placed insurance shall not exceed the premiums charged by the insurer, computed at the time the charge to the debtor is determined. (c) A method of billing insurance charges to the debtor on closed-end credit transactions that creates a balloon payment at the end of the credit transaction or extends the credit transaction's maturity date is prohibited, unless specifically disclosed at the time of the origination of the credit agreement and specifically agreed to by the debtor at the time the charge is added to the outstanding credit balance. Acts 1999, ch. 144, § 5.
(a) Premiums for creditor-placed insurance coverage may be calculated based on: (1) An amount not exceeding the net debt even though the coverage may limit the insurer's liability to the net debt, actual cash value or cost of repair; or (2) Other premium calculation methods that more closely reflect the exposure of each item insured and approximate the premium calculation method of the coverage required by the credit agreement.
(1) An amount not exceeding the net debt even though the coverage may limit the insurer's liability to the net debt, actual cash value or cost of repair; or
(2) Other premium calculation methods that more closely reflect the exposure of each item insured and approximate the premium calculation method of the coverage required by the credit agreement.
(b) An insurer shall not write creditor-placed insurance for which the premium rate differs from that determined by the schedules of the insurer on file with the commissioner. The premium or amount charged to the debtor for creditor-placed insurance shall not exceed the premiums charged by the insurer, computed at the time the charge to the debtor is determined.
(c) A method of billing insurance charges to the debtor on closed-end credit transactions that creates a balloon payment at the end of the credit transaction or extends the credit transaction's maturity date is prohibited, unless specifically disclosed at the time of the origination of the credit agreement and specifically agreed to by the debtor at the time the charge is added to the outstanding credit balance.
Acts 1999, ch. 144, § 5.
Tenn. Code Ann. § 56-25-302 — TN Code / Title 56 / Chapter 25 / Section 56-25-302
Amendment of laws
Status: in_force

(a) A domestic society may amend its laws in accordance with the provisions thereof by action of its supreme governing body at any regular or special meeting thereof or, if its laws so provide, by referendum. The referendum may be held in accordance with its laws by the vote of the voting members of the society, by the vote of delegates or representative of voting members, or by the vote of local lodges. A society may provide for voting by mail. No amendment submitted for adoption by referendum shall be adopted unless, within six (6) months from the date of submission of the amendment, a majority of the members voting have signified their consent to the amendment by one (1) of the methods specified in this section. (b) All amendments to the laws of any domestic society shall be filed with the commissioner and shall become operative upon the filing unless a later time be provided in the amendments or in laws of the society. (c) Within ninety (90) days from the effective date of the amendment, all the amendments, or a synopsis thereof, shall be furnished to all members of the society either by mail or publication in full in the official publication of the society. The affidavit of any officer of the society or of anyone authorized by it to mail any amendments or synopsis, stating facts that show that same have been duly addressed and mailed, shall be prima facie evidence that the amendments or synopsis have been furnished the addressee. (d) Every foreign or alien society authorized to do business in this state shall file with the commissioner a duly certified copy of all amendments of, or additions to, its laws within ninety (90) days after the enactment of the amendments. (e) Printed copies of the laws as amended, certified by the secretary or corresponding officer of the society, shall be prima facie evidence of the legal adoption of the laws. Acts 1990, ch. 703, § 1.
(a) A domestic society may amend its laws in accordance with the provisions thereof by action of its supreme governing body at any regular or special meeting thereof or, if its laws so provide, by referendum. The referendum may be held in accordance with its laws by the vote of the voting members of the society, by the vote of delegates or representative of voting members, or by the vote of local lodges. A society may provide for voting by mail. No amendment submitted for adoption by referendum shall be adopted unless, within six (6) months from the date of submission of the amendment, a majority of the members voting have signified their consent to the amendment by one (1) of the methods specified in this section.
(b) All amendments to the laws of any domestic society shall be filed with the commissioner and shall become operative upon the filing unless a later time be provided in the amendments or in laws of the society.
(c) Within ninety (90) days from the effective date of the amendment, all the amendments, or a synopsis thereof, shall be furnished to all members of the society either by mail or publication in full in the official publication of the society. The affidavit of any officer of the society or of anyone authorized by it to mail any amendments or synopsis, stating facts that show that same have been duly addressed and mailed, shall be prima facie evidence that the amendments or synopsis have been furnished the addressee.
(d) Every foreign or alien society authorized to do business in this state shall file with the commissioner a duly certified copy of all amendments of, or additions to, its laws within ninety (90) days after the enactment of the amendments.
(e) Printed copies of the laws as amended, certified by the secretary or corresponding officer of the society, shall be prima facie evidence of the legal adoption of the laws.
Acts 1990, ch. 703, § 1.
Tenn. Code Ann. § 56-2-402 — TN Code / Title 56 / Chapter 2 / Section 56-2-402
Issuance of license to company controlled by foreign government prohibited
Status: in_force

The commissioner is forbidden to grant a license to any insurance company or other insurance entity that is financially owned or financially controlled by any alien or foreign government outside the continental limits of the United States or the territories of the United States, or to authorize the company or entity to transact any kind of insurance business in this state. Acts 1955, ch. 3, § 2; T.C.A., §§ 56-324, 56-229.
The commissioner is forbidden to grant a license to any insurance company or other insurance entity that is financially owned or financially controlled by any alien or foreign government outside the continental limits of the United States or the territories of the United States, or to authorize the company or entity to transact any kind of insurance business in this state.
Acts 1955, ch. 3, § 2; T.C.A., §§ 56-324, 56-229.
Tenn. Code Ann. § 56-7-704 — TN Code / Title 56 / Chapter 7 / Section 56-7-704
Provisions in industrial life insurance policies more favorable to policyholder permissible
Status: in_force

Any industrial life insurance contracts may be delivered or issued for delivery in this state, which contracts contain provisions more favorable to the policyholder than those required by §§ 56-7-701 - 56-7-704, and nothing in §§ 56-7-701 - 56-7-704 shall be construed as prohibiting more favorable provisions. Acts 1945, ch. 27, § 4; C. Supp. 1950, § 6447.4; T.C.A. (orig. ed.), § 56-1131.
Any industrial life insurance contracts may be delivered or issued for delivery in this state, which contracts contain provisions more favorable to the policyholder than those required by §§ 56-7-701 - 56-7-704, and nothing in §§ 56-7-701 - 56-7-704 shall be construed as prohibiting more favorable provisions.
Acts 1945, ch. 27, § 4; C. Supp. 1950, § 6447.4; T.C.A. (orig. ed.), § 56-1131.
Tenn. Code Ann. § 56-42-104 — TN Code / Title 56 / Chapter 42 / Section 56-42-104
Policies issued in other states
Status: in_force

No group long-term care insurance coverage may be offered to a resident of this state under a group policy issued in another state to a group described in § 56-42-103(4)(D) , unless this state or another state having statutory and regulatory long-term care insurance requirements substantially similar to those adopted in this state has made a determination that the requirements have been met. Acts 1988, ch. 873, § 5.
No group long-term care insurance coverage may be offered to a resident of this state under a group policy issued in another state to a group described in § 56-42-103(4)(D) , unless this state or another state having statutory and regulatory long-term care insurance requirements substantially similar to those adopted in this state has made a determination that the requirements have been met.
Acts 1988, ch. 873, § 5.
Tenn. Code Ann. § 56-47-109 — TN Code / Title 56 / Chapter 47 / Section 56-47-109
Exclusivity of remedies under Section 56-47-108
Status: in_force

(a) The remedies expressly provided in § 56-47-108 shall be the only private remedies for violations of this chapter and no additional remedies shall be implied. The remedies available under § 56-47-108 shall not be used in conjunction with or in addition to any other remedies available at law or in equity to duplicate recovery for the same element of economic damage. Further, in any civil action pleading both exemplary damages and the treble damages available in § 56-47-108(c) , the plaintiff shall elect one or the other remedy, but not both, at the conclusion of the evidentiary phase of the trial. (b) However, nothing in this chapter shall limit or abrogate any right of action that would have existed in the absence of this chapter, but no action based on such a right shall rely on this chapter to establish a standard of conduct or for any other purpose. Acts 1996, ch. 944, § 48.
(a) The remedies expressly provided in § 56-47-108 shall be the only private remedies for violations of this chapter and no additional remedies shall be implied. The remedies available under § 56-47-108 shall not be used in conjunction with or in addition to any other remedies available at law or in equity to duplicate recovery for the same element of economic damage. Further, in any civil action pleading both exemplary damages and the treble damages available in § 56-47-108(c) , the plaintiff shall elect one or the other remedy, but not both, at the conclusion of the evidentiary phase of the trial.
(b) However, nothing in this chapter shall limit or abrogate any right of action that would have existed in the absence of this chapter, but no action based on such a right shall rely on this chapter to establish a standard of conduct or for any other purpose.
Acts 1996, ch. 944, § 48.
Tenn. Code Ann. § 56-6-120 — TN Code / Title 56 / Chapter 6 / Section 56-6-120
Investigations
Status: in_force

(a) The commissioner may make investigations necessary for the proper administration of this part. For the purpose of making the investigations, the commissioner shall have inquisitorial powers and shall be empowered to subpoena witnesses and examine them under oath; provided that: (1) Any investigatory action be reasonable in scope and relevant to the administration of this part; (2) In the course of an investigation conducted pursuant to this section, the commissioner shall be given access to all business records of a person licensed or required to be licensed under this part. The department shall endeavor to conduct its investigation in a manner that is least obtrusive to the ongoing business of the person; and (3) (A) All testimony, documents, other information in the control or possession of the commissioner that is obtained in an investigation pursuant to this section shall, except as provided in subdivision (a)(3)(B), be confidential and absolutely privileged and shall not be: (i) Subject to § 10-7-503(a) or § 56-1-602 ; (ii) Subject to subpoena; (iii) Subject to discovery; or (iv) Admissible as evidence in any private civil action; (B) (i) The commissioner is authorized to use the testimony, documents, and other information in the control or possession of the department in the furtherance of any regulatory or legal action brought as a part of the commissioner's duties; (ii) Subject to subsection (b), a person being investigated pursuant to this section, or counsel for such person, may obtain from the commissioner a copy of each and any inquisitorial order and complaint filed against the person. Further, upon initiation of a formal proceeding against any person, the person shall be entitled to any and all discovery rights available under the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, or the Tennessee Rules of Civil Procedure. (b) (1) Upon issuance by the commissioner of an inquisitorial order or upon receipt by the department of a written complaint against a person, the department shall provide the person with a copy of the inquisitorial order or complaint within thirty (30) days of issuance of the order or receipt of the complaint. (2) Before seeking a statement from a person being investigated, the department shall notify the person that any statement may be used in an investigation or become evidence in a hearing. Failure of the department to comply with subdivision (b)(1) shall render any statement provided to the department prior to its compliance with subdivision (b)(1) inadmissible in any administrative actions against such person. However, failure to comply with subdivision (b)(1) shall not prevent the department from proceeding with any actions arising from such order or complaint. Further, nothing in this section shall prevent the department from taking a statement from a person being investigated prior to giving the notice required by subdivision (b)(1) as long as it is taken within thirty (30) days of the receipt of the complaint or the entry of the inquisitorial order. (c) Upon receiving notice under subdivision (b)(1), the person being investigated may obtain a copy of any written, formal or recorded statements made by such person. The department shall produce such information requested pursuant to this subsection (c) within thirty (30) days of the request. (d) In the course of an investigation conducted pursuant to this section, the commissioner shall have the right to take under oath the testimony of any person involved in the business of insurance. Such person shall be given no less than fourteen (14) days' written notice of the commissioner's intent to take testimony and the place where the testimony will be taken. Upon good cause shown, and in the commissioner's sole discretion, the commissioner may provide additional time to the requester. (e) If the commissioner requests a person to produce records, originals or copies, in conjunction with an investigation conducted pursuant to this section, and the person from whom the documents have been requested believes the request is overbroad and will not lead to the discovery of facts relevant to the commissioner's investigation, that person may seek review of the commissioner's request by application to an administrative judge, including seeking entry of a protective order. The cost of document production pursuant to this section shall be borne by the person from whom the documents are sought; provided, however, that all other costs of investigation shall be borne by the department. (f) No later than thirty (30) days after completion of an investigation, or closure of a complaint file, the commissioner shall provide notice of such completion or closure to the person being investigated or against whom the complaint was filed. (g) In the commissioner's annual report made pursuant to § 56-1-601 , the department shall identify the total number of open investigations, the number of investigations opened in the year covered by the report, and the number of investigations closed in the year covered by the report. (h) Any investigation initiated under this part shall be completed within two (2) years of the entry of an inquisitorial order. The filing of an action under subsection (e) shall toll this limitation until such time as there is a final order issued pursuant to the Uniform Administrative Procedures Act and there is no judicial order staying the effectiveness of the final order. All actions shall be commenced within five (5) years of the date that the commissioner knew or reasonably should have known of the cause of action. Nothing in this subsection (h) shall prevent the department from taking action based upon an order previously entered by another state or the federal government or a felony conviction, regardless of the date of such order or conviction. (i) Any notices required by the department pursuant to this section may be transmitted electronically. Amended by 2023 Tenn. Acts, ch. 112,Secs.s16, s17 eff. 4/4/2023. Acts 2002, ch. 798, § 21; 2011 , ch. 90, § 2.
(a) The commissioner may make investigations necessary for the proper administration of this part. For the purpose of making the investigations, the commissioner shall have inquisitorial powers and shall be empowered to subpoena witnesses and examine them under oath; provided that: (1) Any investigatory action be reasonable in scope and relevant to the administration of this part; (2) In the course of an investigation conducted pursuant to this section, the commissioner shall be given access to all business records of a person licensed or required to be licensed under this part. The department shall endeavor to conduct its investigation in a manner that is least obtrusive to the ongoing business of the person; and (3) (A) All testimony, documents, other information in the control or possession of the commissioner that is obtained in an investigation pursuant to this section shall, except as provided in subdivision (a)(3)(B), be confidential and absolutely privileged and shall not be: (i) Subject to § 10-7-503(a) or § 56-1-602 ; (ii) Subject to subpoena; (iii) Subject to discovery; or (iv) Admissible as evidence in any private civil action; (B) (i) The commissioner is authorized to use the testimony, documents, and other information in the control or possession of the department in the furtherance of any regulatory or legal action brought as a part of the commissioner's duties; (ii) Subject to subsection (b), a person being investigated pursuant to this section, or counsel for such person, may obtain from the commissioner a copy of each and any inquisitorial order and complaint filed against the person. Further, upon initiation of a formal proceeding against any person, the person shall be entitled to any and all discovery rights available under the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, or the Tennessee Rules of Civil Procedure.
(1) Any investigatory action be reasonable in scope and relevant to the administration of this part;
(2) In the course of an investigation conducted pursuant to this section, the commissioner shall be given access to all business records of a person licensed or required to be licensed under this part. The department shall endeavor to conduct its investigation in a manner that is least obtrusive to the ongoing business of the person; and
(3) (A) All testimony, documents, other information in the control or possession of the commissioner that is obtained in an investigation pursuant to this section shall, except as provided in subdivision (a)(3)(B), be confidential and absolutely privileged and shall not be: (i) Subject to § 10-7-503(a) or § 56-1-602 ; (ii) Subject to subpoena; (iii) Subject to discovery; or (iv) Admissible as evidence in any private civil action; (B) (i) The commissioner is authorized to use the testimony, documents, and other information in the control or possession of the department in the furtherance of any regulatory or legal action brought as a part of the commissioner's duties; (ii) Subject to subsection (b), a person being investigated pursuant to this section, or counsel for such person, may obtain from the commissioner a copy of each and any inquisitorial order and complaint filed against the person. Further, upon initiation of a formal proceeding against any person, the person shall be entitled to any and all discovery rights available under the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, or the Tennessee Rules of Civil Procedure.
(A) All testimony, documents, other information in the control or possession of the commissioner that is obtained in an investigation pursuant to this section shall, except as provided in subdivision (a)(3)(B), be confidential and absolutely privileged and shall not be: (i) Subject to § 10-7-503(a) or § 56-1-602 ; (ii) Subject to subpoena; (iii) Subject to discovery; or (iv) Admissible as evidence in any private civil action;
(i) Subject to § 10-7-503(a) or § 56-1-602 ;
(ii) Subject to subpoena;
(iii) Subject to discovery; or
(iv) Admissible as evidence in any private civil action;
(B) (i) The commissioner is authorized to use the testimony, documents, and other information in the control or possession of the department in the furtherance of any regulatory or legal action brought as a part of the commissioner's duties; (ii) Subject to subsection (b), a person being investigated pursuant to this section, or counsel for such person, may obtain from the commissioner a copy of each and any inquisitorial order and complaint filed against the person. Further, upon initiation of a formal proceeding against any person, the person shall be entitled to any and all discovery rights available under the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, or the Tennessee Rules of Civil Procedure.
(i) The commissioner is authorized to use the testimony, documents, and other information in the control or possession of the department in the furtherance of any regulatory or legal action brought as a part of the commissioner's duties;
(ii) Subject to subsection (b), a person being investigated pursuant to this section, or counsel for such person, may obtain from the commissioner a copy of each and any inquisitorial order and complaint filed against the person. Further, upon initiation of a formal proceeding against any person, the person shall be entitled to any and all discovery rights available under the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, or the Tennessee Rules of Civil Procedure.
(b) (1) Upon issuance by the commissioner of an inquisitorial order or upon receipt by the department of a written complaint against a person, the department shall provide the person with a copy of the inquisitorial order or complaint within thirty (30) days of issuance of the order or receipt of the complaint. (2) Before seeking a statement from a person being investigated, the department shall notify the person that any statement may be used in an investigation or become evidence in a hearing. Failure of the department to comply with subdivision (b)(1) shall render any statement provided to the department prior to its compliance with subdivision (b)(1) inadmissible in any administrative actions against such person. However, failure to comply with subdivision (b)(1) shall not prevent the department from proceeding with any actions arising from such order or complaint. Further, nothing in this section shall prevent the department from taking a statement from a person being investigated prior to giving the notice required by subdivision (b)(1) as long as it is taken within thirty (30) days of the receipt of the complaint or the entry of the inquisitorial order.
(1) Upon issuance by the commissioner of an inquisitorial order or upon receipt by the department of a written complaint against a person, the department shall provide the person with a copy of the inquisitorial order or complaint within thirty (30) days of issuance of the order or receipt of the complaint.
(2) Before seeking a statement from a person being investigated, the department shall notify the person that any statement may be used in an investigation or become evidence in a hearing. Failure of the department to comply with subdivision (b)(1) shall render any statement provided to the department prior to its compliance with subdivision (b)(1) inadmissible in any administrative actions against such person. However, failure to comply with subdivision (b)(1) shall not prevent the department from proceeding with any actions arising from such order or complaint. Further, nothing in this section shall prevent the department from taking a statement from a person being investigated prior to giving the notice required by subdivision (b)(1) as long as it is taken within thirty (30) days of the receipt of the complaint or the entry of the inquisitorial order.
(c) Upon receiving notice under subdivision (b)(1), the person being investigated may obtain a copy of any written, formal or recorded statements made by such person. The department shall produce such information requested pursuant to this subsection (c) within thirty (30) days of the request.
(d) In the course of an investigation conducted pursuant to this section, the commissioner shall have the right to take under oath the testimony of any person involved in the business of insurance. Such person shall be given no less than fourteen (14) days' written notice of the commissioner's intent to take testimony and the place where the testimony will be taken. Upon good cause shown, and in the commissioner's sole discretion, the commissioner may provide additional time to the requester.
(e) If the commissioner requests a person to produce records, originals or copies, in conjunction with an investigation conducted pursuant to this section, and the person from whom the documents have been requested believes the request is overbroad and will not lead to the discovery of facts relevant to the commissioner's investigation, that person may seek review of the commissioner's request by application to an administrative judge, including seeking entry of a protective order. The cost of document production pursuant to this section shall be borne by the person from whom the documents are sought; provided, however, that all other costs of investigation shall be borne by the department.
(f) No later than thirty (30) days after completion of an investigation, or closure of a complaint file, the commissioner shall provide notice of such completion or closure to the person being investigated or against whom the complaint was filed.
(g) In the commissioner's annual report made pursuant to § 56-1-601 , the department shall identify the total number of open investigations, the number of investigations opened in the year covered by the report, and the number of investigations closed in the year covered by the report.
(h) Any investigation initiated under this part shall be completed within two (2) years of the entry of an inquisitorial order. The filing of an action under subsection (e) shall toll this limitation until such time as there is a final order issued pursuant to the Uniform Administrative Procedures Act and there is no judicial order staying the effectiveness of the final order. All actions shall be commenced within five (5) years of the date that the commissioner knew or reasonably should have known of the cause of action. Nothing in this subsection (h) shall prevent the department from taking action based upon an order previously entered by another state or the federal government or a felony conviction, regardless of the date of such order or conviction.
(i) Any notices required by the department pursuant to this section may be transmitted electronically.
Amended by 2023 Tenn. Acts, ch. 112,Secs.s16, s17 eff. 4/4/2023.
Acts 2002, ch. 798, § 21; 2011 , ch. 90, § 2.
Tenn. Code Ann. § 56-18-108 — TN Code / Title 56 / Chapter 18 / Section 56-18-108
Conversion of stock life insurance company into mutual - Authority to convert - Requirements
Status: in_force

(a) Any domestic stock life insurance corporation, duly incorporated under the laws of this state, may become a mutual life insurance corporation, and to that end may carry out a plan for the acquisition of shares of its capital stock; provided, that the plan has been: (1) Adopted by a vote of a majority of the directors of the corporation; (2) Submitted to the commissioner and has been approved by the commissioner in writing as conforming to this chapter and not prejudicial to policyholders; (3) Approved by a vote of stockholders representing a majority of the capital stock then outstanding; and (4) Approved by a majority of the policyholders, as defined in this chapter, voting at a meeting called for the purpose, the majority required being a majority of those policyholders who vote at the meeting, and not a majority of all the policyholders. (b) As used in this chapter: (1) "Commissioner" means the commissioner of commerce and insurance; (2) "Domestic stock life insurance corporation" means a corporation organized and doing business under the laws of this state, with its principal office or place of business located within the state, having an authorized capital stock, and shares of capital stock, and engaged in writing life insurance or life, health and accident insurance, either separately or in combined policies; and (3) "Mutual life insurance corporation" means a corporation organized and doing business under the laws of this state, upon the principle of a mutual participation in the profits, with its principal office or place of business located within the state, without capital stock or shares of capital stock, engaged in the writing of life insurance or life, health and accident insurance, either separately or in combined policies. (c) If, at the time of any election called for the purpose of approving or disapproving a plan of mutualization or called for any purpose after a plan of mutualization is approved or adopted or completed, an insured is below fifteen (15) years of age, then the insured's parent or other legal guardian, upon proper affidavit, may cast the insured's vote. An insured fifteen (15) years of age or older may cast the person's own vote. (d) In the case of any individual policy or contract insuring two (2) or more persons jointly, the persons insured shall be deemed one (1) policyholder, within the meaning of this section. In the case of any group life or group annuity policy or contract, the employer or other person, firm, corporation or association to whom or in whose name the master policy has been issued and held shall be deemed one (1) policyholder, within the meaning of this section. (e) In case the policy or contract has been assigned by a bona fide assignment absolute on its face to an assignee other than the corporation, and the assignment has been filed at the home office of the corporation at least thirty (30) days prior to the date of any meeting called for the purpose of approving or disapproving a plan of mutualization, then the assignee shall be deemed a policyholder, insofar as the person's interest may appear, for the purpose of voting on the plan of mutualization; provided, that the policy is of the type and size required by § 56-18-110(b) . Except as provided in this section, an assignee of a policy or contract shall not be deemed to be a policyholder within the meaning of this section. Acts 1949, ch. 91, § 1; C. Supp. 1950, § 6433.13 (Williams, §§ 6433.14-6433.16); impl. am. Acts 1971, ch. 137, § 2; T.C.A. (orig. ed.), § 56-1609.
(a) Any domestic stock life insurance corporation, duly incorporated under the laws of this state, may become a mutual life insurance corporation, and to that end may carry out a plan for the acquisition of shares of its capital stock; provided, that the plan has been: (1) Adopted by a vote of a majority of the directors of the corporation; (2) Submitted to the commissioner and has been approved by the commissioner in writing as conforming to this chapter and not prejudicial to policyholders; (3) Approved by a vote of stockholders representing a majority of the capital stock then outstanding; and (4) Approved by a majority of the policyholders, as defined in this chapter, voting at a meeting called for the purpose, the majority required being a majority of those policyholders who vote at the meeting, and not a majority of all the policyholders.
(1) Adopted by a vote of a majority of the directors of the corporation;
(2) Submitted to the commissioner and has been approved by the commissioner in writing as conforming to this chapter and not prejudicial to policyholders;
(3) Approved by a vote of stockholders representing a majority of the capital stock then outstanding; and
(4) Approved by a majority of the policyholders, as defined in this chapter, voting at a meeting called for the purpose, the majority required being a majority of those policyholders who vote at the meeting, and not a majority of all the policyholders.
(b) As used in this chapter: (1) "Commissioner" means the commissioner of commerce and insurance; (2) "Domestic stock life insurance corporation" means a corporation organized and doing business under the laws of this state, with its principal office or place of business located within the state, having an authorized capital stock, and shares of capital stock, and engaged in writing life insurance or life, health and accident insurance, either separately or in combined policies; and (3) "Mutual life insurance corporation" means a corporation organized and doing business under the laws of this state, upon the principle of a mutual participation in the profits, with its principal office or place of business located within the state, without capital stock or shares of capital stock, engaged in the writing of life insurance or life, health and accident insurance, either separately or in combined policies.
(1) "Commissioner" means the commissioner of commerce and insurance;
(2) "Domestic stock life insurance corporation" means a corporation organized and doing business under the laws of this state, with its principal office or place of business located within the state, having an authorized capital stock, and shares of capital stock, and engaged in writing life insurance or life, health and accident insurance, either separately or in combined policies; and
(3) "Mutual life insurance corporation" means a corporation organized and doing business under the laws of this state, upon the principle of a mutual participation in the profits, with its principal office or place of business located within the state, without capital stock or shares of capital stock, engaged in the writing of life insurance or life, health and accident insurance, either separately or in combined policies.
(c) If, at the time of any election called for the purpose of approving or disapproving a plan of mutualization or called for any purpose after a plan of mutualization is approved or adopted or completed, an insured is below fifteen (15) years of age, then the insured's parent or other legal guardian, upon proper affidavit, may cast the insured's vote. An insured fifteen (15) years of age or older may cast the person's own vote.
(d) In the case of any individual policy or contract insuring two (2) or more persons jointly, the persons insured shall be deemed one (1) policyholder, within the meaning of this section. In the case of any group life or group annuity policy or contract, the employer or other person, firm, corporation or association to whom or in whose name the master policy has been issued and held shall be deemed one (1) policyholder, within the meaning of this section.
(e) In case the policy or contract has been assigned by a bona fide assignment absolute on its face to an assignee other than the corporation, and the assignment has been filed at the home office of the corporation at least thirty (30) days prior to the date of any meeting called for the purpose of approving or disapproving a plan of mutualization, then the assignee shall be deemed a policyholder, insofar as the person's interest may appear, for the purpose of voting on the plan of mutualization; provided, that the policy is of the type and size required by § 56-18-110(b) . Except as provided in this section, an assignee of a policy or contract shall not be deemed to be a policyholder within the meaning of this section.
Acts 1949, ch. 91, § 1; C. Supp. 1950, § 6433.13 (Williams, §§ 6433.14-6433.16); impl. am. Acts 1971, ch. 137, § 2; T.C.A. (orig. ed.), § 56-1609.
Tenn. Code Ann. § 56-11-102 — TN Code / Title 56 / Chapter 11 / Section 56-11-102
Authorization for subsidiary
Status: in_force

(a) Authorization. Any domestic insurer or licensed health maintenance organization, either by itself or in cooperation with one (1) or more persons, may organize or acquire one (1) or more subsidiaries. The subsidiaries may conduct any kind of business or businesses and their authority to do so shall not be limited by reason of the fact that they are subsidiaries of a domestic insurer or a licensed health maintenance organization. (b) Additional Investment Authority. In addition to investments in common stock, preferred stock, debt obligations and other securities permitted under all other sections of this title, a domestic insurer or licensed health maintenance organization may also: (1) Invest, in common stock, preferred stock, debt obligations, and other securities of one (1) or more subsidiaries, amounts which do not exceed the lesser of ten percent (10%) of the insurer's assets or fifty percent (50%) of the insurer's surplus as regards policyholders, or, with respect to health maintenance organization's, net worth; provided, that after such investments, the insurer's surplus as regards policyholders or health maintenance organizations net worth will be reasonable in relation to the insurer's or health maintenance organization's outstanding liabilities and adequate to meet its financial needs. In calculating the amount of such investments, investments in domestic or foreign insurance subsidiaries and health maintenance organizations shall be excluded, and there shall be included: (A) Total net moneys or other consideration expended and obligations assumed in the acquisition or formation of a subsidiary, including all organizational expenses and contributions to capital and surplus of the subsidiary whether or not represented by the purchase of capital stock or issuance of other securities, and (B) 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 subsequent to its acquisition or formation; (2) (A) Invest any amount in common stock, preferred stock, debt obligations and other securities of one or more subsidiaries engaged or organized to engage exclusively in the ownership and management of assets authorized as investments for the insurer; provided, that each subsidiary agrees to limit its investments in any asset so that such investments will not cause the amount of the total investment of the insurer to exceed any of the investment limitations specified in subdivision (b)(1) or in §§ 56-3-301 - 56-3-307 or §§ 56-3-401 - 56-3-409 applicable to the insurer. (B) For the purpose of this subdivision (b)(2), "the total investment of the insurer" includes: (i) Any direct investment by the insurer or health maintenance organization in an asset, and (ii) The insurer's or health maintenance organization's proportionate share of any investment in an asset by any subsidiary of the insurer or health maintenance organization, which shall be calculated by multiplying the amount of the subsidiary's investment by the percentage of the ownership of the subsidiary; (3) With the approval of the commissioner, invest any greater amount in common stock, preferred stock, debt obligations, or other securities of one (1) or more subsidiaries; provided, that after the investment the insurer's surplus as regards policyholders or health maintenance organization's net worth will be reasonable in relation to the insurer's or health maintenance organization's outstanding liabilities and adequate to its financial needs. (c) Exemption from Investment Restrictions. Investments in common stock, preferred stock, debt obligations or other securities of subsidiaries made pursuant to subsection (b) shall not be subject to any of the otherwise applicable restrictions or prohibitions contained in this title applicable to such investments of insurers except §§ 56-3-303 , 56-3-402 , 56-3-403 and 56-3-404 . (d) Qualification of Investment; When Determined. Whether any investment made pursuant to subsection (b) meets the applicable requirements of subsection (b) is to be determined before the investment is made, by calculating the applicable investment limitations as though the investment had already been made, taking into account the then outstanding principal balance on all previous investments in debt obligations, and the value of all previous investments in equity securities as of the day they were made, net of any return of capital invested, not including dividends. (e) Cessation of Control. If an insurer ceases to control a subsidiary, it shall dispose of any investment in that subsidiary made pursuant to this section within three (3) years from the time of the cessation of control or within such further time as the commissioner may prescribe, unless at any time after the investment shall have been made, the investment shall have met the requirements for investment under any other section of this part, and the insurer has so notified the commissioner. Amended by 2014 Tenn. Acts, ch. 583, s 3, eff. 3/28/2014. Acts 1986, ch. 572, § 2; T.C.A. § 56-11-202 .
(a) Authorization. Any domestic insurer or licensed health maintenance organization, either by itself or in cooperation with one (1) or more persons, may organize or acquire one (1) or more subsidiaries. The subsidiaries may conduct any kind of business or businesses and their authority to do so shall not be limited by reason of the fact that they are subsidiaries of a domestic insurer or a licensed health maintenance organization.
(b) Additional Investment Authority. In addition to investments in common stock, preferred stock, debt obligations and other securities permitted under all other sections of this title, a domestic insurer or licensed health maintenance organization may also: (1) Invest, in common stock, preferred stock, debt obligations, and other securities of one (1) or more subsidiaries, amounts which do not exceed the lesser of ten percent (10%) of the insurer's assets or fifty percent (50%) of the insurer's surplus as regards policyholders, or, with respect to health maintenance organization's, net worth; provided, that after such investments, the insurer's surplus as regards policyholders or health maintenance organizations net worth will be reasonable in relation to the insurer's or health maintenance organization's outstanding liabilities and adequate to meet its financial needs. In calculating the amount of such investments, investments in domestic or foreign insurance subsidiaries and health maintenance organizations shall be excluded, and there shall be included: (A) Total net moneys or other consideration expended and obligations assumed in the acquisition or formation of a subsidiary, including all organizational expenses and contributions to capital and surplus of the subsidiary whether or not represented by the purchase of capital stock or issuance of other securities, and (B) 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 subsequent to its acquisition or formation; (2) (A) Invest any amount in common stock, preferred stock, debt obligations and other securities of one or more subsidiaries engaged or organized to engage exclusively in the ownership and management of assets authorized as investments for the insurer; provided, that each subsidiary agrees to limit its investments in any asset so that such investments will not cause the amount of the total investment of the insurer to exceed any of the investment limitations specified in subdivision (b)(1) or in §§ 56-3-301 - 56-3-307 or §§ 56-3-401 - 56-3-409 applicable to the insurer. (B) For the purpose of this subdivision (b)(2), "the total investment of the insurer" includes: (i) Any direct investment by the insurer or health maintenance organization in an asset, and (ii) The insurer's or health maintenance organization's proportionate share of any investment in an asset by any subsidiary of the insurer or health maintenance organization, which shall be calculated by multiplying the amount of the subsidiary's investment by the percentage of the ownership of the subsidiary; (3) With the approval of the commissioner, invest any greater amount in common stock, preferred stock, debt obligations, or other securities of one (1) or more subsidiaries; provided, that after the investment the insurer's surplus as regards policyholders or health maintenance organization's net worth will be reasonable in relation to the insurer's or health maintenance organization's outstanding liabilities and adequate to its financial needs.
(1) Invest, in common stock, preferred stock, debt obligations, and other securities of one (1) or more subsidiaries, amounts which do not exceed the lesser of ten percent (10%) of the insurer's assets or fifty percent (50%) of the insurer's surplus as regards policyholders, or, with respect to health maintenance organization's, net worth; provided, that after such investments, the insurer's surplus as regards policyholders or health maintenance organizations net worth will be reasonable in relation to the insurer's or health maintenance organization's outstanding liabilities and adequate to meet its financial needs. In calculating the amount of such investments, investments in domestic or foreign insurance subsidiaries and health maintenance organizations shall be excluded, and there shall be included: (A) Total net moneys or other consideration expended and obligations assumed in the acquisition or formation of a subsidiary, including all organizational expenses and contributions to capital and surplus of the subsidiary whether or not represented by the purchase of capital stock or issuance of other securities, and (B) 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 subsequent to its acquisition or formation;
(A) Total net moneys or other consideration expended and obligations assumed in the acquisition or formation of a subsidiary, including all organizational expenses and contributions to capital and surplus of the subsidiary whether or not represented by the purchase of capital stock or issuance of other securities, and
(B) 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 subsequent to its acquisition or formation;
(2) (A) Invest any amount in common stock, preferred stock, debt obligations and other securities of one or more subsidiaries engaged or organized to engage exclusively in the ownership and management of assets authorized as investments for the insurer; provided, that each subsidiary agrees to limit its investments in any asset so that such investments will not cause the amount of the total investment of the insurer to exceed any of the investment limitations specified in subdivision (b)(1) or in §§ 56-3-301 - 56-3-307 or §§ 56-3-401 - 56-3-409 applicable to the insurer. (B) For the purpose of this subdivision (b)(2), "the total investment of the insurer" includes: (i) Any direct investment by the insurer or health maintenance organization in an asset, and (ii) The insurer's or health maintenance organization's proportionate share of any investment in an asset by any subsidiary of the insurer or health maintenance organization, which shall be calculated by multiplying the amount of the subsidiary's investment by the percentage of the ownership of the subsidiary;
(A) Invest any amount in common stock, preferred stock, debt obligations and other securities of one or more subsidiaries engaged or organized to engage exclusively in the ownership and management of assets authorized as investments for the insurer; provided, that each subsidiary agrees to limit its investments in any asset so that such investments will not cause the amount of the total investment of the insurer to exceed any of the investment limitations specified in subdivision (b)(1) or in §§ 56-3-301 - 56-3-307 or §§ 56-3-401 - 56-3-409 applicable to the insurer.
(B) For the purpose of this subdivision (b)(2), "the total investment of the insurer" includes: (i) Any direct investment by the insurer or health maintenance organization in an asset, and (ii) The insurer's or health maintenance organization's proportionate share of any investment in an asset by any subsidiary of the insurer or health maintenance organization, which shall be calculated by multiplying the amount of the subsidiary's investment by the percentage of the ownership of the subsidiary;
(i) Any direct investment by the insurer or health maintenance organization in an asset, and
(ii) The insurer's or health maintenance organization's proportionate share of any investment in an asset by any subsidiary of the insurer or health maintenance organization, which shall be calculated by multiplying the amount of the subsidiary's investment by the percentage of the ownership of the subsidiary;
(3) With the approval of the commissioner, invest any greater amount in common stock, preferred stock, debt obligations, or other securities of one (1) or more subsidiaries; provided, that after the investment the insurer's surplus as regards policyholders or health maintenance organization's net worth will be reasonable in relation to the insurer's or health maintenance organization's outstanding liabilities and adequate to its financial needs.
(c) Exemption from Investment Restrictions. Investments in common stock, preferred stock, debt obligations or other securities of subsidiaries made pursuant to subsection (b) shall not be subject to any of the otherwise applicable restrictions or prohibitions contained in this title applicable to such investments of insurers except §§ 56-3-303 , 56-3-402 , 56-3-403 and 56-3-404 .
(d) Qualification of Investment; When Determined. Whether any investment made pursuant to subsection (b) meets the applicable requirements of subsection (b) is to be determined before the investment is made, by calculating the applicable investment limitations as though the investment had already been made, taking into account the then outstanding principal balance on all previous investments in debt obligations, and the value of all previous investments in equity securities as of the day they were made, net of any return of capital invested, not including dividends.
(e) Cessation of Control. If an insurer ceases to control a subsidiary, it shall dispose of any investment in that subsidiary made pursuant to this section within three (3) years from the time of the cessation of control or within such further time as the commissioner may prescribe, unless at any time after the investment shall have been made, the investment shall have met the requirements for investment under any other section of this part, and the insurer has so notified the commissioner.
Amended by 2014 Tenn. Acts, ch. 583, s 3, eff. 3/28/2014.
Acts 1986, ch. 572, § 2; T.C.A. § 56-11-202 .
Tenn. Code Ann. § 56-49-107 — TN Code / Title 56 / Chapter 49 / Section 56-49-107
Policy delivery to debtor
Status: in_force

Creditor-placed insurance shall be set forth in an individual policy or certificate of insurance. A copy of the individual policy, certificate of insurance coverage, or other evidence of insurance coverage shall be mailed, first class mail, or delivered in person to the last known address of the debtor. Acts 1999, ch. 144, § 7.
Creditor-placed insurance shall be set forth in an individual policy or certificate of insurance. A copy of the individual policy, certificate of insurance coverage, or other evidence of insurance coverage shall be mailed, first class mail, or delivered in person to the last known address of the debtor.
Acts 1999, ch. 144, § 7.
Tenn. Code Ann. § 56-12-119 — TN Code / Title 56 / Chapter 12 / Section 56-12-119
Credit for guaranty fund assessments
Status: in_force

Assessments made by the Tennessee insurance guaranty association as provided in § 56-12-107(a)(3) shall be allowed as a credit against premium taxes imposed on member insurers up to twenty-five percent (25%) of the net premium taxes due in any one (1) calendar year, until the aggregate of all assessments paid to the association have been offset by such premium tax credits. Acts 1975, ch. 63, § 2; T.C.A., § 56-4019.
Assessments made by the Tennessee insurance guaranty association as provided in § 56-12-107(a)(3) shall be allowed as a credit against premium taxes imposed on member insurers up to twenty-five percent (25%) of the net premium taxes due in any one (1) calendar year, until the aggregate of all assessments paid to the association have been offset by such premium tax credits.
Acts 1975, ch. 63, § 2; T.C.A., § 56-4019.
Tenn. Code Ann. § 56-43-106 — TN Code / Title 56 / Chapter 43 / Section 56-43-106
Policies - Certificates of coverage - Forms - Rates - Schedule of compensation paid
Status: in_force

(a) (1) Each contractual obligation for legal insurance shall be evidenced by a policy or master policy. Legal insurance may be written on an individual, group, blanket or franchise basis. Each person insured under a group policy must be issued a certificate of coverage. No legal insurance policy or certificate of any kind may be issued or delivered in this state unless and until a copy of the form of the policy or certificate has been filed with the commissioner and approved. (2) The forms must meet the following requirements: (A) Policies must contain a detailed list and description of the legal services promised or the legal matters for which expenses are to be reimbursed and the amount of reimbursement; (B) Policies and certificates must indicate prominently the name of the insurer and the full address of its principal place of business; and (C) Certificates issued under group policies may summarize the terms of the master contract but must contain a full and clear statement of the benefits provided. (3) The commissioner may disapprove a form if it is found that it: (A) Does not meet the requirements of subdivision (a)(2); (B) Is unfair, unfairly discriminatory, misleading, obscure or encourages misrepresentation or misunderstanding of the contract, including cases where the form: (i) Provides coverage or benefits that are too restricted to achieve the purposes for which the policy is designed; (ii) Fails to attain a reasonable degree of readability, simplicity and conciseness; or (iii) Is misleading, deceptive or obscure because of its physical aspects, such as format, typography, style, color, material or organization; (C) Provides coverage or benefits or contains other provisions that would endanger the financial soundness of the insurer; or (D) Is contrary to law. (b) (1) Rate filing or rate review requirements shall be the same as those for personal risk insurance in chapter 5, part 3 of this title. (2) The rates must meet the following requirements: (A) They must be established and justified in accordance with generally accepted insurance principles, including, but not limited to, the experience or judgment of the insurer making the rate filing or actuarial computations; (B) They may not be excessive, inadequate or unfairly discriminatory. Rates are not unfairly discriminatory because they are averaged broadly among persons insured under group, franchise or blanket policies; and (C) The commissioner may by written order suspend or modify the requirement of filing for any risk, group or class of risk, the rates for which cannot practically be filed before they are used. (c) If the commissioner determines that any form reviewed under subsection (a) and any schedule of rates reviewed under subsection (b) complies with the requirements of this section, the commissioner shall approve, within thirty (30) days, which may be extended for an additional thirty (30) days by notice in writing to the person making the filing prior to the expiration of the first thirty (30) days. If disapproving a filing, the commissioner shall notify the person making it in writing specifying the reasons for the disapproval. A hearing shall be granted within thirty (30) days after a request in writing by any person aggrieved by the decision of the commissioner. If the commissioner does not disapprove a form or schedule of rates within thirty (30) days of the filing or an extension of the form or schedule, it shall be deemed approved. The commissioner may, after notice and hearing, disapprove any rate that has been previously approved or deemed approved. (d) Any schedule of compensation paid either directly to lawyers or to beneficiaries as reimbursement of costs incurred for covered legal services shall be filed with the commissioner within thirty (30) days after its use. (e) The commissioner may require the submission of whatever relevant information is reasonably necessary in determining whether to approve or disapprove a filing made pursuant to subsection (a), (b) or (d). Acts 1989, ch. 423, § 5.
(a) (1) Each contractual obligation for legal insurance shall be evidenced by a policy or master policy. Legal insurance may be written on an individual, group, blanket or franchise basis. Each person insured under a group policy must be issued a certificate of coverage. No legal insurance policy or certificate of any kind may be issued or delivered in this state unless and until a copy of the form of the policy or certificate has been filed with the commissioner and approved. (2) The forms must meet the following requirements: (A) Policies must contain a detailed list and description of the legal services promised or the legal matters for which expenses are to be reimbursed and the amount of reimbursement; (B) Policies and certificates must indicate prominently the name of the insurer and the full address of its principal place of business; and (C) Certificates issued under group policies may summarize the terms of the master contract but must contain a full and clear statement of the benefits provided. (3) The commissioner may disapprove a form if it is found that it: (A) Does not meet the requirements of subdivision (a)(2); (B) Is unfair, unfairly discriminatory, misleading, obscure or encourages misrepresentation or misunderstanding of the contract, including cases where the form: (i) Provides coverage or benefits that are too restricted to achieve the purposes for which the policy is designed; (ii) Fails to attain a reasonable degree of readability, simplicity and conciseness; or (iii) Is misleading, deceptive or obscure because of its physical aspects, such as format, typography, style, color, material or organization; (C) Provides coverage or benefits or contains other provisions that would endanger the financial soundness of the insurer; or (D) Is contrary to law.
(1) Each contractual obligation for legal insurance shall be evidenced by a policy or master policy. Legal insurance may be written on an individual, group, blanket or franchise basis. Each person insured under a group policy must be issued a certificate of coverage. No legal insurance policy or certificate of any kind may be issued or delivered in this state unless and until a copy of the form of the policy or certificate has been filed with the commissioner and approved.
(2) The forms must meet the following requirements: (A) Policies must contain a detailed list and description of the legal services promised or the legal matters for which expenses are to be reimbursed and the amount of reimbursement; (B) Policies and certificates must indicate prominently the name of the insurer and the full address of its principal place of business; and (C) Certificates issued under group policies may summarize the terms of the master contract but must contain a full and clear statement of the benefits provided.
(A) Policies must contain a detailed list and description of the legal services promised or the legal matters for which expenses are to be reimbursed and the amount of reimbursement;
(B) Policies and certificates must indicate prominently the name of the insurer and the full address of its principal place of business; and
(C) Certificates issued under group policies may summarize the terms of the master contract but must contain a full and clear statement of the benefits provided.
(3) The commissioner may disapprove a form if it is found that it: (A) Does not meet the requirements of subdivision (a)(2); (B) Is unfair, unfairly discriminatory, misleading, obscure or encourages misrepresentation or misunderstanding of the contract, including cases where the form: (i) Provides coverage or benefits that are too restricted to achieve the purposes for which the policy is designed; (ii) Fails to attain a reasonable degree of readability, simplicity and conciseness; or (iii) Is misleading, deceptive or obscure because of its physical aspects, such as format, typography, style, color, material or organization; (C) Provides coverage or benefits or contains other provisions that would endanger the financial soundness of the insurer; or (D) Is contrary to law.
(A) Does not meet the requirements of subdivision (a)(2);
(B) Is unfair, unfairly discriminatory, misleading, obscure or encourages misrepresentation or misunderstanding of the contract, including cases where the form: (i) Provides coverage or benefits that are too restricted to achieve the purposes for which the policy is designed; (ii) Fails to attain a reasonable degree of readability, simplicity and conciseness; or (iii) Is misleading, deceptive or obscure because of its physical aspects, such as format, typography, style, color, material or organization;
(i) Provides coverage or benefits that are too restricted to achieve the purposes for which the policy is designed;
(ii) Fails to attain a reasonable degree of readability, simplicity and conciseness; or
(iii) Is misleading, deceptive or obscure because of its physical aspects, such as format, typography, style, color, material or organization;
(C) Provides coverage or benefits or contains other provisions that would endanger the financial soundness of the insurer; or
(D) Is contrary to law.
(b) (1) Rate filing or rate review requirements shall be the same as those for personal risk insurance in chapter 5, part 3 of this title. (2) The rates must meet the following requirements: (A) They must be established and justified in accordance with generally accepted insurance principles, including, but not limited to, the experience or judgment of the insurer making the rate filing or actuarial computations; (B) They may not be excessive, inadequate or unfairly discriminatory. Rates are not unfairly discriminatory because they are averaged broadly among persons insured under group, franchise or blanket policies; and (C) The commissioner may by written order suspend or modify the requirement of filing for any risk, group or class of risk, the rates for which cannot practically be filed before they are used.
(1) Rate filing or rate review requirements shall be the same as those for personal risk insurance in chapter 5, part 3 of this title.
(2) The rates must meet the following requirements: (A) They must be established and justified in accordance with generally accepted insurance principles, including, but not limited to, the experience or judgment of the insurer making the rate filing or actuarial computations; (B) They may not be excessive, inadequate or unfairly discriminatory. Rates are not unfairly discriminatory because they are averaged broadly among persons insured under group, franchise or blanket policies; and (C) The commissioner may by written order suspend or modify the requirement of filing for any risk, group or class of risk, the rates for which cannot practically be filed before they are used.
(A) They must be established and justified in accordance with generally accepted insurance principles, including, but not limited to, the experience or judgment of the insurer making the rate filing or actuarial computations;
(B) They may not be excessive, inadequate or unfairly discriminatory. Rates are not unfairly discriminatory because they are averaged broadly among persons insured under group, franchise or blanket policies; and
(C) The commissioner may by written order suspend or modify the requirement of filing for any risk, group or class of risk, the rates for which cannot practically be filed before they are used.
(c) If the commissioner determines that any form reviewed under subsection (a) and any schedule of rates reviewed under subsection (b) complies with the requirements of this section, the commissioner shall approve, within thirty (30) days, which may be extended for an additional thirty (30) days by notice in writing to the person making the filing prior to the expiration of the first thirty (30) days. If disapproving a filing, the commissioner shall notify the person making it in writing specifying the reasons for the disapproval. A hearing shall be granted within thirty (30) days after a request in writing by any person aggrieved by the decision of the commissioner. If the commissioner does not disapprove a form or schedule of rates within thirty (30) days of the filing or an extension of the form or schedule, it shall be deemed approved. The commissioner may, after notice and hearing, disapprove any rate that has been previously approved or deemed approved.
(d) Any schedule of compensation paid either directly to lawyers or to beneficiaries as reimbursement of costs incurred for covered legal services shall be filed with the commissioner within thirty (30) days after its use.
(e) The commissioner may require the submission of whatever relevant information is reasonably necessary in determining whether to approve or disapprove a filing made pursuant to subsection (a), (b) or (d).
Acts 1989, ch. 423, § 5.
Tenn. Code Ann. § 56-6-910 — TN Code / Title 56 / Chapter 6 / Section 56-6-910
Probation, cancellation, termination, suspension, revocation or refusal to issue or renew license - Levy of penalties - Enforcement - Notice
Status: in_force

(a) The commissioner may place on probation, cancel, terminate, suspend, revoke or refuse to issue or renew a public adjuster's license, or may levy a civil penalty, in accordance with this section, or any combination of actions, for any one (1) or more of the following causes: (1) Providing materially incorrect, misleading, incomplete, or untrue information in the license application; (2) Violating any laws administered by the commissioner, or violating lawful regulations, or final orders of the commissioner or of another state's insurance commissioner; (3) Obtaining or attempting to obtain a license through misrepresentation or fraud; (4) Improperly withholding, misappropriating, or converting to the licensee's own use any moneys or properties received in the course of conducting business under this license; (5) Intentionally misrepresenting the terms of an actual or proposed insurance contract or application for insurance; (6) Having been convicted of a felony or other offense involving dishonesty, fraud, deceit or misrepresentation, in a final decision of a court of competent jurisdiction; (7) Having committed any insurance unfair trade practice or insurance fraud prohibited under chapters 8 and 53 of this title; (8) Using fraudulent, coercive or dishonest practices, or demonstrating incompetence, untrustworthiness or financial irresponsibility in the conduct of business in this state or elsewhere; (9) Having an insurance producer license, or its equivalent, suspended or revoked in any other state, province, district or territory; (10) Forging another's name to an application for insurance or to any document related to an insurance transaction; (11) Cheating on an examination for an insurance license; (12) Knowingly accepting insurance business from an individual who is not licensed by the commissioner but who is required to be so licensed; (13) Allowing a person not licensed under this part to perform actions requiring licensure under this part; (14) Failing to comply with a final administrative or court order imposing a child support obligation; or (15) Failing to notify the insured, verbally and in writing, of the statutory requirements of this part, as they pertain to solicitation, contracting, and recission and the timeframes contained in this part. (b) Any action by the commissioner to put on probation, suspend, revoke or deny the renewal of a license pursuant to this part shall be governed by the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. (c) In the event that the action of the commissioner is to deny an application for a license, the commissioner shall notify the applicant and advise, in writing, the applicant of the denial of the applicant's application within thirty (30) days. (d) The license of a business entity may be suspended, revoked or refused, if the commissioner finds that an individual's violation was known or should have been known by one (1) or more of the partners, officers or managers acting on behalf of the business entity, and the violation was not timely reported to the commissioner and corrective action was not taken. (e) In addition to, or in lieu of, any applicable denial, suspension, cancellation, termination, or revocation of a license, a person may, after a hearing, be subject to a civil penalty in an amount not less than one hundred dollars ($100), nor more than one thousand dollars ($1,000), for each separate violation of the grounds in subsection (a). Each day of continued violation shall constitute a separate violation. (f) The commissioner shall retain the authority to enforce this part and impose any penalty or remedy authorized by this part, or any other provision of this title against any person who is under investigation for or charged with a violation of this part, even if the person's license or registration has been surrendered or has lapsed by operation of law. (g) The commissioner may serve a notice or order in any action arising under this part by registered or certified mail to the public adjuster or applicant at the address of record on file with the commissioner. Notwithstanding any law to the contrary, service in the manner set forth in this subsection (g) shall be deemed to constitute actual service on the public adjuster or applicant. Acts 2006, ch. 997, § 11.
(a) The commissioner may place on probation, cancel, terminate, suspend, revoke or refuse to issue or renew a public adjuster's license, or may levy a civil penalty, in accordance with this section, or any combination of actions, for any one (1) or more of the following causes: (1) Providing materially incorrect, misleading, incomplete, or untrue information in the license application; (2) Violating any laws administered by the commissioner, or violating lawful regulations, or final orders of the commissioner or of another state's insurance commissioner; (3) Obtaining or attempting to obtain a license through misrepresentation or fraud; (4) Improperly withholding, misappropriating, or converting to the licensee's own use any moneys or properties received in the course of conducting business under this license; (5) Intentionally misrepresenting the terms of an actual or proposed insurance contract or application for insurance; (6) Having been convicted of a felony or other offense involving dishonesty, fraud, deceit or misrepresentation, in a final decision of a court of competent jurisdiction; (7) Having committed any insurance unfair trade practice or insurance fraud prohibited under chapters 8 and 53 of this title; (8) Using fraudulent, coercive or dishonest practices, or demonstrating incompetence, untrustworthiness or financial irresponsibility in the conduct of business in this state or elsewhere; (9) Having an insurance producer license, or its equivalent, suspended or revoked in any other state, province, district or territory; (10) Forging another's name to an application for insurance or to any document related to an insurance transaction; (11) Cheating on an examination for an insurance license; (12) Knowingly accepting insurance business from an individual who is not licensed by the commissioner but who is required to be so licensed; (13) Allowing a person not licensed under this part to perform actions requiring licensure under this part; (14) Failing to comply with a final administrative or court order imposing a child support obligation; or (15) Failing to notify the insured, verbally and in writing, of the statutory requirements of this part, as they pertain to solicitation, contracting, and recission and the timeframes contained in this part.
(1) Providing materially incorrect, misleading, incomplete, or untrue information in the license application;
(2) Violating any laws administered by the commissioner, or violating lawful regulations, or final orders of the commissioner or of another state's insurance commissioner;
(3) Obtaining or attempting to obtain a license through misrepresentation or fraud;
(4) Improperly withholding, misappropriating, or converting to the licensee's own use any moneys or properties received in the course of conducting business under this license;
(5) Intentionally misrepresenting the terms of an actual or proposed insurance contract or application for insurance;
(6) Having been convicted of a felony or other offense involving dishonesty, fraud, deceit or misrepresentation, in a final decision of a court of competent jurisdiction;
(7) Having committed any insurance unfair trade practice or insurance fraud prohibited under chapters 8 and 53 of this title;
(8) Using fraudulent, coercive or dishonest practices, or demonstrating incompetence, untrustworthiness or financial irresponsibility in the conduct of business in this state or elsewhere;
(9) Having an insurance producer license, or its equivalent, suspended or revoked in any other state, province, district or territory;
(10) Forging another's name to an application for insurance or to any document related to an insurance transaction;
(11) Cheating on an examination for an insurance license;
(12) Knowingly accepting insurance business from an individual who is not licensed by the commissioner but who is required to be so licensed;
(13) Allowing a person not licensed under this part to perform actions requiring licensure under this part;
(14) Failing to comply with a final administrative or court order imposing a child support obligation; or
(15) Failing to notify the insured, verbally and in writing, of the statutory requirements of this part, as they pertain to solicitation, contracting, and recission and the timeframes contained in this part.
(b) Any action by the commissioner to put on probation, suspend, revoke or deny the renewal of a license pursuant to this part shall be governed by the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
(c) In the event that the action of the commissioner is to deny an application for a license, the commissioner shall notify the applicant and advise, in writing, the applicant of the denial of the applicant's application within thirty (30) days.
(d) The license of a business entity may be suspended, revoked or refused, if the commissioner finds that an individual's violation was known or should have been known by one (1) or more of the partners, officers or managers acting on behalf of the business entity, and the violation was not timely reported to the commissioner and corrective action was not taken.
(e) In addition to, or in lieu of, any applicable denial, suspension, cancellation, termination, or revocation of a license, a person may, after a hearing, be subject to a civil penalty in an amount not less than one hundred dollars ($100), nor more than one thousand dollars ($1,000), for each separate violation of the grounds in subsection (a). Each day of continued violation shall constitute a separate violation.
(f) The commissioner shall retain the authority to enforce this part and impose any penalty or remedy authorized by this part, or any other provision of this title against any person who is under investigation for or charged with a violation of this part, even if the person's license or registration has been surrendered or has lapsed by operation of law.
(g) The commissioner may serve a notice or order in any action arising under this part by registered or certified mail to the public adjuster or applicant at the address of record on file with the commissioner. Notwithstanding any law to the contrary, service in the manner set forth in this subsection (g) shall be deemed to constitute actual service on the public adjuster or applicant.
Acts 2006, ch. 997, § 11.
Tenn. Code Ann. § 56-19-107 — TN Code / Title 56 / Chapter 19 / Section 56-19-107
Legal existence - Bylaws and transaction of business
Status: in_force

(a) The company shall have legal existence from and after the date of the certificate of incorporation. (b) (1) The board of directors named in the articles may thereupon adopt bylaws, accept applications for insurance and proceed to transact the business of the company; provided, that no insurance shall be put into force until the company has been licensed to transact insurance as provided by this chapter. (2) The bylaws and any amendments thereto shall within thirty (30) days after adoption be filed with the commissioner. Acts 1919, ch. 108, § 5; Shan. Supp., § 3369a58b11; Code 1932, § 6323; T.C.A. (orig. ed.), § 56-1707.
(a) The company shall have legal existence from and after the date of the certificate of incorporation.
(b) (1) The board of directors named in the articles may thereupon adopt bylaws, accept applications for insurance and proceed to transact the business of the company; provided, that no insurance shall be put into force until the company has been licensed to transact insurance as provided by this chapter. (2) The bylaws and any amendments thereto shall within thirty (30) days after adoption be filed with the commissioner.
(1) The board of directors named in the articles may thereupon adopt bylaws, accept applications for insurance and proceed to transact the business of the company; provided, that no insurance shall be put into force until the company has been licensed to transact insurance as provided by this chapter.
(2) The bylaws and any amendments thereto shall within thirty (30) days after adoption be filed with the commissioner.
Acts 1919, ch. 108, § 5; Shan. Supp., § 3369a58b11; Code 1932, § 6323; T.C.A. (orig. ed.), § 56-1707.
Tenn. Code Ann. § 56-1-313 — TN Code / Title 56 / Chapter 1 / Section 56-1-313
Disciplinary authority of governmental entities attached to the division of regulatory boards
Status: in_force

(a) In addition to any other lawful disciplinary authority, any board, commission or agency attached to the division of regulatory boards may, upon receipt of a certified order, refuse to issue or renew a license, permit or authorization to practice, and revoke, suspend or restrict any license, permit or authorization to practice that the board, commission, or agency has issued to any person who: (1) Has had the person's license, permit or authorization to practice in the profession or occupation subject to the jurisdiction of the board, commission or agency suspended or revoked by another state or national board, commission or agency for any acts or omissions that would constitute grounds for discipline in this state; or (2) Has voluntarily surrendered the person's license, permit or authorization to practice in the profession or occupation that is subject to the jurisdiction of the board, commission or agency, as a result of or during the pendency of disciplinary proceedings by another state or national board, commission or agency, for any acts or omissions that would constitute grounds for discipline in this state. (b) The Uniform Administrative Procedures Act, compiled in title 4, chapter 5, shall govern all matters and procedures respecting the hearing and judicial review of any contested case, as defined in § 4-5-102 , arising under the authority of this section. (c) Any board, commission or agency attached to the division of regulatory boards is authorized to promulgate rules to effectuate the purposes of this section. The rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act. Acts 2005, ch. 285, § 1.
(a) In addition to any other lawful disciplinary authority, any board, commission or agency attached to the division of regulatory boards may, upon receipt of a certified order, refuse to issue or renew a license, permit or authorization to practice, and revoke, suspend or restrict any license, permit or authorization to practice that the board, commission, or agency has issued to any person who: (1) Has had the person's license, permit or authorization to practice in the profession or occupation subject to the jurisdiction of the board, commission or agency suspended or revoked by another state or national board, commission or agency for any acts or omissions that would constitute grounds for discipline in this state; or (2) Has voluntarily surrendered the person's license, permit or authorization to practice in the profession or occupation that is subject to the jurisdiction of the board, commission or agency, as a result of or during the pendency of disciplinary proceedings by another state or national board, commission or agency, for any acts or omissions that would constitute grounds for discipline in this state.
(1) Has had the person's license, permit or authorization to practice in the profession or occupation subject to the jurisdiction of the board, commission or agency suspended or revoked by another state or national board, commission or agency for any acts or omissions that would constitute grounds for discipline in this state; or
(2) Has voluntarily surrendered the person's license, permit or authorization to practice in the profession or occupation that is subject to the jurisdiction of the board, commission or agency, as a result of or during the pendency of disciplinary proceedings by another state or national board, commission or agency, for any acts or omissions that would constitute grounds for discipline in this state.
(b) The Uniform Administrative Procedures Act, compiled in title 4, chapter 5, shall govern all matters and procedures respecting the hearing and judicial review of any contested case, as defined in § 4-5-102 , arising under the authority of this section.
(c) Any board, commission or agency attached to the division of regulatory boards is authorized to promulgate rules to effectuate the purposes of this section. The rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act.
Acts 2005, ch. 285, § 1.
Tenn. Code Ann. § 56-58-101 — TN Code / Title 56 / Chapter 58 / Section 56-58-101
Short title
Status: in_force

This chapter shall be known and may be cited as the "Interstate Insurance Product Regulation Compact Act of 2007." Acts 2007, ch. 148, § 2.
This chapter shall be known and may be cited as the "Interstate Insurance Product Regulation Compact Act of 2007."
Acts 2007, ch. 148, § 2.
Tenn. Code Ann. § 56-4-102 — TN Code / Title 56 / Chapter 4 / Section 56-4-102
Disposition of fees
Status: in_force

(a) The fees for the valuation of life insurance policies, which are provided in § 56-4-101 , shall be collected for the use and benefit of the state and shall be held by the commissioner as expendable receipts, and the expense of operation of the department, including the salaries and traveling expenses of the actuaries employed pursuant to § 56-1-207 , shall be paid out of the fees collected. At the end of each fiscal year, any remaining funds after the payment of the expense of operation of the department shall be remitted to the state treasurer and become a part of the general fund. (b) The fees for receiving and reviewing each new application for admission and the annual fee for review of continuing eligibility of surplus lines insurers shall be collected for use and benefit of the state and shall be held by the commissioner as expendable receipts, and all salaries and traveling expenses of the personnel employed in the processing and review for admission or eligibility shall be paid out of such fees collected. At the end of each fiscal year, any remaining funds after payment of salaries and expenses of the personnel shall be remitted to the state treasurer and become a part of the general fund. Acts 1943, ch. 97, § 3; mod. C. Supp. 1950, § 6459.42 (Williams, § 6459.45); impl. am. Acts 1971, ch. 137, § 2; T.C.A. (orig. ed.), § 56-402; Acts 1983, ch. 262, § 2.
(a) The fees for the valuation of life insurance policies, which are provided in § 56-4-101 , shall be collected for the use and benefit of the state and shall be held by the commissioner as expendable receipts, and the expense of operation of the department, including the salaries and traveling expenses of the actuaries employed pursuant to § 56-1-207 , shall be paid out of the fees collected. At the end of each fiscal year, any remaining funds after the payment of the expense of operation of the department shall be remitted to the state treasurer and become a part of the general fund.
(b) The fees for receiving and reviewing each new application for admission and the annual fee for review of continuing eligibility of surplus lines insurers shall be collected for use and benefit of the state and shall be held by the commissioner as expendable receipts, and all salaries and traveling expenses of the personnel employed in the processing and review for admission or eligibility shall be paid out of such fees collected. At the end of each fiscal year, any remaining funds after payment of salaries and expenses of the personnel shall be remitted to the state treasurer and become a part of the general fund.
Acts 1943, ch. 97, § 3; mod. C. Supp. 1950, § 6459.42 (Williams, § 6459.45); impl. am. Acts 1971, ch. 137, § 2; T.C.A. (orig. ed.), § 56-402; Acts 1983, ch. 262, § 2.
Tenn. Code Ann. § 56-6-1009 — TN Code / Title 56 / Chapter 6 / Section 56-6-1009
Regulations - Licensure fees - Setting of standards for licensure - Accounting of fees and costs
Status: in_force

The commissioner may promulgate regulations as are necessary or proper to carry out the purposes of this part. These regulations may include provisions relating to the assessment of licensure fees reasonable to defray the costs of examinations and testing of crop insurance adjusters. The commissioner may also set standards for the maintenance of a crop insurance adjuster license. The commissioner shall keep a separate accounting of fees and costs to administer this part, and no other fees generated under this chapter shall be used to administer this part. Acts 2009, ch. 476, § 10.
The commissioner may promulgate regulations as are necessary or proper to carry out the purposes of this part. These regulations may include provisions relating to the assessment of licensure fees reasonable to defray the costs of examinations and testing of crop insurance adjusters. The commissioner may also set standards for the maintenance of a crop insurance adjuster license. The commissioner shall keep a separate accounting of fees and costs to administer this part, and no other fees generated under this chapter shall be used to administer this part.
Acts 2009, ch. 476, § 10.
Tenn. Code Ann. § 56-7-2355 — TN Code / Title 56 / Chapter 7 / Section 56-7-2355
Coverage of emergency services
Status: in_force

(a) As used in this section, unless the context otherwise requires: (1) "Emergency medical condition" means a medical condition that manifests itself by symptoms of sufficient severity, including severe pain, regardless of the final diagnosis of the symptoms, that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to potentially result in: (A) Placing the person's health in serious jeopardy; (B) Serious impairment to bodily functions; or (C) Serious dysfunction of a bodily organ or part; (2) "Emergency services" means health care items and services furnished in a hospital that are required to determine, evaluate and/or treat an emergency medical condition, until the condition is stabilized, as directed or ordered by a physician or directed by physician or hospital protocol; (3) "Health benefit plan" means any hospital or medical expense policy, health, hospital or medical service corporation contract, a policy or agreement entered into by a health insurer or a health maintenance organization contract offered by an employer, other plans administered by the state government, or any certificate issued under the policies, contracts or plans. "Health benefit plan" does not include policies or certificates covering only accident, credit, dental, disability income, long-term care, hospital indemnity, medicare supplement as defined in § 1882(g)(1) of the Social Security Act ( 42 U.S.C. § 1395ss(g)(1) ), specified disease, vision care, other limited benefit health insurance, coverage issued as a supplement to liability insurance, workers' compensation insurance, automobile medical payment insurance, or insurance under which benefits are payable with or without regard to fault and that is statutorily required to be contained in any liability insurance policy or equivalent self-insurance; (4) "Health insurer" means any entity offering a health benefit plan; (5) "Participating provider" means a provider who, under a contract with the health insurer or with its contractor or subcontractor, has agreed to provide one (1) or more health care services to enrollees of the health insurer's health benefit plan with an expectation of receiving payment, other than coinsurance, copayments or deductibles, directly or indirectly from the health insurer; (6) "Physician" means a person licensed or permitted to practice medicine and surgery under title 63, chapter 6 or 9; (7) "Provider" means a physician, hospital or other person licensed, accredited or certified to perform specified health care services pursuant to title 63, chapter 6 or 9, or title 68; and (8) "Stabilized" means, with respect to an emergency medical condition, that no material deterioration of the condition is likely, within a reasonable medical probability, to result from or occur during the transfer of the individual from a facility. (b) (1) A health benefit plan shall not deny coverage or payment for emergency services if the symptoms presented by an enrollee of a health benefit plan and recorded by the attending provider indicate that an emergency medical condition could exist, regardless of: (A) The final diagnosis of the symptoms; (B) Whether prior authorization was obtained to provide those services; and (C) Whether the provider furnishing the services has a contractual agreement with the health benefit plan for the provision of the services to the enrollee. (2) If a participating provider or other authorized representative of a health insurer authorizes emergency services, the health insurer shall not subsequently rescind or modify that authorization after the provider renders the authorized care in good faith and pursuant to the authorization except for payments made as a result of misrepresentation, fraud, omission or clerical error. (3) Once an enrollee is stabilized pursuant to subdivision (a)(8), a health benefit plan may require as a condition of further coverage that a provider promptly contact the health insurer for prior authorization for continuing treatment, specialty consultations, transfer arrangements or other medically necessary and appropriate care for an enrollee. (4) Coverage of emergency services shall be subject to applicable copayments, coinsurance and deductibles. Amended by 2022 Tenn. Acts, ch. 784, Secs.s1, s2 eff. 4/8/2022. Acts 1997 , ch. 524, § 1; 1998, ch. 1134, § 1.
(a) As used in this section, unless the context otherwise requires: (1) "Emergency medical condition" means a medical condition that manifests itself by symptoms of sufficient severity, including severe pain, regardless of the final diagnosis of the symptoms, that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to potentially result in: (A) Placing the person's health in serious jeopardy; (B) Serious impairment to bodily functions; or (C) Serious dysfunction of a bodily organ or part; (2) "Emergency services" means health care items and services furnished in a hospital that are required to determine, evaluate and/or treat an emergency medical condition, until the condition is stabilized, as directed or ordered by a physician or directed by physician or hospital protocol; (3) "Health benefit plan" means any hospital or medical expense policy, health, hospital or medical service corporation contract, a policy or agreement entered into by a health insurer or a health maintenance organization contract offered by an employer, other plans administered by the state government, or any certificate issued under the policies, contracts or plans. "Health benefit plan" does not include policies or certificates covering only accident, credit, dental, disability income, long-term care, hospital indemnity, medicare supplement as defined in § 1882(g)(1) of the Social Security Act ( 42 U.S.C. § 1395ss(g)(1) ), specified disease, vision care, other limited benefit health insurance, coverage issued as a supplement to liability insurance, workers' compensation insurance, automobile medical payment insurance, or insurance under which benefits are payable with or without regard to fault and that is statutorily required to be contained in any liability insurance policy or equivalent self-insurance; (4) "Health insurer" means any entity offering a health benefit plan; (5) "Participating provider" means a provider who, under a contract with the health insurer or with its contractor or subcontractor, has agreed to provide one (1) or more health care services to enrollees of the health insurer's health benefit plan with an expectation of receiving payment, other than coinsurance, copayments or deductibles, directly or indirectly from the health insurer; (6) "Physician" means a person licensed or permitted to practice medicine and surgery under title 63, chapter 6 or 9; (7) "Provider" means a physician, hospital or other person licensed, accredited or certified to perform specified health care services pursuant to title 63, chapter 6 or 9, or title 68; and (8) "Stabilized" means, with respect to an emergency medical condition, that no material deterioration of the condition is likely, within a reasonable medical probability, to result from or occur during the transfer of the individual from a facility.
(1) "Emergency medical condition" means a medical condition that manifests itself by symptoms of sufficient severity, including severe pain, regardless of the final diagnosis of the symptoms, that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to potentially result in: (A) Placing the person's health in serious jeopardy; (B) Serious impairment to bodily functions; or (C) Serious dysfunction of a bodily organ or part;
(A) Placing the person's health in serious jeopardy;
(B) Serious impairment to bodily functions; or
(C) Serious dysfunction of a bodily organ or part;
(2) "Emergency services" means health care items and services furnished in a hospital that are required to determine, evaluate and/or treat an emergency medical condition, until the condition is stabilized, as directed or ordered by a physician or directed by physician or hospital protocol;
(3) "Health benefit plan" means any hospital or medical expense policy, health, hospital or medical service corporation contract, a policy or agreement entered into by a health insurer or a health maintenance organization contract offered by an employer, other plans administered by the state government, or any certificate issued under the policies, contracts or plans. "Health benefit plan" does not include policies or certificates covering only accident, credit, dental, disability income, long-term care, hospital indemnity, medicare supplement as defined in § 1882(g)(1) of the Social Security Act ( 42 U.S.C. § 1395ss(g)(1) ), specified disease, vision care, other limited benefit health insurance, coverage issued as a supplement to liability insurance, workers' compensation insurance, automobile medical payment insurance, or insurance under which benefits are payable with or without regard to fault and that is statutorily required to be contained in any liability insurance policy or equivalent self-insurance;
(4) "Health insurer" means any entity offering a health benefit plan;
(5) "Participating provider" means a provider who, under a contract with the health insurer or with its contractor or subcontractor, has agreed to provide one (1) or more health care services to enrollees of the health insurer's health benefit plan with an expectation of receiving payment, other than coinsurance, copayments or deductibles, directly or indirectly from the health insurer;
(6) "Physician" means a person licensed or permitted to practice medicine and surgery under title 63, chapter 6 or 9;
(7) "Provider" means a physician, hospital or other person licensed, accredited or certified to perform specified health care services pursuant to title 63, chapter 6 or 9, or title 68; and
(8) "Stabilized" means, with respect to an emergency medical condition, that no material deterioration of the condition is likely, within a reasonable medical probability, to result from or occur during the transfer of the individual from a facility.
(b) (1) A health benefit plan shall not deny coverage or payment for emergency services if the symptoms presented by an enrollee of a health benefit plan and recorded by the attending provider indicate that an emergency medical condition could exist, regardless of: (A) The final diagnosis of the symptoms; (B) Whether prior authorization was obtained to provide those services; and (C) Whether the provider furnishing the services has a contractual agreement with the health benefit plan for the provision of the services to the enrollee. (2) If a participating provider or other authorized representative of a health insurer authorizes emergency services, the health insurer shall not subsequently rescind or modify that authorization after the provider renders the authorized care in good faith and pursuant to the authorization except for payments made as a result of misrepresentation, fraud, omission or clerical error. (3) Once an enrollee is stabilized pursuant to subdivision (a)(8), a health benefit plan may require as a condition of further coverage that a provider promptly contact the health insurer for prior authorization for continuing treatment, specialty consultations, transfer arrangements or other medically necessary and appropriate care for an enrollee. (4) Coverage of emergency services shall be subject to applicable copayments, coinsurance and deductibles.
(1) A health benefit plan shall not deny coverage or payment for emergency services if the symptoms presented by an enrollee of a health benefit plan and recorded by the attending provider indicate that an emergency medical condition could exist, regardless of: (A) The final diagnosis of the symptoms; (B) Whether prior authorization was obtained to provide those services; and (C) Whether the provider furnishing the services has a contractual agreement with the health benefit plan for the provision of the services to the enrollee.
(A) The final diagnosis of the symptoms;
(B) Whether prior authorization was obtained to provide those services; and
(C) Whether the provider furnishing the services has a contractual agreement with the health benefit plan for the provision of the services to the enrollee.
(2) If a participating provider or other authorized representative of a health insurer authorizes emergency services, the health insurer shall not subsequently rescind or modify that authorization after the provider renders the authorized care in good faith and pursuant to the authorization except for payments made as a result of misrepresentation, fraud, omission or clerical error.
(3) Once an enrollee is stabilized pursuant to subdivision (a)(8), a health benefit plan may require as a condition of further coverage that a provider promptly contact the health insurer for prior authorization for continuing treatment, specialty consultations, transfer arrangements or other medically necessary and appropriate care for an enrollee.
(4) Coverage of emergency services shall be subject to applicable copayments, coinsurance and deductibles.
Amended by 2022 Tenn. Acts, ch. 784, Secs.s1, s2 eff. 4/8/2022.
Acts 1997 , ch. 524, § 1; 1998, ch. 1134, § 1.
Tenn. Code Ann. § 56-7-2302 — TN Code / Title 56 / Chapter 7 / Section 56-7-2302
Dependent children under hospital or medical expense policies - Coverage - Services by charitable research hospitals
Status: in_force

(a) (1) An individual hospital or medical expense insurance policy or contract, as provided under chapter 26, 28 or 29 of this title, delivered or issued for delivery in this state, or that is amended or renewed by agreement or otherwise, on or after August 13, 1986, and that provides that coverage of a dependent child shall terminate upon attainment of the limiting age for dependent children specified in the policy, shall also provide that the limiting age not be earlier than twenty-four (24) years for those dependent children who are unmarried and dependent on the insured for support and maintenance. This subdivision (a)(1) shall not be construed to require coverage for a dependent child under the policy of insurance, if the dependent child would be otherwise ineligible for the coverage either by the terms of the policy of insurance or other provisions of this title, except those relating to the limiting age for the dependent child stated in this subdivision (a)(1). (2) A group hospital or medical expense insurance policy or contract, as provided under chapter 26, 28 or 29 of this title, delivered or issued for delivery in this state, or that is amended or renewed by agreement or otherwise, on or after August 13, 1986, and that provides that coverage of a dependent child shall terminate upon attainment of the limiting age for dependent children specified in the policy, shall also provide that the limiting age not be earlier than twenty-four (24) years for those dependent children who are unmarried and dependent on the insured for support and maintenance. This subdivision (a)(2) shall not be construed to require coverage for a dependent child under the policy of insurance if the dependent child would be otherwise ineligible for the coverage either by the terms of the policy of insurance or other provisions of this title, except those relating to the limiting age for the dependent child stated in this subdivision (a)(2). (b) (1) An individual hospital or medical expense insurance policy or contract, as provided under chapter 26, 28 or 29 of this title, delivered or issued for delivery in this state more than one hundred twenty (120) days after May 7, 1969, that provides that coverage of a dependent child shall terminate upon attainment of the limiting age for dependent children specified in the policy, shall also provide in substance that attainment of the limiting age shall not operate to terminate the coverage of the child while the child is and continues to be both: (A) Incapable of self-sustaining employment by reason of intellectual or physical disability; and (B) Chiefly dependent upon the policyholder for support and maintenance, provided proof of the incapacity and dependency is furnished to the insurer by the policyholder within thirty-one (31) days of the child's attainment of the limiting age and subsequently as may be required by the insurer, but not more frequently than annually after the two-year period following the child's attainment of the limiting age. (2) A group hospital or medical expense insurance policy or contract, as provided under chapter 26, 28 or 29 of this title, delivered or issued for delivery in this state more than one hundred twenty (120) days after May 7, 1969, that provides that coverage of a dependent child of an employee or other member of the covered group shall terminate upon attainment of the limiting age for dependent children specified in the policy, shall also provide in substance that attainment of the limiting age shall not operate to terminate the coverage of the child while the child is and continues to be both: (A) Incapable of self-sustaining employment by reason of intellectual or physical disability; and (B) Chiefly dependent upon the employee or member for support and maintenance, provided proof of the incapacity and dependency is furnished to the insurer by the employee or member within thirty-one (31) days of the child's attainment of the limiting age and subsequently as may be required by the insurer, but not more frequently than annually after the two-year period following the child's attainment of the limiting age. (3) Any group hospital or medical expense insurance policy or contract that is issued to replace an existing group policy or contract shall continue the coverage for those dependents with disabilities covered under the prior group insurance policy or contract, regardless of age, in the manner specified in subdivisions (a)(1) and (2). The dependents with disabilities covered under the prior plan on the date of discontinuance who would be eligible for coverage in accordance with the succeeding carrier's plan of benefits, except for the fact that they have attained the limiting age, shall be covered under the succeeding carrier's plan on its effective date so long as they have a disability and are dependent under the definitions in subdivisions (b)(1) and (2). (c) (1) Notwithstanding any other law to the contrary, no insurer, or employer or other entity that administers health, medical, or surgical insurance or that has an insurance company administering its health services program, and no individual, blanket or group policy of insurance issued pursuant to this title, that is entered into, amended, delivered, issued for delivery, or renewed by agreement or otherwise, on or after March 17, 1982, shall deny, for the reason that the insured or the covered dependent incurred no expense, charge, or obligation, a claim for expenses incurred in connection with the patient's hospitalization for hospital, medical or surgical services rendered by a nongovernmental, charitable research hospital that bills all patients for services rendered but does not enforce by judicial proceedings payment from an individual patient in the absence of insurance coverage. (2) No expense incurred, individual or group hospital, medical or surgical policy issued, delivered, amended or renewed on or after March 17, 1982, or employer or other entity that administers health, medical, or surgical insurance or that has an insurance company administering its health services program, shall except, limit, or reduce benefits or otherwise fail to pay for services rendered by a nongovernmental charitable research hospital because it bills patients for services rendered, but does not enforce by judicial proceedings collection from individual patients in the absence of insurance coverage. (d) (1) All policies or contracts as described in subdivisions (a)(1) and (2), and all ERISA group health plans and health maintenance organizations, are prohibited from denying coverage to a child because the child was born out of wedlock, was not claimed as a dependent on the parent's income tax return, or does not reside with the parent or in the service area of the entity providing health insurance or coverage. (2) Should health insurance or coverage be ordered by a court of law or administrative order and the parent so ordered is eligible for coverage, the insurer, the employer or the ERISA group health plan administrator, nonprofit hospital and medical service plan or health maintenance organization of the parent so ordered must permit enrollment of the child who is otherwise eligible, without regard to any enrollment season restriction. The entity providing health insurance or coverage must accept the applications for coverage of the child made by either the child's other parent or the state agency administering Title XIX of the Social Security Act ( 42 U.S.C. § 1396 et seq.), or the Title IV-D child support enforcement program ( 42 U.S.C. §§ 661- 669 ). (3) No entity providing health care benefits may disenroll or eliminate coverage under subdivision (d)(2) without satisfactory written evidence that the court or administrative order is no longer in effect or that there is written evidence that the child will be enrolled in comparable health coverage through another insurer that will take effect not later than the effective date of the disenrollment or, in the case of an employer, where the employer has eliminated family health coverage for all of its employees. (4) No entity providing health care benefits may impose different requirements on a state, as assignee of the rights of a covered individual who is enrolled in any insurance program offered in the state, that differ from requirements imposed on agents or assignees of any other covered individual. (5) In cases where the noncustodial parent is providing coverage, all entities providing the coverage must provide information to the custodial parent, or provider, with the custodial parent's approval, that is necessary for the child to obtain benefits, though that coverage must permit the custodial parent or the provider with approval of the custodial parent, to submit claims for covered services without the approval of the noncustodial parent, and must make payment of the claims directly to the custodial parent, the provider, the state agency administering Title XIX or IV-D of the Social Security Act or any contractor who has contracted with the state to provide medicaid services. (6) The commissioner is authorized to adopt rules and standards establishing reasonable procedures for use by group health plans to determine whether a child is covered under a qualified medical support order. (e) All policies and contracts as described in subdivision (a)(2), all ERISA group health plans and health maintenance organizations must provide the same coverage to adopted children under eighteen (18) years of age as of the date of placement for adoption or adoption as for natural children effective upon placement of the children, regardless of whether the adoption has become final. No preexisting conditions of an adopted child may be used to deny coverage if the adoption or placement for adoption occurs while the parent is eligible for coverage. Acts 1969, ch. 230, § 1; T.C.A., § 56-1160; Acts 1982, ch. 596, § 1; 1985, ch. 206, § 1; 1986, ch. 773, § 1; 1992, ch. 984, § 1; T.C.A., § 56-7-1005; Acts 1994, ch. 881, § 1; 2011 , ch. 47, §§ 65, 66.
(a) (1) An individual hospital or medical expense insurance policy or contract, as provided under chapter 26, 28 or 29 of this title, delivered or issued for delivery in this state, or that is amended or renewed by agreement or otherwise, on or after August 13, 1986, and that provides that coverage of a dependent child shall terminate upon attainment of the limiting age for dependent children specified in the policy, shall also provide that the limiting age not be earlier than twenty-four (24) years for those dependent children who are unmarried and dependent on the insured for support and maintenance. This subdivision (a)(1) shall not be construed to require coverage for a dependent child under the policy of insurance, if the dependent child would be otherwise ineligible for the coverage either by the terms of the policy of insurance or other provisions of this title, except those relating to the limiting age for the dependent child stated in this subdivision (a)(1). (2) A group hospital or medical expense insurance policy or contract, as provided under chapter 26, 28 or 29 of this title, delivered or issued for delivery in this state, or that is amended or renewed by agreement or otherwise, on or after August 13, 1986, and that provides that coverage of a dependent child shall terminate upon attainment of the limiting age for dependent children specified in the policy, shall also provide that the limiting age not be earlier than twenty-four (24) years for those dependent children who are unmarried and dependent on the insured for support and maintenance. This subdivision (a)(2) shall not be construed to require coverage for a dependent child under the policy of insurance if the dependent child would be otherwise ineligible for the coverage either by the terms of the policy of insurance or other provisions of this title, except those relating to the limiting age for the dependent child stated in this subdivision (a)(2).
(1) An individual hospital or medical expense insurance policy or contract, as provided under chapter 26, 28 or 29 of this title, delivered or issued for delivery in this state, or that is amended or renewed by agreement or otherwise, on or after August 13, 1986, and that provides that coverage of a dependent child shall terminate upon attainment of the limiting age for dependent children specified in the policy, shall also provide that the limiting age not be earlier than twenty-four (24) years for those dependent children who are unmarried and dependent on the insured for support and maintenance. This subdivision (a)(1) shall not be construed to require coverage for a dependent child under the policy of insurance, if the dependent child would be otherwise ineligible for the coverage either by the terms of the policy of insurance or other provisions of this title, except those relating to the limiting age for the dependent child stated in this subdivision (a)(1).
(2) A group hospital or medical expense insurance policy or contract, as provided under chapter 26, 28 or 29 of this title, delivered or issued for delivery in this state, or that is amended or renewed by agreement or otherwise, on or after August 13, 1986, and that provides that coverage of a dependent child shall terminate upon attainment of the limiting age for dependent children specified in the policy, shall also provide that the limiting age not be earlier than twenty-four (24) years for those dependent children who are unmarried and dependent on the insured for support and maintenance. This subdivision (a)(2) shall not be construed to require coverage for a dependent child under the policy of insurance if the dependent child would be otherwise ineligible for the coverage either by the terms of the policy of insurance or other provisions of this title, except those relating to the limiting age for the dependent child stated in this subdivision (a)(2).
(b) (1) An individual hospital or medical expense insurance policy or contract, as provided under chapter 26, 28 or 29 of this title, delivered or issued for delivery in this state more than one hundred twenty (120) days after May 7, 1969, that provides that coverage of a dependent child shall terminate upon attainment of the limiting age for dependent children specified in the policy, shall also provide in substance that attainment of the limiting age shall not operate to terminate the coverage of the child while the child is and continues to be both: (A) Incapable of self-sustaining employment by reason of intellectual or physical disability; and (B) Chiefly dependent upon the policyholder for support and maintenance, provided proof of the incapacity and dependency is furnished to the insurer by the policyholder within thirty-one (31) days of the child's attainment of the limiting age and subsequently as may be required by the insurer, but not more frequently than annually after the two-year period following the child's attainment of the limiting age. (2) A group hospital or medical expense insurance policy or contract, as provided under chapter 26, 28 or 29 of this title, delivered or issued for delivery in this state more than one hundred twenty (120) days after May 7, 1969, that provides that coverage of a dependent child of an employee or other member of the covered group shall terminate upon attainment of the limiting age for dependent children specified in the policy, shall also provide in substance that attainment of the limiting age shall not operate to terminate the coverage of the child while the child is and continues to be both: (A) Incapable of self-sustaining employment by reason of intellectual or physical disability; and (B) Chiefly dependent upon the employee or member for support and maintenance, provided proof of the incapacity and dependency is furnished to the insurer by the employee or member within thirty-one (31) days of the child's attainment of the limiting age and subsequently as may be required by the insurer, but not more frequently than annually after the two-year period following the child's attainment of the limiting age. (3) Any group hospital or medical expense insurance policy or contract that is issued to replace an existing group policy or contract shall continue the coverage for those dependents with disabilities covered under the prior group insurance policy or contract, regardless of age, in the manner specified in subdivisions (a)(1) and (2). The dependents with disabilities covered under the prior plan on the date of discontinuance who would be eligible for coverage in accordance with the succeeding carrier's plan of benefits, except for the fact that they have attained the limiting age, shall be covered under the succeeding carrier's plan on its effective date so long as they have a disability and are dependent under the definitions in subdivisions (b)(1) and (2).
(1) An individual hospital or medical expense insurance policy or contract, as provided under chapter 26, 28 or 29 of this title, delivered or issued for delivery in this state more than one hundred twenty (120) days after May 7, 1969, that provides that coverage of a dependent child shall terminate upon attainment of the limiting age for dependent children specified in the policy, shall also provide in substance that attainment of the limiting age shall not operate to terminate the coverage of the child while the child is and continues to be both: (A) Incapable of self-sustaining employment by reason of intellectual or physical disability; and (B) Chiefly dependent upon the policyholder for support and maintenance, provided proof of the incapacity and dependency is furnished to the insurer by the policyholder within thirty-one (31) days of the child's attainment of the limiting age and subsequently as may be required by the insurer, but not more frequently than annually after the two-year period following the child's attainment of the limiting age.
(A) Incapable of self-sustaining employment by reason of intellectual or physical disability; and
(B) Chiefly dependent upon the policyholder for support and maintenance, provided proof of the incapacity and dependency is furnished to the insurer by the policyholder within thirty-one (31) days of the child's attainment of the limiting age and subsequently as may be required by the insurer, but not more frequently than annually after the two-year period following the child's attainment of the limiting age.
(2) A group hospital or medical expense insurance policy or contract, as provided under chapter 26, 28 or 29 of this title, delivered or issued for delivery in this state more than one hundred twenty (120) days after May 7, 1969, that provides that coverage of a dependent child of an employee or other member of the covered group shall terminate upon attainment of the limiting age for dependent children specified in the policy, shall also provide in substance that attainment of the limiting age shall not operate to terminate the coverage of the child while the child is and continues to be both: (A) Incapable of self-sustaining employment by reason of intellectual or physical disability; and (B) Chiefly dependent upon the employee or member for support and maintenance, provided proof of the incapacity and dependency is furnished to the insurer by the employee or member within thirty-one (31) days of the child's attainment of the limiting age and subsequently as may be required by the insurer, but not more frequently than annually after the two-year period following the child's attainment of the limiting age.
(A) Incapable of self-sustaining employment by reason of intellectual or physical disability; and
(B) Chiefly dependent upon the employee or member for support and maintenance, provided proof of the incapacity and dependency is furnished to the insurer by the employee or member within thirty-one (31) days of the child's attainment of the limiting age and subsequently as may be required by the insurer, but not more frequently than annually after the two-year period following the child's attainment of the limiting age.
(3) Any group hospital or medical expense insurance policy or contract that is issued to replace an existing group policy or contract shall continue the coverage for those dependents with disabilities covered under the prior group insurance policy or contract, regardless of age, in the manner specified in subdivisions (a)(1) and (2). The dependents with disabilities covered under the prior plan on the date of discontinuance who would be eligible for coverage in accordance with the succeeding carrier's plan of benefits, except for the fact that they have attained the limiting age, shall be covered under the succeeding carrier's plan on its effective date so long as they have a disability and are dependent under the definitions in subdivisions (b)(1) and (2).
(c) (1) Notwithstanding any other law to the contrary, no insurer, or employer or other entity that administers health, medical, or surgical insurance or that has an insurance company administering its health services program, and no individual, blanket or group policy of insurance issued pursuant to this title, that is entered into, amended, delivered, issued for delivery, or renewed by agreement or otherwise, on or after March 17, 1982, shall deny, for the reason that the insured or the covered dependent incurred no expense, charge, or obligation, a claim for expenses incurred in connection with the patient's hospitalization for hospital, medical or surgical services rendered by a nongovernmental, charitable research hospital that bills all patients for services rendered but does not enforce by judicial proceedings payment from an individual patient in the absence of insurance coverage. (2) No expense incurred, individual or group hospital, medical or surgical policy issued, delivered, amended or renewed on or after March 17, 1982, or employer or other entity that administers health, medical, or surgical insurance or that has an insurance company administering its health services program, shall except, limit, or reduce benefits or otherwise fail to pay for services rendered by a nongovernmental charitable research hospital because it bills patients for services rendered, but does not enforce by judicial proceedings collection from individual patients in the absence of insurance coverage.
(1) Notwithstanding any other law to the contrary, no insurer, or employer or other entity that administers health, medical, or surgical insurance or that has an insurance company administering its health services program, and no individual, blanket or group policy of insurance issued pursuant to this title, that is entered into, amended, delivered, issued for delivery, or renewed by agreement or otherwise, on or after March 17, 1982, shall deny, for the reason that the insured or the covered dependent incurred no expense, charge, or obligation, a claim for expenses incurred in connection with the patient's hospitalization for hospital, medical or surgical services rendered by a nongovernmental, charitable research hospital that bills all patients for services rendered but does not enforce by judicial proceedings payment from an individual patient in the absence of insurance coverage.
(2) No expense incurred, individual or group hospital, medical or surgical policy issued, delivered, amended or renewed on or after March 17, 1982, or employer or other entity that administers health, medical, or surgical insurance or that has an insurance company administering its health services program, shall except, limit, or reduce benefits or otherwise fail to pay for services rendered by a nongovernmental charitable research hospital because it bills patients for services rendered, but does not enforce by judicial proceedings collection from individual patients in the absence of insurance coverage.
(d) (1) All policies or contracts as described in subdivisions (a)(1) and (2), and all ERISA group health plans and health maintenance organizations, are prohibited from denying coverage to a child because the child was born out of wedlock, was not claimed as a dependent on the parent's income tax return, or does not reside with the parent or in the service area of the entity providing health insurance or coverage. (2) Should health insurance or coverage be ordered by a court of law or administrative order and the parent so ordered is eligible for coverage, the insurer, the employer or the ERISA group health plan administrator, nonprofit hospital and medical service plan or health maintenance organization of the parent so ordered must permit enrollment of the child who is otherwise eligible, without regard to any enrollment season restriction. The entity providing health insurance or coverage must accept the applications for coverage of the child made by either the child's other parent or the state agency administering Title XIX of the Social Security Act ( 42 U.S.C. § 1396 et seq.), or the Title IV-D child support enforcement program ( 42 U.S.C. §§ 661- 669 ). (3) No entity providing health care benefits may disenroll or eliminate coverage under subdivision (d)(2) without satisfactory written evidence that the court or administrative order is no longer in effect or that there is written evidence that the child will be enrolled in comparable health coverage through another insurer that will take effect not later than the effective date of the disenrollment or, in the case of an employer, where the employer has eliminated family health coverage for all of its employees. (4) No entity providing health care benefits may impose different requirements on a state, as assignee of the rights of a covered individual who is enrolled in any insurance program offered in the state, that differ from requirements imposed on agents or assignees of any other covered individual. (5) In cases where the noncustodial parent is providing coverage, all entities providing the coverage must provide information to the custodial parent, or provider, with the custodial parent's approval, that is necessary for the child to obtain benefits, though that coverage must permit the custodial parent or the provider with approval of the custodial parent, to submit claims for covered services without the approval of the noncustodial parent, and must make payment of the claims directly to the custodial parent, the provider, the state agency administering Title XIX or IV-D of the Social Security Act or any contractor who has contracted with the state to provide medicaid services. (6) The commissioner is authorized to adopt rules and standards establishing reasonable procedures for use by group health plans to determine whether a child is covered under a qualified medical support order.
(1) All policies or contracts as described in subdivisions (a)(1) and (2), and all ERISA group health plans and health maintenance organizations, are prohibited from denying coverage to a child because the child was born out of wedlock, was not claimed as a dependent on the parent's income tax return, or does not reside with the parent or in the service area of the entity providing health insurance or coverage.
(2) Should health insurance or coverage be ordered by a court of law or administrative order and the parent so ordered is eligible for coverage, the insurer, the employer or the ERISA group health plan administrator, nonprofit hospital and medical service plan or health maintenance organization of the parent so ordered must permit enrollment of the child who is otherwise eligible, without regard to any enrollment season restriction. The entity providing health insurance or coverage must accept the applications for coverage of the child made by either the child's other parent or the state agency administering Title XIX of the Social Security Act ( 42 U.S.C. § 1396 et seq.), or the Title IV-D child support enforcement program ( 42 U.S.C. §§ 661- 669 ).
(3) No entity providing health care benefits may disenroll or eliminate coverage under subdivision (d)(2) without satisfactory written evidence that the court or administrative order is no longer in effect or that there is written evidence that the child will be enrolled in comparable health coverage through another insurer that will take effect not later than the effective date of the disenrollment or, in the case of an employer, where the employer has eliminated family health coverage for all of its employees.
(4) No entity providing health care benefits may impose different requirements on a state, as assignee of the rights of a covered individual who is enrolled in any insurance program offered in the state, that differ from requirements imposed on agents or assignees of any other covered individual.
(5) In cases where the noncustodial parent is providing coverage, all entities providing the coverage must provide information to the custodial parent, or provider, with the custodial parent's approval, that is necessary for the child to obtain benefits, though that coverage must permit the custodial parent or the provider with approval of the custodial parent, to submit claims for covered services without the approval of the noncustodial parent, and must make payment of the claims directly to the custodial parent, the provider, the state agency administering Title XIX or IV-D of the Social Security Act or any contractor who has contracted with the state to provide medicaid services.
(6) The commissioner is authorized to adopt rules and standards establishing reasonable procedures for use by group health plans to determine whether a child is covered under a qualified medical support order.
(e) All policies and contracts as described in subdivision (a)(2), all ERISA group health plans and health maintenance organizations must provide the same coverage to adopted children under eighteen (18) years of age as of the date of placement for adoption or adoption as for natural children effective upon placement of the children, regardless of whether the adoption has become final. No preexisting conditions of an adopted child may be used to deny coverage if the adoption or placement for adoption occurs while the parent is eligible for coverage.
Acts 1969, ch. 230, § 1; T.C.A., § 56-1160; Acts 1982, ch. 596, § 1; 1985, ch. 206, § 1; 1986, ch. 773, § 1; 1992, ch. 984, § 1; T.C.A., § 56-7-1005; Acts 1994, ch. 881, § 1; 2011 , ch. 47, §§ 65, 66.
Tenn. Code Ann. § 56-7-2349 — TN Code / Title 56 / Chapter 7 / Section 56-7-2349
Patients' right to truth - Alternative medical care, treatments, programs, or pharmaceuticals
Status: in_force

(a) This section shall be known and may be cited as the "Patients' Right to Truth Act of 1996." (b) Each managed care organization, health maintenance organization or preferred provider organization, referred to as the "plan" in this section, shall not in any way restrict medical personnel regarding informing patients of alternative medical care, treatments, programs or pharmaceuticals that may be available to the enrollee or participant, regardless of whether covered by the plan or not. (c) A violation of this section is punishable by payment of a civil penalty of not more than one thousand dollars ($1,000) for each violation, but not to exceed an aggregate penalty of ten thousand dollars ($10,000), unless the person knew or reasonably should have known the person was in violation of this section, in which case the penalty is not more than five thousand ($5,000) for each violation, but not to exceed an aggregate penalty of fifty thousand dollars ($50,000) in any six-month period. Acts 1996, ch. 874, § 1.
(a) This section shall be known and may be cited as the "Patients' Right to Truth Act of 1996."
(b) Each managed care organization, health maintenance organization or preferred provider organization, referred to as the "plan" in this section, shall not in any way restrict medical personnel regarding informing patients of alternative medical care, treatments, programs or pharmaceuticals that may be available to the enrollee or participant, regardless of whether covered by the plan or not.
(c) A violation of this section is punishable by payment of a civil penalty of not more than one thousand dollars ($1,000) for each violation, but not to exceed an aggregate penalty of ten thousand dollars ($10,000), unless the person knew or reasonably should have known the person was in violation of this section, in which case the penalty is not more than five thousand ($5,000) for each violation, but not to exceed an aggregate penalty of fifty thousand dollars ($50,000) in any six-month period.
Acts 1996, ch. 874, § 1.