Tenn. Code Ann. § 56-9-504 — TN Code / Title 56 / Chapter 9 / Section 56-9-504
Confidentiality of proceedings and records - Access - Applicability
Status: in_force

(a) Notwithstanding any other law and except as set forth in this section, proceedings, hearings, notices, correspondence, reports, records and other information in the possession of the commissioner or the department relating to the supervision of any insurer are confidential except as provided by this section. (b) The personnel of the department have access to these proceedings, hearings, notices, correspondence, reports, records or information as permitted by the commissioner. (c) The commissioner may open the proceedings or hearings or disclose the notices, correspondence, reports, records or information to a department, agency or instrumentality of this, or another, state or the United States, if the commissioner determines that the disclosure is necessary or proper for the enforcement of the laws of this state, another state or the United States. (d) The commissioner may open the proceedings or hearings or make public the notices, correspondence, reports, records or other information if the commissioner deems that it is in the best interest of the public or in the best interest of the insurer, its insureds, creditors or the general public. (e) This section does not apply to hearings, notices, correspondence, reports, records or other information obtained upon the appointment of a receiver for the insurer by a court of competent jurisdiction. (f) This section does not apply to hearings, notices, correspondence, reports, records or other information obtained by the placing under supervision of any insurer who derived as of the date of the supervision fifty-one percent (51%) or more of its total revenues for the past twelve (12) months from a contract or contracts with a governmental entity to provide health care services to enrollees in a publicly funded medical assistance program pursuant to title 71. In these cases, the hearings, notices, correspondence, reports, records, or other information which reflect the financial solvency of the insurer obtained during the supervision shall be open to the public under the Tennessee Public Records Act, compiled in title 10, chapter 7, unless otherwise required to be maintained as confidential under the federal or state law. An insurer within fifteen (15) days from the notice of supervision may apply to the court for a stay of application of this subsection (f), or for a protective order for particularized information that is proprietary in nature, the disclosure of which would be injurious to the rehabilitation of the insurer. This subsection (f) shall be stayed from the notice of supervision until a court of competent jurisdiction rules on the application for a stay or a protective order. Acts 1991, ch. 142, § 4; 2002, ch. 660, § 2.
(a) Notwithstanding any other law and except as set forth in this section, proceedings, hearings, notices, correspondence, reports, records and other information in the possession of the commissioner or the department relating to the supervision of any insurer are confidential except as provided by this section.
(b) The personnel of the department have access to these proceedings, hearings, notices, correspondence, reports, records or information as permitted by the commissioner.
(c) The commissioner may open the proceedings or hearings or disclose the notices, correspondence, reports, records or information to a department, agency or instrumentality of this, or another, state or the United States, if the commissioner determines that the disclosure is necessary or proper for the enforcement of the laws of this state, another state or the United States.
(d) The commissioner may open the proceedings or hearings or make public the notices, correspondence, reports, records or other information if the commissioner deems that it is in the best interest of the public or in the best interest of the insurer, its insureds, creditors or the general public.
(e) This section does not apply to hearings, notices, correspondence, reports, records or other information obtained upon the appointment of a receiver for the insurer by a court of competent jurisdiction.
(f) This section does not apply to hearings, notices, correspondence, reports, records or other information obtained by the placing under supervision of any insurer who derived as of the date of the supervision fifty-one percent (51%) or more of its total revenues for the past twelve (12) months from a contract or contracts with a governmental entity to provide health care services to enrollees in a publicly funded medical assistance program pursuant to title 71. In these cases, the hearings, notices, correspondence, reports, records, or other information which reflect the financial solvency of the insurer obtained during the supervision shall be open to the public under the Tennessee Public Records Act, compiled in title 10, chapter 7, unless otherwise required to be maintained as confidential under the federal or state law. An insurer within fifteen (15) days from the notice of supervision may apply to the court for a stay of application of this subsection (f), or for a protective order for particularized information that is proprietary in nature, the disclosure of which would be injurious to the rehabilitation of the insurer. This subsection (f) shall be stayed from the notice of supervision until a court of competent jurisdiction rules on the application for a stay or a protective order.
Acts 1991, ch. 142, § 4; 2002, ch. 660, § 2.
Tenn. Code Ann. § 56-1-105 — TN Code / Title 56 / Chapter 1 / Section 56-1-105
Exclusion of types of insurance from specific insurance definitions
Status: in_force

(a) Notwithstanding any law to the contrary, "accident and health insurance," "accident and sickness insurance," "health insurance," "health benefit plan" or other similar term used in any legislation enacted after May 24, 2000, shall not include, unless specifically provided, the following types of insurance or any combination of these types of insurance: hospital indemnity, accident, dental, specified disease, disability income, long-term care, Champus supplement, or Medicare supplement, except as provided in this section. (b) Nothing contained in this section shall apply to chapters 4 and 12 of this title. (c) Nothing contained in this section shall apply to programs and services provided pursuant to Title XIX of the Social Security Act ( 42 U.S.C. § 1396 et seq.), and regulations promulgated pursuant to Title XIX of the Social Security Act. Acts 2000, ch. 808, §§ 1-3.
(a) Notwithstanding any law to the contrary, "accident and health insurance," "accident and sickness insurance," "health insurance," "health benefit plan" or other similar term used in any legislation enacted after May 24, 2000, shall not include, unless specifically provided, the following types of insurance or any combination of these types of insurance: hospital indemnity, accident, dental, specified disease, disability income, long-term care, Champus supplement, or Medicare supplement, except as provided in this section.
(b) Nothing contained in this section shall apply to chapters 4 and 12 of this title.
(c) Nothing contained in this section shall apply to programs and services provided pursuant to Title XIX of the Social Security Act ( 42 U.S.C. § 1396 et seq.), and regulations promulgated pursuant to Title XIX of the Social Security Act.
Acts 2000, ch. 808, §§ 1-3.
Tenn. Code Ann. § 56-1-1001 — TN Code / Title 56 / Chapter 1 / Section 56-1-1001
Definitions
Status: in_force

As used in this part: (1) "Health benefit plan" means a policy, contract, certificate, or agreement entered into, offered by, or issued by an insurer to provide, deliver, arrange for, pay for, or reimburse any of the costs of healthcare services, including a vision or dental benefit plan and a nonprofit dental service plan, as defined in § 56-30-102 ; and (2) "Plan sponsor" means an insured person, other than a regulated entity, who establishes, adopts, or maintains a health benefit plan that covers residents of this state, including a plan established, adopted, or maintained by an employer or jointly by an employer and one (1) or more employee organizations, an association, a committee, a joint board of trustees, or any similar group of representatives who establish, adopt, or maintain a plan. Added by 2023 Tenn. Acts, ch. 104, s 1, eff. 7/1/2023.
As used in this part:
(1) "Health benefit plan" means a policy, contract, certificate, or agreement entered into, offered by, or issued by an insurer to provide, deliver, arrange for, pay for, or reimburse any of the costs of healthcare services, including a vision or dental benefit plan and a nonprofit dental service plan, as defined in § 56-30-102 ; and
(2) "Plan sponsor" means an insured person, other than a regulated entity, who establishes, adopts, or maintains a health benefit plan that covers residents of this state, including a plan established, adopted, or maintained by an employer or jointly by an employer and one (1) or more employee organizations, an association, a committee, a joint board of trustees, or any similar group of representatives who establish, adopt, or maintain a plan.
Added by 2023 Tenn. Acts, ch. 104, s 1, eff. 7/1/2023.
Tenn. Code Ann. § 56-7-1501 — TN Code / Title 56 / Chapter 7 / Section 56-7-1501
Definitions
Status: in_force

As used in this part, unless the context otherwise requires: (1) "Applicant" means: (A) In the case of an individual medicare supplement policy, the person who seeks to contract for insurance benefits; and (B) In the case of a group medicare supplement policy, the proposed certificate holder; (2) "Certificate" means, any certificate delivered or issued for delivery in this state under a group medicare supplement policy; (3) "Certificate form" means the form on which the certificate is delivered or issued for delivery by the issuer; (4) "Issuer" includes insurance companies, fraternal benefit societies, health care service plans, health maintenance organizations, and any other entity delivering or issuing for delivery in this state medicare supplement policies or certificates; (5) "Medicare" means the Health Insurance for the Aged Act, Title XVIII of the Social Security Amendments of 1965; (6) "Medicare supplement policy" means a group or individual policy of accident and sickness insurance or a subscriber contract of hospital and medical service associations or health maintenance organizations other than a policy issued pursuant to a contract under § 1876 [repealed] of the Social Security Act ( 42 U.S.C. § 1395 et seq.), or an issued policy under a demonstration project specified in 42 U.S.C. § 1395ss(g)(1) that is advertised, marketed or designed primarily as a supplement to reimbursements under medicare for the hospital, medical or surgical expenses of persons eligible for medicare; and (7) "Policy form" means the form on which the policy is delivered or issued for delivery by the issuer. Acts 1992, ch. 735, § 1; 1996, ch. 750, §§ 16, 17.
As used in this part, unless the context otherwise requires:
(1) "Applicant" means: (A) In the case of an individual medicare supplement policy, the person who seeks to contract for insurance benefits; and (B) In the case of a group medicare supplement policy, the proposed certificate holder;
(A) In the case of an individual medicare supplement policy, the person who seeks to contract for insurance benefits; and
(B) In the case of a group medicare supplement policy, the proposed certificate holder;
(2) "Certificate" means, any certificate delivered or issued for delivery in this state under a group medicare supplement policy;
(3) "Certificate form" means the form on which the certificate is delivered or issued for delivery by the issuer;
(4) "Issuer" includes insurance companies, fraternal benefit societies, health care service plans, health maintenance organizations, and any other entity delivering or issuing for delivery in this state medicare supplement policies or certificates;
(5) "Medicare" means the Health Insurance for the Aged Act, Title XVIII of the Social Security Amendments of 1965;
(6) "Medicare supplement policy" means a group or individual policy of accident and sickness insurance or a subscriber contract of hospital and medical service associations or health maintenance organizations other than a policy issued pursuant to a contract under § 1876 [repealed] of the Social Security Act ( 42 U.S.C. § 1395 et seq.), or an issued policy under a demonstration project specified in 42 U.S.C. § 1395ss(g)(1) that is advertised, marketed or designed primarily as a supplement to reimbursements under medicare for the hospital, medical or surgical expenses of persons eligible for medicare; and
(7) "Policy form" means the form on which the policy is delivered or issued for delivery by the issuer.
Acts 1992, ch. 735, § 1; 1996, ch. 750, §§ 16, 17.
Tenn. Code Ann. § 56-1-601 — TN Code / Title 56 / Chapter 1 / Section 56-1-601
Duty of commissioner to keep records of proceedings and examinations - Commissioner's report
Status: in_force

(a) The commissioner shall preserve in a permanent form a record of the commissioner's proceedings, including a concise statement of the result of official examinations of insurance companies. (b) The commissioner shall, annually, and as early as consistent with full and accurate preparation, make a report to the governor of all official transactions, and shall include in the report a statement of the receipts and expenditures of the department for the preceding year, an exhibit of the financial condition and business transactions of the several insurance companies as disclosed by their annual statements, abstracts of which statements shall appear in the report, and other information and comments in relation to insurance and the public interest in insurance the commissioner deems fit to communicate. Acts 1895, ch. 160, § 17; Shan., § 3300; mod. Code 1932, § 6116; T.C.A. (orig. ed.), § 56-134.
(a) The commissioner shall preserve in a permanent form a record of the commissioner's proceedings, including a concise statement of the result of official examinations of insurance companies.
(b) The commissioner shall, annually, and as early as consistent with full and accurate preparation, make a report to the governor of all official transactions, and shall include in the report a statement of the receipts and expenditures of the department for the preceding year, an exhibit of the financial condition and business transactions of the several insurance companies as disclosed by their annual statements, abstracts of which statements shall appear in the report, and other information and comments in relation to insurance and the public interest in insurance the commissioner deems fit to communicate.
Acts 1895, ch. 160, § 17; Shan., § 3300; mod. Code 1932, § 6116; T.C.A. (orig. ed.), § 56-134.
Tenn. Code Ann. § 56-25-304 — TN Code / Title 56 / Chapter 25 / Section 56-25-304
Restrictions on merger, consolidation or reinsurance
Status: in_force

(a) No fraternal benefit society organized under the laws of this state to do the business of life, accident, or health insurance shall consolidate or merge with any other fraternal benefit society, or reinsure its insurance risks, or any part thereof, with any other fraternal benefit society, or assume or reinsure the whole or any portion of the risks of any other fraternal benefit society, except as provided in this chapter. (b) No fraternal benefit society or subordinate body thereof shall merge or consolidate with any company or association not licensed to transact business as a fraternal benefit society. (c) Each fraternal benefit society subject to this chapter shall comply with §§ 56-2-207 - 56-2-209 governing reinsurance contracts. In addition, no reinsurance contract of a fraternal benefit society shall cede or assume risks resident of this state if the principal purpose of such reinsurance contract, as determined by the commissioner, is to avoid the tax due under § 56-4-205 . Acts 1990, ch. 703, § 1; 1999, ch. 177, §§ 1, 2.
(a) No fraternal benefit society organized under the laws of this state to do the business of life, accident, or health insurance shall consolidate or merge with any other fraternal benefit society, or reinsure its insurance risks, or any part thereof, with any other fraternal benefit society, or assume or reinsure the whole or any portion of the risks of any other fraternal benefit society, except as provided in this chapter.
(b) No fraternal benefit society or subordinate body thereof shall merge or consolidate with any company or association not licensed to transact business as a fraternal benefit society.
(c) Each fraternal benefit society subject to this chapter shall comply with §§ 56-2-207 - 56-2-209 governing reinsurance contracts. In addition, no reinsurance contract of a fraternal benefit society shall cede or assume risks resident of this state if the principal purpose of such reinsurance contract, as determined by the commissioner, is to avoid the tax due under § 56-4-205 .
Acts 1990, ch. 703, § 1; 1999, ch. 177, §§ 1, 2.
Tenn. Code Ann. § 56-26-123 — TN Code / Title 56 / Chapter 26 / Section 56-26-123
Violation - Forfeiture - Revocation of license
Status: in_force

(a) Any person, partnership or corporation willfully violating any provision of this chapter or order of the commissioner made in accordance with this chapter shall forfeit to this state a sum not to exceed one thousand dollars ($1,000) for each violation, which may be recovered by a civil action. (b) The commissioner may also suspend or revoke the license of an insurer or agent for any willful violation. Acts 1955, ch. 4, § 10; T.C.A., § 56-3323.
(a) Any person, partnership or corporation willfully violating any provision of this chapter or order of the commissioner made in accordance with this chapter shall forfeit to this state a sum not to exceed one thousand dollars ($1,000) for each violation, which may be recovered by a civil action.
(b) The commissioner may also suspend or revoke the license of an insurer or agent for any willful violation.
Acts 1955, ch. 4, § 10; T.C.A., § 56-3323.
Tenn. Code Ann. § 56-51-119 — TN Code / Title 56 / Chapter 51 / Section 56-51-119
Execution of contracts
Status: in_force

(a) Every prepaid limited health services contract must be executed in the name of and on behalf of the prepaid limited health service organization by its officer, attorney in fact, employee, or representative duly authorized by the organization. (b) A facsimile signature of any executing individual may be used in lieu of an original signature. (c) No prepaid limited health services contract that is otherwise valid is rendered invalid by reason of the apparent execution of the contract on behalf of the prepaid limited health service organization by the imprinted facsimile signature of an individual not authorized so to execute as of the date of the contract. Acts 2000, ch. 948, § 19.
(a) Every prepaid limited health services contract must be executed in the name of and on behalf of the prepaid limited health service organization by its officer, attorney in fact, employee, or representative duly authorized by the organization.
(b) A facsimile signature of any executing individual may be used in lieu of an original signature.
(c) No prepaid limited health services contract that is otherwise valid is rendered invalid by reason of the apparent execution of the contract on behalf of the prepaid limited health service organization by the imprinted facsimile signature of an individual not authorized so to execute as of the date of the contract.
Acts 2000, ch. 948, § 19.
Tenn. Code Ann. § 56-7-2810 — TN Code / Title 56 / Chapter 7 / Section 56-7-2810
Guaranteed renewability of coverage for individuals
Status: in_force

(a) A health insurance issuer that provides individual health insurance coverage to an individual shall renew or continue in force the coverage at the option of the individual for all such coverage in effect on or after July 1, 1997, except as provided in this section. (b) A health insurance issuer may nonrenew or discontinue health insurance coverage of an individual in the individual market based only on one (1) or more of the following: (1) The individual has failed to pay premiums or contributions in accordance with the terms of the health insurance coverage or the issuer has not received timely premium payments; (2) The individual has performed an act or practice that constitutes fraud or made an intentional misrepresentation of material fact under the terms of the coverage; (3) The issuer is ceasing to offer coverage in the individual market in accordance with subsection (c) and other applicable insurance law; (4) In the case of a health insurance issuer that offers health insurance coverage in the market through a network plan, the individual no longer resides, lives, or works in the service area, or in an area for which the issuer is authorized to do business, but only if the coverage is terminated under this subdivision (b)(4) uniformly without regard to any health status-related factor of covered individuals; and (5) In the case of health insurance coverage that is made available in the individual market only through one (1) or more bona fide associations, the membership of the individual in the association, on the basis of which the coverage is provided, ceases, but only if the coverage is terminated under this subdivision (b)(5) uniformly without regard to any health status-related factor of covered individuals. (c) In any case in which an issuer decides to discontinue offering a particular type of health insurance coverage offered in the individual market, coverage of the type may be discontinued by the issuer only if: (1) The issuer provides notice to each covered individual provided coverage of this type in the market of the discontinuation at least ninety (90) days prior to the date of the discontinuation of the coverage; (2) The issuer offers to each individual in the individual market provided coverage of this type, the option to purchase any other individual health insurance coverage currently being offered by the issuer for individuals in the market; and (3) In exercising the option to discontinue coverage of this type and in offering the option of coverage under subdivision (c)(2), the issuer acts uniformly without regard to any health status-related factor of enrolled individuals or individuals who may become eligible for the coverage. (d) (1) Subject to subdivision (d)(2), in any case in which a health insurance issuer elects to discontinue offering all health insurance coverage in the individual market in this state, health insurance coverage may be discontinued by the issuer only if: (A) The issuer provides notice to the commissioner and to each individual of the discontinuation at least one hundred eighty (180) days prior to the date of the expiration of the coverage; and (B) All health insurance issued or delivered for issuance in this state in the market is discontinued and coverage under the health insurance coverage in the market is not renewed. (2) In the case of a discontinuation under subdivision (d)(1)(A) in the individual market, the issuer may not provide for the issuance of any health insurance coverage in the individual market in the state during the five-year period beginning on this date of the discontinuation of the last health insurance coverage not so renewed. (3) The commissioner may waive subdivision (d)(2) upon written request by a health insurance issuer that demonstrates to the satisfaction of the commissioner that a waiver would benefit insurance consumers in this state and would strengthen the individual market. (e) At the time of coverage renewal, a health insurance issuer may modify the health insurance coverage for a policy form offered to individuals in the individual market so long as the modification is consistent with state law and effective on a uniform basis among all individuals with that policy form. (f) In applying this section in the case of health insurance coverage that is made available by a health insurance issuer in the individual market to individuals only through one (1) or more associations, a reference to an "individual" is deemed to include a reference to the association of which the individual is a member. Amended by 2018 Tenn. Acts, ch. 873,s 12, eff. 5/3/2018. Acts 1997, ch. 157, § 11.
(a) A health insurance issuer that provides individual health insurance coverage to an individual shall renew or continue in force the coverage at the option of the individual for all such coverage in effect on or after July 1, 1997, except as provided in this section.
(b) A health insurance issuer may nonrenew or discontinue health insurance coverage of an individual in the individual market based only on one (1) or more of the following: (1) The individual has failed to pay premiums or contributions in accordance with the terms of the health insurance coverage or the issuer has not received timely premium payments; (2) The individual has performed an act or practice that constitutes fraud or made an intentional misrepresentation of material fact under the terms of the coverage; (3) The issuer is ceasing to offer coverage in the individual market in accordance with subsection (c) and other applicable insurance law; (4) In the case of a health insurance issuer that offers health insurance coverage in the market through a network plan, the individual no longer resides, lives, or works in the service area, or in an area for which the issuer is authorized to do business, but only if the coverage is terminated under this subdivision (b)(4) uniformly without regard to any health status-related factor of covered individuals; and (5) In the case of health insurance coverage that is made available in the individual market only through one (1) or more bona fide associations, the membership of the individual in the association, on the basis of which the coverage is provided, ceases, but only if the coverage is terminated under this subdivision (b)(5) uniformly without regard to any health status-related factor of covered individuals.
(1) The individual has failed to pay premiums or contributions in accordance with the terms of the health insurance coverage or the issuer has not received timely premium payments;
(2) The individual has performed an act or practice that constitutes fraud or made an intentional misrepresentation of material fact under the terms of the coverage;
(3) The issuer is ceasing to offer coverage in the individual market in accordance with subsection (c) and other applicable insurance law;
(4) In the case of a health insurance issuer that offers health insurance coverage in the market through a network plan, the individual no longer resides, lives, or works in the service area, or in an area for which the issuer is authorized to do business, but only if the coverage is terminated under this subdivision (b)(4) uniformly without regard to any health status-related factor of covered individuals; and
(5) In the case of health insurance coverage that is made available in the individual market only through one (1) or more bona fide associations, the membership of the individual in the association, on the basis of which the coverage is provided, ceases, but only if the coverage is terminated under this subdivision (b)(5) uniformly without regard to any health status-related factor of covered individuals.
(c) In any case in which an issuer decides to discontinue offering a particular type of health insurance coverage offered in the individual market, coverage of the type may be discontinued by the issuer only if: (1) The issuer provides notice to each covered individual provided coverage of this type in the market of the discontinuation at least ninety (90) days prior to the date of the discontinuation of the coverage; (2) The issuer offers to each individual in the individual market provided coverage of this type, the option to purchase any other individual health insurance coverage currently being offered by the issuer for individuals in the market; and (3) In exercising the option to discontinue coverage of this type and in offering the option of coverage under subdivision (c)(2), the issuer acts uniformly without regard to any health status-related factor of enrolled individuals or individuals who may become eligible for the coverage.
(1) The issuer provides notice to each covered individual provided coverage of this type in the market of the discontinuation at least ninety (90) days prior to the date of the discontinuation of the coverage;
(2) The issuer offers to each individual in the individual market provided coverage of this type, the option to purchase any other individual health insurance coverage currently being offered by the issuer for individuals in the market; and
(3) In exercising the option to discontinue coverage of this type and in offering the option of coverage under subdivision (c)(2), the issuer acts uniformly without regard to any health status-related factor of enrolled individuals or individuals who may become eligible for the coverage.
(d) (1) Subject to subdivision (d)(2), in any case in which a health insurance issuer elects to discontinue offering all health insurance coverage in the individual market in this state, health insurance coverage may be discontinued by the issuer only if: (A) The issuer provides notice to the commissioner and to each individual of the discontinuation at least one hundred eighty (180) days prior to the date of the expiration of the coverage; and (B) All health insurance issued or delivered for issuance in this state in the market is discontinued and coverage under the health insurance coverage in the market is not renewed. (2) In the case of a discontinuation under subdivision (d)(1)(A) in the individual market, the issuer may not provide for the issuance of any health insurance coverage in the individual market in the state during the five-year period beginning on this date of the discontinuation of the last health insurance coverage not so renewed. (3) The commissioner may waive subdivision (d)(2) upon written request by a health insurance issuer that demonstrates to the satisfaction of the commissioner that a waiver would benefit insurance consumers in this state and would strengthen the individual market.
(1) Subject to subdivision (d)(2), in any case in which a health insurance issuer elects to discontinue offering all health insurance coverage in the individual market in this state, health insurance coverage may be discontinued by the issuer only if: (A) The issuer provides notice to the commissioner and to each individual of the discontinuation at least one hundred eighty (180) days prior to the date of the expiration of the coverage; and (B) All health insurance issued or delivered for issuance in this state in the market is discontinued and coverage under the health insurance coverage in the market is not renewed.
(A) The issuer provides notice to the commissioner and to each individual of the discontinuation at least one hundred eighty (180) days prior to the date of the expiration of the coverage; and
(B) All health insurance issued or delivered for issuance in this state in the market is discontinued and coverage under the health insurance coverage in the market is not renewed.
(2) In the case of a discontinuation under subdivision (d)(1)(A) in the individual market, the issuer may not provide for the issuance of any health insurance coverage in the individual market in the state during the five-year period beginning on this date of the discontinuation of the last health insurance coverage not so renewed.
(3) The commissioner may waive subdivision (d)(2) upon written request by a health insurance issuer that demonstrates to the satisfaction of the commissioner that a waiver would benefit insurance consumers in this state and would strengthen the individual market.
(e) At the time of coverage renewal, a health insurance issuer may modify the health insurance coverage for a policy form offered to individuals in the individual market so long as the modification is consistent with state law and effective on a uniform basis among all individuals with that policy form.
(f) In applying this section in the case of health insurance coverage that is made available by a health insurance issuer in the individual market to individuals only through one (1) or more associations, a reference to an "individual" is deemed to include a reference to the association of which the individual is a member.
Amended by 2018 Tenn. Acts, ch. 873,s 12, eff. 5/3/2018.
Acts 1997, ch. 157, § 11.
Tenn. Code Ann. § 56-7-3405 — TN Code / Title 56 / Chapter 7 / Section 56-7-3405
Failure to comply with part may constitute unfair claims settlement practice - No private cause of action created
Status: in_force

A pattern of failures to meet the requirements of this part may constitute an unfair claims settlement practice under the Tennessee Unfair Trade Practices and Unfair Claims Settlement Act of 2009, compiled in chapter 8 of this title. Nothing in this part shall be construed to create or imply a private cause of action for a violation of this part. Added by 2014 Tenn. Acts, ch. 974,s 1, eff. 7/1/2015.
A pattern of failures to meet the requirements of this part may constitute an unfair claims settlement practice under the Tennessee Unfair Trade Practices and Unfair Claims Settlement Act of 2009, compiled in chapter 8 of this title. Nothing in this part shall be construed to create or imply a private cause of action for a violation of this part.
Added by 2014 Tenn. Acts, ch. 974,s 1, eff. 7/1/2015.
Tenn. Code Ann. § 56-15-104 — TN Code / Title 56 / Chapter 15 / Section 56-15-104
Conditions for beginning business - Filing charter and statement of assets and liabilities - License
Status: in_force

(a) Every company, before transacting any business under this chapter, shall deposit with the commissioner a copy of its charter, or articles of incorporation, and a statement, signed and sworn to by its president and secretary, showing its assets and liabilities. (b) If the commissioner is satisfied that the company has authority under its charter to do the business provided for in this chapter, and that it has a paid-up capital of not less than one hundred thousand dollars ($100,000) in cash, or its equivalent, and is able to keep and perform its contracts, the commissioner shall grant authority, in writing, to the company to do business under this chapter. Acts 1895, ch. 175, § 3; Shan., § 2216; mod. Code 1932, § 3948; Acts 1967, ch. 240, § 2; impl. am. Acts 1971, ch. 137, § 2; T.C.A. (orig. ed.), § 56-1404.
(a) Every company, before transacting any business under this chapter, shall deposit with the commissioner a copy of its charter, or articles of incorporation, and a statement, signed and sworn to by its president and secretary, showing its assets and liabilities.
(b) If the commissioner is satisfied that the company has authority under its charter to do the business provided for in this chapter, and that it has a paid-up capital of not less than one hundred thousand dollars ($100,000) in cash, or its equivalent, and is able to keep and perform its contracts, the commissioner shall grant authority, in writing, to the company to do business under this chapter.
Acts 1895, ch. 175, § 3; Shan., § 2216; mod. Code 1932, § 3948; Acts 1967, ch. 240, § 2; impl. am. Acts 1971, ch. 137, § 2; T.C.A. (orig. ed.), § 56-1404.
Tenn. Code Ann. § 56-6-1204 — TN Code / Title 56 / Chapter 6 / Section 56-6-1204
Employees not subject to licensure under certain conditions - Charge for insurance coverage allowed
Status: in_force

(a) Notwithstanding any law to the contrary, the employees and authorized representatives of an owner may sell or offer self-service storage insurance to occupants and shall not be subject to licensure as an insurance producer under this part; provided, that: (1) The owner obtains a limited lines license to authorize its employees or authorized representatives to sell or offer self-service storage insurance pursuant to § 56-6-1202 ; (2) The insurer issuing the self-service storage insurance either directly supervises or appoints a supervising entity to supervise the administration of the program, including development of a training program for employees and authorized representatives of the owner. The training required by this subdivision (a)(2) shall comply with the following: (A) The training shall be delivered to employees and authorized representatives of an owner who are directly engaged in the activity of selling or offering self-service storage insurance; (B) The training may be provided in electronic form. If the training is conducted in an electronic form, the supervising entity shall implement a supplemental education program regarding self-service storage insurance that is conducted and overseen by the supervising entity; and (C) Each employee and authorized representative shall receive basic instruction concerning the self-service storage insurance offered to customers and the disclosures required under § 56-6-1203 ; (3) No employee or authorized representative of an owner of self-service storage space shall advertise, represent or otherwise hold themselves out as a nonlimited lines licensed insurance producer; and (4) No employee or authorized representative of an owner shall be compensated based primarily on the number of occupants enrolled for self-service storage coverage; provided, however, the employee or authorized representative may receive compensation for activities under the limited lines license which is incidental to overall compensation. (b) (1) The charge for self-service storage insurance coverage may be assessed and collected by the owner; provided, however, that such charge shall be a separate item within or an addendum to a rental agreement. (2) Owners assessing and collecting such charges shall not be required to maintain such funds in a segregated account; provided, the owner is authorized by the insurer to hold such funds in a nonsegregated account and remits such amounts to the supervising entity within sixty (60) days of receipt. (3) All funds received by an owner from an enrolled occupant for the sale of self-service storage insurance shall be considered funds held in trust by the owner in a fiduciary capacity for the benefit of the insurer. (4) Owners may receive compensation for assessing and collection services. Added by 2013 Tenn. Acts, ch. 293,s 5, eff. 7/1/2013.
(a) Notwithstanding any law to the contrary, the employees and authorized representatives of an owner may sell or offer self-service storage insurance to occupants and shall not be subject to licensure as an insurance producer under this part; provided, that: (1) The owner obtains a limited lines license to authorize its employees or authorized representatives to sell or offer self-service storage insurance pursuant to § 56-6-1202 ; (2) The insurer issuing the self-service storage insurance either directly supervises or appoints a supervising entity to supervise the administration of the program, including development of a training program for employees and authorized representatives of the owner. The training required by this subdivision (a)(2) shall comply with the following: (A) The training shall be delivered to employees and authorized representatives of an owner who are directly engaged in the activity of selling or offering self-service storage insurance; (B) The training may be provided in electronic form. If the training is conducted in an electronic form, the supervising entity shall implement a supplemental education program regarding self-service storage insurance that is conducted and overseen by the supervising entity; and (C) Each employee and authorized representative shall receive basic instruction concerning the self-service storage insurance offered to customers and the disclosures required under § 56-6-1203 ; (3) No employee or authorized representative of an owner of self-service storage space shall advertise, represent or otherwise hold themselves out as a nonlimited lines licensed insurance producer; and (4) No employee or authorized representative of an owner shall be compensated based primarily on the number of occupants enrolled for self-service storage coverage; provided, however, the employee or authorized representative may receive compensation for activities under the limited lines license which is incidental to overall compensation.
(1) The owner obtains a limited lines license to authorize its employees or authorized representatives to sell or offer self-service storage insurance pursuant to § 56-6-1202 ;
(2) The insurer issuing the self-service storage insurance either directly supervises or appoints a supervising entity to supervise the administration of the program, including development of a training program for employees and authorized representatives of the owner. The training required by this subdivision (a)(2) shall comply with the following: (A) The training shall be delivered to employees and authorized representatives of an owner who are directly engaged in the activity of selling or offering self-service storage insurance; (B) The training may be provided in electronic form. If the training is conducted in an electronic form, the supervising entity shall implement a supplemental education program regarding self-service storage insurance that is conducted and overseen by the supervising entity; and (C) Each employee and authorized representative shall receive basic instruction concerning the self-service storage insurance offered to customers and the disclosures required under § 56-6-1203 ;
(A) The training shall be delivered to employees and authorized representatives of an owner who are directly engaged in the activity of selling or offering self-service storage insurance;
(B) The training may be provided in electronic form. If the training is conducted in an electronic form, the supervising entity shall implement a supplemental education program regarding self-service storage insurance that is conducted and overseen by the supervising entity; and
(C) Each employee and authorized representative shall receive basic instruction concerning the self-service storage insurance offered to customers and the disclosures required under § 56-6-1203 ;
(3) No employee or authorized representative of an owner of self-service storage space shall advertise, represent or otherwise hold themselves out as a nonlimited lines licensed insurance producer; and
(4) No employee or authorized representative of an owner shall be compensated based primarily on the number of occupants enrolled for self-service storage coverage; provided, however, the employee or authorized representative may receive compensation for activities under the limited lines license which is incidental to overall compensation.
(b) (1) The charge for self-service storage insurance coverage may be assessed and collected by the owner; provided, however, that such charge shall be a separate item within or an addendum to a rental agreement. (2) Owners assessing and collecting such charges shall not be required to maintain such funds in a segregated account; provided, the owner is authorized by the insurer to hold such funds in a nonsegregated account and remits such amounts to the supervising entity within sixty (60) days of receipt. (3) All funds received by an owner from an enrolled occupant for the sale of self-service storage insurance shall be considered funds held in trust by the owner in a fiduciary capacity for the benefit of the insurer. (4) Owners may receive compensation for assessing and collection services.
(1) The charge for self-service storage insurance coverage may be assessed and collected by the owner; provided, however, that such charge shall be a separate item within or an addendum to a rental agreement.
(2) Owners assessing and collecting such charges shall not be required to maintain such funds in a segregated account; provided, the owner is authorized by the insurer to hold such funds in a nonsegregated account and remits such amounts to the supervising entity within sixty (60) days of receipt.
(3) All funds received by an owner from an enrolled occupant for the sale of self-service storage insurance shall be considered funds held in trust by the owner in a fiduciary capacity for the benefit of the insurer.
(4) Owners may receive compensation for assessing and collection services.
Added by 2013 Tenn. Acts, ch. 293,s 5, eff. 7/1/2013.
Tenn. Code Ann. § 56-32-135 — TN Code / Title 56 / Chapter 32 / Section 56-32-135
Confidentiality
Status: in_force

Any information and documentation obtained by the department pursuant to § 56-32-117(c) or § 56-32-132 , shall be considered confidential, unless the commissioner in the commissioner's sole discretion determines to disclose the information or documentation. Acts 2000, ch. 708, § 8; T.C.A. § 56-32-235.
Any information and documentation obtained by the department pursuant to § 56-32-117(c) or § 56-32-132 , shall be considered confidential, unless the commissioner in the commissioner's sole discretion determines to disclose the information or documentation.
Acts 2000, ch. 708, § 8; T.C.A. § 56-32-235.
Tenn. Code Ann. § 56-35-108 — TN Code / Title 56 / Chapter 35 / Section 56-35-108
Annual statement - Forms
Status: in_force

The commissioner shall, in December of each year, furnish to each of the insurance companies authorized to do business under this chapter, two (2) blanks in form adopted for their annual statement. The companies shall, annually, on or before March 1, file in the office of the commissioner a statement that shall exhibit its financial condition on December 31 of the previous year, and its business of that year. The annual statement shall be in the form and of the specifications the commissioner may require. The statement shall be subscribed and sworn to by the president and secretary, or in their absence, by two (2) of its principal officers. Acts 1955, ch. 173, § 5; T.C.A., § 56-3408.
The commissioner shall, in December of each year, furnish to each of the insurance companies authorized to do business under this chapter, two (2) blanks in form adopted for their annual statement. The companies shall, annually, on or before March 1, file in the office of the commissioner a statement that shall exhibit its financial condition on December 31 of the previous year, and its business of that year. The annual statement shall be in the form and of the specifications the commissioner may require. The statement shall be subscribed and sworn to by the president and secretary, or in their absence, by two (2) of its principal officers.
Acts 1955, ch. 173, § 5; T.C.A., § 56-3408.
Tenn. Code Ann. § 56-4-309 — TN Code / Title 56 / Chapter 4 / Section 56-4-309
Disposition of revenue
Status: in_force

The net amount of all taxes collected under this part shall be payable by the commissioner to the state treasurer, and shall become part of the general funds of the state. Acts 1939, ch. 187, § 8; C. Supp. 1950, § 1248.40 (Williams, § 1248.167); T.C.A. (orig. ed.), §§ 67-4409, 67-4-1209.
The net amount of all taxes collected under this part shall be payable by the commissioner to the state treasurer, and shall become part of the general funds of the state.
Acts 1939, ch. 187, § 8; C. Supp. 1950, § 1248.40 (Williams, § 1248.167); T.C.A. (orig. ed.), §§ 67-4409, 67-4-1209.
Tenn. Code Ann. § 56-29-106 — TN Code / Title 56 / Chapter 29 / Section 56-29-106
License required
Status: in_force

A corporation, subject to this chapter, may issue contracts only when the department has, by formal license, authorized it to do so. Acts 1949, ch. 234, § 5; C. Supp. 1950, § 4186.47 (Williams, § 4186.50); impl. am. Acts 1971, ch. 137, § 1; T.C.A. (orig. ed.), § 56-3106.
A corporation, subject to this chapter, may issue contracts only when the department has, by formal license, authorized it to do so.
Acts 1949, ch. 234, § 5; C. Supp. 1950, § 4186.47 (Williams, § 4186.50); impl. am. Acts 1971, ch. 137, § 1; T.C.A. (orig. ed.), § 56-3106.
Tenn. Code Ann. § 56-9-320 — TN Code / Title 56 / Chapter 9 / Section 56-9-320
Assessment - Liquidator to make report to court - Levy of assessment on members of insurer - Enforcement
Status: in_force

(a) As soon as practicable, but not more than two (2) years from the date of an order of liquidation under § 56-9-307 of an insurer issuing assessable policies, the liquidator shall make a report to the court setting forth: (1) The reasonable value of the assets of the insurer; (2) The insurer's probable total liabilities; (3) The probable aggregate amount of the assessment necessary to pay all claims of creditors and expenses in full, including expenses of administration and costs of collecting the assessment; and (4) A recommendation as to whether or not an assessment should be made and in what amount. (b) (1) Upon the basis of the report provided in subsection (a), including any supplements and amendments thereto, the chancery court of Davidson County may levy one (1) or more assessments against all members of the insurer who are subject to assessment. (2) Subject to any applicable legal limits on assessability, the aggregate assessment shall be for the amount that the sum of the probable liabilities, the expenses of administration, and the estimated cost of collection of the assessment exceeds the value of existing assets, with due regard being given to assessments that cannot be collected economically. (c) After levy of assessment under subsection (b), the liquidator shall issue an order directing each member who has not paid the assessment pursuant to the order to show cause why the liquidator should not pursue a judgment therefor. (d) The liquidator shall give notice of the order to show cause by publication and by first class mail to each member liable thereunder mailed to the member's last known address as it appears on the insurer's records, at least twenty (20) days before the return day of the order to show cause. (e) (1) If a member does not appear and serve duly verified objections upon the liquidator on or before the return day of the order to show cause under subsection (c), the court shall make an order adjudging the member liable for the amount of the assessment against the member pursuant to subsection (c), together with costs, and the liquidator shall have a judgment against the member therefor. (2) If, on or before the return day, the member appears and serves duly verified objections upon the liquidator, the commissioner may hear and determine the matter or may appoint a referee to hear it and make the order as the facts warrant. In the event that the commissioner determines that the objections do not warrant relief from assessment, the member may request the court to review the matter and vacate the order to show cause. (f) The liquidator may enforce any order or collect any judgment under subsection (e) by any lawful means. Acts 1991, ch. 142, § 4.
(a) As soon as practicable, but not more than two (2) years from the date of an order of liquidation under § 56-9-307 of an insurer issuing assessable policies, the liquidator shall make a report to the court setting forth: (1) The reasonable value of the assets of the insurer; (2) The insurer's probable total liabilities; (3) The probable aggregate amount of the assessment necessary to pay all claims of creditors and expenses in full, including expenses of administration and costs of collecting the assessment; and (4) A recommendation as to whether or not an assessment should be made and in what amount.
(1) The reasonable value of the assets of the insurer;
(2) The insurer's probable total liabilities;
(3) The probable aggregate amount of the assessment necessary to pay all claims of creditors and expenses in full, including expenses of administration and costs of collecting the assessment; and
(4) A recommendation as to whether or not an assessment should be made and in what amount.
(b) (1) Upon the basis of the report provided in subsection (a), including any supplements and amendments thereto, the chancery court of Davidson County may levy one (1) or more assessments against all members of the insurer who are subject to assessment. (2) Subject to any applicable legal limits on assessability, the aggregate assessment shall be for the amount that the sum of the probable liabilities, the expenses of administration, and the estimated cost of collection of the assessment exceeds the value of existing assets, with due regard being given to assessments that cannot be collected economically.
(1) Upon the basis of the report provided in subsection (a), including any supplements and amendments thereto, the chancery court of Davidson County may levy one (1) or more assessments against all members of the insurer who are subject to assessment.
(2) Subject to any applicable legal limits on assessability, the aggregate assessment shall be for the amount that the sum of the probable liabilities, the expenses of administration, and the estimated cost of collection of the assessment exceeds the value of existing assets, with due regard being given to assessments that cannot be collected economically.
(c) After levy of assessment under subsection (b), the liquidator shall issue an order directing each member who has not paid the assessment pursuant to the order to show cause why the liquidator should not pursue a judgment therefor.
(d) The liquidator shall give notice of the order to show cause by publication and by first class mail to each member liable thereunder mailed to the member's last known address as it appears on the insurer's records, at least twenty (20) days before the return day of the order to show cause.
(e) (1) If a member does not appear and serve duly verified objections upon the liquidator on or before the return day of the order to show cause under subsection (c), the court shall make an order adjudging the member liable for the amount of the assessment against the member pursuant to subsection (c), together with costs, and the liquidator shall have a judgment against the member therefor. (2) If, on or before the return day, the member appears and serves duly verified objections upon the liquidator, the commissioner may hear and determine the matter or may appoint a referee to hear it and make the order as the facts warrant. In the event that the commissioner determines that the objections do not warrant relief from assessment, the member may request the court to review the matter and vacate the order to show cause.
(1) If a member does not appear and serve duly verified objections upon the liquidator on or before the return day of the order to show cause under subsection (c), the court shall make an order adjudging the member liable for the amount of the assessment against the member pursuant to subsection (c), together with costs, and the liquidator shall have a judgment against the member therefor.
(2) If, on or before the return day, the member appears and serves duly verified objections upon the liquidator, the commissioner may hear and determine the matter or may appoint a referee to hear it and make the order as the facts warrant. In the event that the commissioner determines that the objections do not warrant relief from assessment, the member may request the court to review the matter and vacate the order to show cause.
(f) The liquidator may enforce any order or collect any judgment under subsection (e) by any lawful means.
Acts 1991, ch. 142, § 4.
Tenn. Code Ann. § 56-7-2405 — TN Code / Title 56 / Chapter 7 / Section 56-7-2405
Health and accident policies - Surgical procedures within scope of dentistry and podiatry
Status: in_force

(a) "Physician" or "doctor," whenever used in any group or individual health or accident insurance policy issued in this state or in a medical service plan or hospital service contract or hospital and medical service contract, as provided in chapters 27-29 of this title or any similar statutes, providing for reimbursement or payment for surgical procedures or other medical or health care services that are specified in the policy, plan or contract, and are within the scope of practice of dentistry as defined in § 63-5-108 or within the scope of practice of a podiatrist as defined in § 63-3-101 , shall be construed to include a duly licensed dentist or duly licensed podiatrist who performs the specified procedures or services, any provision in any policy, plan or contract to the contrary notwithstanding. (b) This section shall apply to all policies, plans and contracts issued, renewed or reinstated on and after July 1, 1974, and to all other policies, plans and contracts otherwise in existence on July 1, 1974, whenever there is a premium or rate change under the policies, plans and contracts. (c) The provisions of this section relating to podiatric services shall apply to all contracts, plans or policies issued or renewed on or after July 1, 1981. Acts 1974, ch. 515, §§ 1, 2; T.C.A., § 56-1166; Acts 1981, ch. 168, §§ 8-10; 1992, ch. 984, § 2; T.C.A., § 56-7-1002 .
(a) "Physician" or "doctor," whenever used in any group or individual health or accident insurance policy issued in this state or in a medical service plan or hospital service contract or hospital and medical service contract, as provided in chapters 27-29 of this title or any similar statutes, providing for reimbursement or payment for surgical procedures or other medical or health care services that are specified in the policy, plan or contract, and are within the scope of practice of dentistry as defined in § 63-5-108 or within the scope of practice of a podiatrist as defined in § 63-3-101 , shall be construed to include a duly licensed dentist or duly licensed podiatrist who performs the specified procedures or services, any provision in any policy, plan or contract to the contrary notwithstanding.
(b) This section shall apply to all policies, plans and contracts issued, renewed or reinstated on and after July 1, 1974, and to all other policies, plans and contracts otherwise in existence on July 1, 1974, whenever there is a premium or rate change under the policies, plans and contracts.
(c) The provisions of this section relating to podiatric services shall apply to all contracts, plans or policies issued or renewed on or after July 1, 1981.
Acts 1974, ch. 515, §§ 1, 2; T.C.A., § 56-1166; Acts 1981, ch. 168, §§ 8-10; 1992, ch. 984, § 2; T.C.A., § 56-7-1002 .
Tenn. Code Ann. § 56-27-123 — TN Code / Title 56 / Chapter 27 / Section 56-27-123
Revocation of license for violation of this chapter
Status: in_force

(a) A medical service plan corporation that neglects to make and file its annual statement in the form and within the time provided by § 56-27-117 , or neglects to reply in writing to the inquiries of the commissioner and within a reasonable time as may be specified by the commissioner, or who otherwise violates this chapter, shall be subject to revocation of license after proper notice and right of hearing. (b) Any agent or solicitor who violates this chapter or any written order or official regulation of the commissioner or any other insurance law, particularly the agents' licensing law set forth in chapter 6 of this title, shall be subject to revocation of the person's license after due notice and right of hearing. Acts 1945, ch. 113, § 18; C. Supp. 1950, § 4186.34 (Williams, § 4186.35); impl. am. Acts 1975, ch. 68, § 12; T.C.A. (orig. ed.), § 56-2923.
(a) A medical service plan corporation that neglects to make and file its annual statement in the form and within the time provided by § 56-27-117 , or neglects to reply in writing to the inquiries of the commissioner and within a reasonable time as may be specified by the commissioner, or who otherwise violates this chapter, shall be subject to revocation of license after proper notice and right of hearing.
(b) Any agent or solicitor who violates this chapter or any written order or official regulation of the commissioner or any other insurance law, particularly the agents' licensing law set forth in chapter 6 of this title, shall be subject to revocation of the person's license after due notice and right of hearing.
Acts 1945, ch. 113, § 18; C. Supp. 1950, § 4186.34 (Williams, § 4186.35); impl. am. Acts 1975, ch. 68, § 12; T.C.A. (orig. ed.), § 56-2923.
Tenn. Code Ann. § 56-7-2811 — TN Code / Title 56 / Chapter 7 / Section 56-7-2811
Provisions applicable to individual as well as group markets
Status: in_force

The provisions for certification and disclosure of coverage shall apply to health insurance coverage offered by a health insurance issuer in the individual market in the same manner as it applies to health insurance coverage offered by a health insurance issuer in connection with a group health plan in the small or large group market. Acts 1997, ch. 157, § 12.
The provisions for certification and disclosure of coverage shall apply to health insurance coverage offered by a health insurance issuer in the individual market in the same manner as it applies to health insurance coverage offered by a health insurance issuer in connection with a group health plan in the small or large group market.
Acts 1997, ch. 157, § 12.
Tenn. Code Ann. § 56-11-208 — TN Code / Title 56 / Chapter 11 / Section 56-11-208
Confidentiality of ORSA-related documents - Permitted sharing and use
Status: in_force

(a) Documents, materials or other information, including the ORSA Summary Report, in the possession of or control of the department that are obtained by, created by or disclosed to the commissioner or any other person under this part, is recognized by this state as being proprietary and to contain trade secrets. All such documents, materials or other information shall be confidential by law and privileged, shall not be subject to § 10-7-503 or § 56-1-602 , shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action. However, the commissioner is authorized to use the documents, materials or other information in the furtherance of any regulatory or legal action brought as a part of the commissioner's official duties. The commissioner shall not otherwise make the documents, materials or other information public without the prior written consent of the insurer or health maintenance organization. (b) Neither the commissioner nor any person who receives documents, materials or other ORSA-related information, through examination or otherwise, while acting under the authority of the commissioner or with whom such documents, materials or other information are shared pursuant to this part shall be permitted or required to testify in any private civil action concerning any confidential documents, materials, or information subject to subsection (a). (c) In order to assist in the performance of the commissioner's regulatory duties, the commissioner: (1) May, upon request, share documents, materials or other ORSA-related information, including the confidential and privileged documents, materials or information subject to subsection (a), including proprietary and trade secret documents and materials with other state, federal and international financial regulatory agencies, including members of any supervisory college as described in § 56-11-116 with the NAIC and with any third-party consultants designated by the commissioner; provided, that the recipient agrees in writing to maintain the confidentiality and privileged status of the ORSA-related documents, materials or other information and has verified in writing the legal authority to maintain confidentiality; (2) May receive documents, materials or other ORSA-related information, including otherwise confidential and privileged documents, materials or information, including proprietary and trade-secret information or documents, from regulatory officials of other foreign or domestic jurisdictions, including members of any supervisory college as described in § 56-11-116 , and from the NAIC, and shall maintain as confidential or privileged any documents, materials or information received with notice or the understanding that it is confidential or privileged under the laws of the jurisdiction that is the source of the document, material or information; and (3) Shall enter into a written agreement with the NAIC or a third-party consultant governing sharing and use of information provided pursuant to this part, consistent with this subsection (c) that shall: (A) Specify procedures and protocols regarding the confidentiality and security of information shared with the NAIC or a third-party consultant pursuant to this part, including procedures and protocols for sharing by the NAIC with other state regulators from states in which the insurance group has domiciled insurers. The agreement shall provide that the recipient agrees in writing to maintain the confidentiality and privileged status of the ORSA-related documents, materials or other information and has verified in writing the legal authority to maintain confidentiality; (B) Specify that ownership of information shared with the NAIC or a third-party consultant pursuant to this part remains with the commissioner and the NAIC's or a third-party consultant's use of the information is subject to the direction of the commissioner; (C) Prohibit the NAIC or third-party consultant from storing the information shared pursuant to this part in a permanent database after the underlying analysis is completed; (D) Require prompt notice to be given to an insurer whose confidential information in the possession of the NAIC or a third-party consultant pursuant to this part is subject to a request or subpoena to the NAIC or a third-party consultant for disclosure or production; (E) Require the NAIC or a third-party consultant to consent to intervention by an insurer in any judicial or administrative action in which the NAIC or a third-party consultant may be required to disclose confidential information about the insurer shared with the NAIC or a third-party consultant pursuant to this part; and (F) In the case of an agreement involving a third-party consultant, provide for the insurer's written consent. (d) The sharing of information and documents by the commissioner pursuant to this part shall not constitute a delegation of regulatory or rulemaking authority or rulemaking. The commissioner is solely responsible for the administration, execution and enforcement of this part. (e) No waiver of any applicable privilege or claim of confidentiality in the documents, proprietary and trade-secret materials or other ORSA-related information shall occur as a result of disclosure of such ORSA-related information or documents to the commissioner under this section or as a result of sharing as authorized in this part. (f) Documents, materials or other information in the possession or control of the NAIC or a third-party consultant pursuant to this part shall be confidential by law and privileged, shall not be subject to § 10-7-503 or § 56-1-602 , shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action. Acts 2014 , ch. 583, § 26.
(a) Documents, materials or other information, including the ORSA Summary Report, in the possession of or control of the department that are obtained by, created by or disclosed to the commissioner or any other person under this part, is recognized by this state as being proprietary and to contain trade secrets. All such documents, materials or other information shall be confidential by law and privileged, shall not be subject to § 10-7-503 or § 56-1-602 , shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action. However, the commissioner is authorized to use the documents, materials or other information in the furtherance of any regulatory or legal action brought as a part of the commissioner's official duties. The commissioner shall not otherwise make the documents, materials or other information public without the prior written consent of the insurer or health maintenance organization.
(b) Neither the commissioner nor any person who receives documents, materials or other ORSA-related information, through examination or otherwise, while acting under the authority of the commissioner or with whom such documents, materials or other information are shared pursuant to this part shall be permitted or required to testify in any private civil action concerning any confidential documents, materials, or information subject to subsection (a).
(c) In order to assist in the performance of the commissioner's regulatory duties, the commissioner: (1) May, upon request, share documents, materials or other ORSA-related information, including the confidential and privileged documents, materials or information subject to subsection (a), including proprietary and trade secret documents and materials with other state, federal and international financial regulatory agencies, including members of any supervisory college as described in § 56-11-116 with the NAIC and with any third-party consultants designated by the commissioner; provided, that the recipient agrees in writing to maintain the confidentiality and privileged status of the ORSA-related documents, materials or other information and has verified in writing the legal authority to maintain confidentiality; (2) May receive documents, materials or other ORSA-related information, including otherwise confidential and privileged documents, materials or information, including proprietary and trade-secret information or documents, from regulatory officials of other foreign or domestic jurisdictions, including members of any supervisory college as described in § 56-11-116 , and from the NAIC, and shall maintain as confidential or privileged any documents, materials or information received with notice or the understanding that it is confidential or privileged under the laws of the jurisdiction that is the source of the document, material or information; and (3) Shall enter into a written agreement with the NAIC or a third-party consultant governing sharing and use of information provided pursuant to this part, consistent with this subsection (c) that shall: (A) Specify procedures and protocols regarding the confidentiality and security of information shared with the NAIC or a third-party consultant pursuant to this part, including procedures and protocols for sharing by the NAIC with other state regulators from states in which the insurance group has domiciled insurers. The agreement shall provide that the recipient agrees in writing to maintain the confidentiality and privileged status of the ORSA-related documents, materials or other information and has verified in writing the legal authority to maintain confidentiality; (B) Specify that ownership of information shared with the NAIC or a third-party consultant pursuant to this part remains with the commissioner and the NAIC's or a third-party consultant's use of the information is subject to the direction of the commissioner; (C) Prohibit the NAIC or third-party consultant from storing the information shared pursuant to this part in a permanent database after the underlying analysis is completed; (D) Require prompt notice to be given to an insurer whose confidential information in the possession of the NAIC or a third-party consultant pursuant to this part is subject to a request or subpoena to the NAIC or a third-party consultant for disclosure or production; (E) Require the NAIC or a third-party consultant to consent to intervention by an insurer in any judicial or administrative action in which the NAIC or a third-party consultant may be required to disclose confidential information about the insurer shared with the NAIC or a third-party consultant pursuant to this part; and (F) In the case of an agreement involving a third-party consultant, provide for the insurer's written consent.
(1) May, upon request, share documents, materials or other ORSA-related information, including the confidential and privileged documents, materials or information subject to subsection (a), including proprietary and trade secret documents and materials with other state, federal and international financial regulatory agencies, including members of any supervisory college as described in § 56-11-116 with the NAIC and with any third-party consultants designated by the commissioner; provided, that the recipient agrees in writing to maintain the confidentiality and privileged status of the ORSA-related documents, materials or other information and has verified in writing the legal authority to maintain confidentiality;
(2) May receive documents, materials or other ORSA-related information, including otherwise confidential and privileged documents, materials or information, including proprietary and trade-secret information or documents, from regulatory officials of other foreign or domestic jurisdictions, including members of any supervisory college as described in § 56-11-116 , and from the NAIC, and shall maintain as confidential or privileged any documents, materials or information received with notice or the understanding that it is confidential or privileged under the laws of the jurisdiction that is the source of the document, material or information; and
(3) Shall enter into a written agreement with the NAIC or a third-party consultant governing sharing and use of information provided pursuant to this part, consistent with this subsection (c) that shall: (A) Specify procedures and protocols regarding the confidentiality and security of information shared with the NAIC or a third-party consultant pursuant to this part, including procedures and protocols for sharing by the NAIC with other state regulators from states in which the insurance group has domiciled insurers. The agreement shall provide that the recipient agrees in writing to maintain the confidentiality and privileged status of the ORSA-related documents, materials or other information and has verified in writing the legal authority to maintain confidentiality; (B) Specify that ownership of information shared with the NAIC or a third-party consultant pursuant to this part remains with the commissioner and the NAIC's or a third-party consultant's use of the information is subject to the direction of the commissioner; (C) Prohibit the NAIC or third-party consultant from storing the information shared pursuant to this part in a permanent database after the underlying analysis is completed; (D) Require prompt notice to be given to an insurer whose confidential information in the possession of the NAIC or a third-party consultant pursuant to this part is subject to a request or subpoena to the NAIC or a third-party consultant for disclosure or production; (E) Require the NAIC or a third-party consultant to consent to intervention by an insurer in any judicial or administrative action in which the NAIC or a third-party consultant may be required to disclose confidential information about the insurer shared with the NAIC or a third-party consultant pursuant to this part; and (F) In the case of an agreement involving a third-party consultant, provide for the insurer's written consent.
(A) Specify procedures and protocols regarding the confidentiality and security of information shared with the NAIC or a third-party consultant pursuant to this part, including procedures and protocols for sharing by the NAIC with other state regulators from states in which the insurance group has domiciled insurers. The agreement shall provide that the recipient agrees in writing to maintain the confidentiality and privileged status of the ORSA-related documents, materials or other information and has verified in writing the legal authority to maintain confidentiality;
(B) Specify that ownership of information shared with the NAIC or a third-party consultant pursuant to this part remains with the commissioner and the NAIC's or a third-party consultant's use of the information is subject to the direction of the commissioner;
(C) Prohibit the NAIC or third-party consultant from storing the information shared pursuant to this part in a permanent database after the underlying analysis is completed;
(D) Require prompt notice to be given to an insurer whose confidential information in the possession of the NAIC or a third-party consultant pursuant to this part is subject to a request or subpoena to the NAIC or a third-party consultant for disclosure or production;
(E) Require the NAIC or a third-party consultant to consent to intervention by an insurer in any judicial or administrative action in which the NAIC or a third-party consultant may be required to disclose confidential information about the insurer shared with the NAIC or a third-party consultant pursuant to this part; and
(F) In the case of an agreement involving a third-party consultant, provide for the insurer's written consent.
(d) The sharing of information and documents by the commissioner pursuant to this part shall not constitute a delegation of regulatory or rulemaking authority or rulemaking. The commissioner is solely responsible for the administration, execution and enforcement of this part.
(e) No waiver of any applicable privilege or claim of confidentiality in the documents, proprietary and trade-secret materials or other ORSA-related information shall occur as a result of disclosure of such ORSA-related information or documents to the commissioner under this section or as a result of sharing as authorized in this part.
(f) Documents, materials or other information in the possession or control of the NAIC or a third-party consultant pursuant to this part shall be confidential by law and privileged, shall not be subject to § 10-7-503 or § 56-1-602 , shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action.
Acts 2014 , ch. 583, § 26.
Tenn. Code Ann. § 56-7-103 — TN Code / Title 56 / Chapter 7 / Section 56-7-103
Misrepresentation or warranty will not void policy - Exceptions
Status: in_force

No written or oral misrepresentation or warranty made in the negotiations of a contract or policy of insurance, or in the application for contract or policy of insurance, by the insured or in the insured's behalf, shall be deemed material or defeat or void the policy or prevent its attaching, unless the misrepresentation or warranty is made with actual intent to deceive, or unless the matter represented increases the risk of loss. Acts 1895, ch. 160, § 22; Shan., § 3306; Code 1932, § 6126; T.C.A. (orig. ed.), § 56-1103.
No written or oral misrepresentation or warranty made in the negotiations of a contract or policy of insurance, or in the application for contract or policy of insurance, by the insured or in the insured's behalf, shall be deemed material or defeat or void the policy or prevent its attaching, unless the misrepresentation or warranty is made with actual intent to deceive, or unless the matter represented increases the risk of loss.
Acts 1895, ch. 160, § 22; Shan., § 3306; Code 1932, § 6126; T.C.A. (orig. ed.), § 56-1103.
Tenn. Code Ann. § 56-12-121 — TN Code / Title 56 / Chapter 12 / Section 56-12-121
Insolvent insurer
Status: in_force

(a) In no case shall a covered claim include any claim filed with the association, domiciliary receiver, ancillary receiver or liquidator, after the earlier of: (1) Eighteen (18) months after the date of the order of liquidation; or (2) The final date set by the court for the filing of claims against the liquidator or receiver of an insolvent insurer. (b) In no case shall a covered claim include any claim filed with the association, domiciliary, or ancillary receiver or a liquidator for protection afforded under the insured's policy for incurred-but-not-reported losses. Acts 1995, ch. 240, § 3; 1999, ch. 48, § 10.
(a) In no case shall a covered claim include any claim filed with the association, domiciliary receiver, ancillary receiver or liquidator, after the earlier of: (1) Eighteen (18) months after the date of the order of liquidation; or (2) The final date set by the court for the filing of claims against the liquidator or receiver of an insolvent insurer.
(1) Eighteen (18) months after the date of the order of liquidation; or
(2) The final date set by the court for the filing of claims against the liquidator or receiver of an insolvent insurer.
(b) In no case shall a covered claim include any claim filed with the association, domiciliary, or ancillary receiver or a liquidator for protection afforded under the insured's policy for incurred-but-not-reported losses.
Acts 1995, ch. 240, § 3; 1999, ch. 48, § 10.
Tenn. Code Ann. § 56-13-202 — TN Code / Title 56 / Chapter 13 / Section 56-13-202
Part definitions
Status: in_force

As used in this part, unless the context requires otherwise: (1) "General account" means all assets and liabilities of a protected cell captive insurance company not attributable to a protected cell; (2) "Participant" means a person or an entity, authorized to be a participant by § 56-13-205 , and any affiliate of a participant, that is insured by a protected cell captive insurance company, if the losses of the participant are limited through a participant contract; (3) "Participant contract" means a contract by which a protected cell captive insurance company insures the risks of a participant and limits the losses of each such participant to its pro rata share of the assets of one (1) or more protected cells identified in such participant contract; (4) "Protected cell" means a separate account established by a protected cell captive insurance company formed or licensed under this chapter, in which an identified pool of assets and liabilities are segregated and insulated by means of this chapter from the remainder of the protected cell captive insurance company's assets and liabilities in accordance with the terms of one (1) or more participant contracts to fund the liability of the protected cell captive insurance company with respect to the participants as set forth in the participant contracts; (5) "Protected cell assets" means all assets, contract rights, and general intangibles identified with and attributable to a specific protected cell of a protected cell captive insurance company; (6) "Protected cell captive insurance company" means any captive insurance company: (A) In which the minimum capital and surplus required by this chapter are provided by one (1) or more sponsors; (B) That is formed or licensed under this chapter; (C) That insures the risks of separate participants through participant contracts; and (D) That funds its liability to each participant through one (1) or more protected cells and segregates the assets of each protected cell from the assets of other protected cells and from the assets of the protected cell captive insurance company's general account; (7) "Protected cell liabilities" means all liabilities and other obligations identified with and attributed to a specific protected cell of a protected cell captive insurance company; and (8) "Sponsor" means any person or entity that is approved by the commissioner to provide all or part of the capital and surplus required by this chapter and to organize and operate a protected cell captive insurance company. Amended by 2013 Tenn. Acts, ch. 139,Secs.s4, s5, s6, s7, s8 eff. 4/12/2013. Acts 2011, ch. 468, § 1.
As used in this part, unless the context requires otherwise:
(1) "General account" means all assets and liabilities of a protected cell captive insurance company not attributable to a protected cell;
(2) "Participant" means a person or an entity, authorized to be a participant by § 56-13-205 , and any affiliate of a participant, that is insured by a protected cell captive insurance company, if the losses of the participant are limited through a participant contract;
(3) "Participant contract" means a contract by which a protected cell captive insurance company insures the risks of a participant and limits the losses of each such participant to its pro rata share of the assets of one (1) or more protected cells identified in such participant contract;
(4) "Protected cell" means a separate account established by a protected cell captive insurance company formed or licensed under this chapter, in which an identified pool of assets and liabilities are segregated and insulated by means of this chapter from the remainder of the protected cell captive insurance company's assets and liabilities in accordance with the terms of one (1) or more participant contracts to fund the liability of the protected cell captive insurance company with respect to the participants as set forth in the participant contracts;
(5) "Protected cell assets" means all assets, contract rights, and general intangibles identified with and attributable to a specific protected cell of a protected cell captive insurance company;
(6) "Protected cell captive insurance company" means any captive insurance company: (A) In which the minimum capital and surplus required by this chapter are provided by one (1) or more sponsors; (B) That is formed or licensed under this chapter; (C) That insures the risks of separate participants through participant contracts; and (D) That funds its liability to each participant through one (1) or more protected cells and segregates the assets of each protected cell from the assets of other protected cells and from the assets of the protected cell captive insurance company's general account;
(A) In which the minimum capital and surplus required by this chapter are provided by one (1) or more sponsors;
(B) That is formed or licensed under this chapter;
(C) That insures the risks of separate participants through participant contracts; and
(D) That funds its liability to each participant through one (1) or more protected cells and segregates the assets of each protected cell from the assets of other protected cells and from the assets of the protected cell captive insurance company's general account;
(7) "Protected cell liabilities" means all liabilities and other obligations identified with and attributed to a specific protected cell of a protected cell captive insurance company; and
(8) "Sponsor" means any person or entity that is approved by the commissioner to provide all or part of the capital and surplus required by this chapter and to organize and operate a protected cell captive insurance company.
Amended by 2013 Tenn. Acts, ch. 139,Secs.s4, s5, s6, s7, s8 eff. 4/12/2013.
Acts 2011, ch. 468, § 1.
Tenn. Code Ann. § 56-26-111 — TN Code / Title 56 / Chapter 26 / Section 56-26-111
Sequence of policy provisions
Status: in_force

The provisions that are the subject of §§ 56-26-108 and 56-26-109 , or any corresponding provisions that are used in lieu thereof in accordance with such sections, shall be printed in the consecutive order of the provisions in the sections or, at the option of the insurer, any such provision may appear as a unit in any part of the policy, with other provisions to which it may be logically related; provided, that the resulting policy shall not be in whole or in part unintelligible, uncertain, ambiguous, abstruse, or likely to mislead a person to whom the policy is offered, delivered, or issued. Acts 1955, ch. 4, § 4; T.C.A., § 56-3311.
The provisions that are the subject of §§ 56-26-108 and 56-26-109 , or any corresponding provisions that are used in lieu thereof in accordance with such sections, shall be printed in the consecutive order of the provisions in the sections or, at the option of the insurer, any such provision may appear as a unit in any part of the policy, with other provisions to which it may be logically related; provided, that the resulting policy shall not be in whole or in part unintelligible, uncertain, ambiguous, abstruse, or likely to mislead a person to whom the policy is offered, delivered, or issued.
Acts 1955, ch. 4, § 4; T.C.A., § 56-3311.
Tenn. Code Ann. § 56-4-302 — TN Code / Title 56 / Chapter 4 / Section 56-4-302
Nature of tax - Exemption from other taxes
Status: in_force

(a) The business declared in this part to be a privilege is for state purposes only and taxable as a privilege by the state alone, and no county or municipality may impose any tax upon the privilege, or upon the privilege of conducting business or acting as agent or representative of any investment company, as defined in §§ 56-4-301 and 56-4-303 . (b) (1) The tax provided in this part shall be in lieu of and substituted for any and all other taxes heretofore imposed by any law, general or special, against or on the investment companies, as defined in §§ 56-4-301 and 56-4-303 , except ad valorem taxes upon real estate and tangible personal property owned by the investment companies and located in the state. (2) The exemption from other taxes shall include all other privilege taxes, such as taxes upon or for the use of the franchise, capital, notes, reserves, surpluses, loans, accounts and other income and profits of the investment companies. The members, shareholders, account holders, certificate holders, or contract holders are exempt from any and all privilege taxes and income taxes imposed by any law now on the statute books, upon profits, dividends, interest or income in the nature of profits, dividends, or interest received from the investment company. (c) Nothing in this section shall be construed to provide an exemption from the sales and use tax imposed by title 67, chapter 6. Acts 1939, ch. 187, §§ 5, 6; C. Supp. 1950, §§ 1248.37, 1248.38 (Williams, §§ 1248.164, 1248.165); modified; T.C.A. (orig. ed.), §§ 67-4406, 67-4410, 67-4-1202; Acts 2005, ch. 499, § 23.
(a) The business declared in this part to be a privilege is for state purposes only and taxable as a privilege by the state alone, and no county or municipality may impose any tax upon the privilege, or upon the privilege of conducting business or acting as agent or representative of any investment company, as defined in §§ 56-4-301 and 56-4-303 .
(b) (1) The tax provided in this part shall be in lieu of and substituted for any and all other taxes heretofore imposed by any law, general or special, against or on the investment companies, as defined in §§ 56-4-301 and 56-4-303 , except ad valorem taxes upon real estate and tangible personal property owned by the investment companies and located in the state. (2) The exemption from other taxes shall include all other privilege taxes, such as taxes upon or for the use of the franchise, capital, notes, reserves, surpluses, loans, accounts and other income and profits of the investment companies. The members, shareholders, account holders, certificate holders, or contract holders are exempt from any and all privilege taxes and income taxes imposed by any law now on the statute books, upon profits, dividends, interest or income in the nature of profits, dividends, or interest received from the investment company.
(1) The tax provided in this part shall be in lieu of and substituted for any and all other taxes heretofore imposed by any law, general or special, against or on the investment companies, as defined in §§ 56-4-301 and 56-4-303 , except ad valorem taxes upon real estate and tangible personal property owned by the investment companies and located in the state.
(2) The exemption from other taxes shall include all other privilege taxes, such as taxes upon or for the use of the franchise, capital, notes, reserves, surpluses, loans, accounts and other income and profits of the investment companies. The members, shareholders, account holders, certificate holders, or contract holders are exempt from any and all privilege taxes and income taxes imposed by any law now on the statute books, upon profits, dividends, interest or income in the nature of profits, dividends, or interest received from the investment company.
(c) Nothing in this section shall be construed to provide an exemption from the sales and use tax imposed by title 67, chapter 6.
Acts 1939, ch. 187, §§ 5, 6; C. Supp. 1950, §§ 1248.37, 1248.38 (Williams, §§ 1248.164, 1248.165); modified; T.C.A. (orig. ed.), §§ 67-4406, 67-4410, 67-4-1202; Acts 2005, ch. 499, § 23.
Tenn. Code Ann. § 56-7-2502 — TN Code / Title 56 / Chapter 7 / Section 56-7-2502
Mammography screening
Status: in_force

(a) As used in this section: (1) "Breast tomosynthesis" means a radiologic mammography procedure that involves the acquisition of projection images over a stationary breast to produce cross-sectional digital three-dimensional images of the breast from which applicable breast cancer screening diagnoses may be determined; (2) "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; (3) "Diagnostic imaging" means an imaging examination using mammography, ultrasound imaging, or magnetic resonance imaging that is designed to evaluate: (A) A subjective or objective abnormality detected by a physician or patient in a breast; (B) An abnormality seen by a physician on a screening mammogram; or (C) An abnormality previously identified by a physician as likely benign in a breast for which follow-up imaging is recommended by a physician; (4) "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; and (B) 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; (5) "Low-dose mammography" means: (A) An x-ray examination of the breast using equipment dedicated specifically for mammography, including an x-ray tube, filter, compression device, and screen, with an average radiation exposure delivery of less than one (1) rad per mid-breast and with two (2) views for each breast; (B) Digital mammography; or (C) Breast tomosynthesis; and (6) "Supplemental breast screening" means a medically necessary and appropriate examination of the breast, including breast magnetic resonance imaging or breast ultrasound that is: (A) Used to screen for breast cancer when there is no abnormality seen or suspected; and (B) Based on personal family medical history, dense breast tissue, or additional factors that may increase the individual's risk of breast cancer. (b) A health benefit plan that provides coverage for imaging services for screening mammography must provide coverage to a patient for low-dose mammography according to the following guidelines: (1) A baseline mammogram for a woman thirty-five (35) to forty (40) years of age; (2) A yearly mammogram for a woman thirty-five (35) to forty (40) years of age if the woman is at high risk based upon personal family medical history, dense breast tissue, or additional factors that may increase the individual's risk of breast cancer; and (3) A yearly mammogram for a woman forty (40) years of age or older based on the recommendation of the woman's physician licensed under title 63, chapters 6 or 9. (c) (1) Except as provided in subdivision (c)(2), a health benefit plan that provides coverage for a screening mammogram must provide coverage for diagnostic imaging and supplemental breast screening without imposing a cost sharing requirement on the patient. (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 ), 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. Amended by 2023 Tenn. Acts, ch. 379, s 2, eff. 8/9/2023. Amended by 2023 Tenn. Acts, ch. 379, s 1, eff. 8/9/2023. Amended by 2022 Tenn. Acts, ch. 1068, s 1, eff. 5/25/2022. Acts 1989, ch. 160, §§ 1, 3; 1990, ch. 859, § 1; 1992, ch. 984, § 3; T.C.A., § 56-7-1012.
(a) As used in this section: (1) "Breast tomosynthesis" means a radiologic mammography procedure that involves the acquisition of projection images over a stationary breast to produce cross-sectional digital three-dimensional images of the breast from which applicable breast cancer screening diagnoses may be determined; (2) "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; (3) "Diagnostic imaging" means an imaging examination using mammography, ultrasound imaging, or magnetic resonance imaging that is designed to evaluate: (A) A subjective or objective abnormality detected by a physician or patient in a breast; (B) An abnormality seen by a physician on a screening mammogram; or (C) An abnormality previously identified by a physician as likely benign in a breast for which follow-up imaging is recommended by a physician; (4) "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; and (B) 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; (5) "Low-dose mammography" means: (A) An x-ray examination of the breast using equipment dedicated specifically for mammography, including an x-ray tube, filter, compression device, and screen, with an average radiation exposure delivery of less than one (1) rad per mid-breast and with two (2) views for each breast; (B) Digital mammography; or (C) Breast tomosynthesis; and (6) "Supplemental breast screening" means a medically necessary and appropriate examination of the breast, including breast magnetic resonance imaging or breast ultrasound that is: (A) Used to screen for breast cancer when there is no abnormality seen or suspected; and (B) Based on personal family medical history, dense breast tissue, or additional factors that may increase the individual's risk of breast cancer.
(1) "Breast tomosynthesis" means a radiologic mammography procedure that involves the acquisition of projection images over a stationary breast to produce cross-sectional digital three-dimensional images of the breast from which applicable breast cancer screening diagnoses may be determined;
(2) "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;
(3) "Diagnostic imaging" means an imaging examination using mammography, ultrasound imaging, or magnetic resonance imaging that is designed to evaluate: (A) A subjective or objective abnormality detected by a physician or patient in a breast; (B) An abnormality seen by a physician on a screening mammogram; or (C) An abnormality previously identified by a physician as likely benign in a breast for which follow-up imaging is recommended by a physician;
(A) A subjective or objective abnormality detected by a physician or patient in a breast;
(B) An abnormality seen by a physician on a screening mammogram; or
(C) An abnormality previously identified by a physician as likely benign in a breast for which follow-up imaging is recommended by a physician;
(4) "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; and (B) 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;
(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; and
(B) 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;
(5) "Low-dose mammography" means: (A) An x-ray examination of the breast using equipment dedicated specifically for mammography, including an x-ray tube, filter, compression device, and screen, with an average radiation exposure delivery of less than one (1) rad per mid-breast and with two (2) views for each breast; (B) Digital mammography; or (C) Breast tomosynthesis; and
(A) An x-ray examination of the breast using equipment dedicated specifically for mammography, including an x-ray tube, filter, compression device, and screen, with an average radiation exposure delivery of less than one (1) rad per mid-breast and with two (2) views for each breast;
(B) Digital mammography; or
(C) Breast tomosynthesis; and
(6) "Supplemental breast screening" means a medically necessary and appropriate examination of the breast, including breast magnetic resonance imaging or breast ultrasound that is: (A) Used to screen for breast cancer when there is no abnormality seen or suspected; and (B) Based on personal family medical history, dense breast tissue, or additional factors that may increase the individual's risk of breast cancer.
(A) Used to screen for breast cancer when there is no abnormality seen or suspected; and
(B) Based on personal family medical history, dense breast tissue, or additional factors that may increase the individual's risk of breast cancer.
(b) A health benefit plan that provides coverage for imaging services for screening mammography must provide coverage to a patient for low-dose mammography according to the following guidelines: (1) A baseline mammogram for a woman thirty-five (35) to forty (40) years of age; (2) A yearly mammogram for a woman thirty-five (35) to forty (40) years of age if the woman is at high risk based upon personal family medical history, dense breast tissue, or additional factors that may increase the individual's risk of breast cancer; and (3) A yearly mammogram for a woman forty (40) years of age or older based on the recommendation of the woman's physician licensed under title 63, chapters 6 or 9.
(1) A baseline mammogram for a woman thirty-five (35) to forty (40) years of age;
(2) A yearly mammogram for a woman thirty-five (35) to forty (40) years of age if the woman is at high risk based upon personal family medical history, dense breast tissue, or additional factors that may increase the individual's risk of breast cancer; and
(3) A yearly mammogram for a woman forty (40) years of age or older based on the recommendation of the woman's physician licensed under title 63, chapters 6 or 9.
(c) (1) Except as provided in subdivision (c)(2), a health benefit plan that provides coverage for a screening mammogram must provide coverage for diagnostic imaging and supplemental breast screening without imposing a cost sharing requirement on the patient. (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 ), 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 a screening mammogram must provide coverage for diagnostic imaging and supplemental breast screening without imposing a cost sharing requirement on the patient.
(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 ), 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.
Amended by 2023 Tenn. Acts, ch. 379, s 2, eff. 8/9/2023.
Amended by 2023 Tenn. Acts, ch. 379, s 1, eff. 8/9/2023.
Amended by 2022 Tenn. Acts, ch. 1068, s 1, eff. 5/25/2022.
Acts 1989, ch. 160, §§ 1, 3; 1990, ch. 859, § 1; 1992, ch. 984, § 3; T.C.A., § 56-7-1012.
Tenn. Code Ann. § 56-27-124 — TN Code / Title 56 / Chapter 27 / Section 56-27-124
Review of order of commissioner - Writ of certiorari
Status: in_force

A review of any order made by the commissioner pursuant to this chapter may be had in the circuit court of Davidson County, upon a writ of certiorari. Application for the writ shall be made within thirty (30) days after the making of the order by the commissioner. Acts 1945, ch. 113, § 3; C. Supp. 1950, § 4186.20; T.C.A. (orig. ed.), § 56-2924.
A review of any order made by the commissioner pursuant to this chapter may be had in the circuit court of Davidson County, upon a writ of certiorari. Application for the writ shall be made within thirty (30) days after the making of the order by the commissioner.
Acts 1945, ch. 113, § 3; C. Supp. 1950, § 4186.20; T.C.A. (orig. ed.), § 56-2924.
Tenn. Code Ann. § 56-1-310 — TN Code / Title 56 / Chapter 1 / Section 56-1-310
Moneys collected by boards attached to division of regulatory boards - Separate account in state general fund
Status: in_force

(a) Notwithstanding any law to the contrary, all moneys collected by any board attached to the division of regulatory boards pursuant to § 4-3-1304 shall be deposited in the state general fund and credited to a separate account for each board. (b) (1) Disbursements from the accounts shall be made solely for the purpose of defraying expenses incurred in the implementation and enforcement of the boards' areas of regulation. (2) Notwithstanding subdivision (b)(1): (A) At a board's discretion and upon the approval of the commissioner of commerce and insurance and the commissioner of finance and administration, funds in board accounts may be expended for the following purposes: (i) Capital purchases, including technology upgrades; (ii) Communications and marketing programs related to the board's regulated industries, including consumer protection campaigns, public service announcements, and targeted media; (iii) Educational programs related to the board's regulated industries, including programs regarding consumer awareness, industry best practices, and industry recruitment; (iv) Payment of legal fees and related costs associated with legal representation by the attorney general and reporter; and (v) Other initiatives related to the department's strategic plan; (B) The commissioner of commerce and insurance, with the approval of the commissioner of finance and administration, may in extraordinary circumstances expend reserve funds in a board account for the purpose of administering the corresponding programs of that board; and (C) On or before December 31 in each year that reserve funds are expended under subdivision (b)(2)(B), the commissioner of commerce and insurance shall report to the chairs of the finance, ways and means committees of the senate and the house of representatives a list containing the name of each regulatory board reserve account for which funds were expended and the amount expended. (c) The expenses shall not be paid from any other state funds. (d) Funds remaining in board accounts at the end of any fiscal year shall not revert to the general fund but shall remain available for expenditure in accordance with law. Amended by 2021 Tenn. Acts, ch. 549, s 9, eff. 10/1/2021. Acts 1991, ch. 440, § 1.
(a) Notwithstanding any law to the contrary, all moneys collected by any board attached to the division of regulatory boards pursuant to § 4-3-1304 shall be deposited in the state general fund and credited to a separate account for each board.
(b) (1) Disbursements from the accounts shall be made solely for the purpose of defraying expenses incurred in the implementation and enforcement of the boards' areas of regulation. (2) Notwithstanding subdivision (b)(1): (A) At a board's discretion and upon the approval of the commissioner of commerce and insurance and the commissioner of finance and administration, funds in board accounts may be expended for the following purposes: (i) Capital purchases, including technology upgrades; (ii) Communications and marketing programs related to the board's regulated industries, including consumer protection campaigns, public service announcements, and targeted media; (iii) Educational programs related to the board's regulated industries, including programs regarding consumer awareness, industry best practices, and industry recruitment; (iv) Payment of legal fees and related costs associated with legal representation by the attorney general and reporter; and (v) Other initiatives related to the department's strategic plan; (B) The commissioner of commerce and insurance, with the approval of the commissioner of finance and administration, may in extraordinary circumstances expend reserve funds in a board account for the purpose of administering the corresponding programs of that board; and (C) On or before December 31 in each year that reserve funds are expended under subdivision (b)(2)(B), the commissioner of commerce and insurance shall report to the chairs of the finance, ways and means committees of the senate and the house of representatives a list containing the name of each regulatory board reserve account for which funds were expended and the amount expended.
(1) Disbursements from the accounts shall be made solely for the purpose of defraying expenses incurred in the implementation and enforcement of the boards' areas of regulation.
(2) Notwithstanding subdivision (b)(1): (A) At a board's discretion and upon the approval of the commissioner of commerce and insurance and the commissioner of finance and administration, funds in board accounts may be expended for the following purposes: (i) Capital purchases, including technology upgrades; (ii) Communications and marketing programs related to the board's regulated industries, including consumer protection campaigns, public service announcements, and targeted media; (iii) Educational programs related to the board's regulated industries, including programs regarding consumer awareness, industry best practices, and industry recruitment; (iv) Payment of legal fees and related costs associated with legal representation by the attorney general and reporter; and (v) Other initiatives related to the department's strategic plan; (B) The commissioner of commerce and insurance, with the approval of the commissioner of finance and administration, may in extraordinary circumstances expend reserve funds in a board account for the purpose of administering the corresponding programs of that board; and (C) On or before December 31 in each year that reserve funds are expended under subdivision (b)(2)(B), the commissioner of commerce and insurance shall report to the chairs of the finance, ways and means committees of the senate and the house of representatives a list containing the name of each regulatory board reserve account for which funds were expended and the amount expended.
(A) At a board's discretion and upon the approval of the commissioner of commerce and insurance and the commissioner of finance and administration, funds in board accounts may be expended for the following purposes: (i) Capital purchases, including technology upgrades; (ii) Communications and marketing programs related to the board's regulated industries, including consumer protection campaigns, public service announcements, and targeted media; (iii) Educational programs related to the board's regulated industries, including programs regarding consumer awareness, industry best practices, and industry recruitment; (iv) Payment of legal fees and related costs associated with legal representation by the attorney general and reporter; and (v) Other initiatives related to the department's strategic plan;
(i) Capital purchases, including technology upgrades;
(ii) Communications and marketing programs related to the board's regulated industries, including consumer protection campaigns, public service announcements, and targeted media;
(iii) Educational programs related to the board's regulated industries, including programs regarding consumer awareness, industry best practices, and industry recruitment;
(iv) Payment of legal fees and related costs associated with legal representation by the attorney general and reporter; and
(v) Other initiatives related to the department's strategic plan;
(B) The commissioner of commerce and insurance, with the approval of the commissioner of finance and administration, may in extraordinary circumstances expend reserve funds in a board account for the purpose of administering the corresponding programs of that board; and
(C) On or before December 31 in each year that reserve funds are expended under subdivision (b)(2)(B), the commissioner of commerce and insurance shall report to the chairs of the finance, ways and means committees of the senate and the house of representatives a list containing the name of each regulatory board reserve account for which funds were expended and the amount expended.
(c) The expenses shall not be paid from any other state funds.
(d) Funds remaining in board accounts at the end of any fiscal year shall not revert to the general fund but shall remain available for expenditure in accordance with law.
Amended by 2021 Tenn. Acts, ch. 549, s 9, eff. 10/1/2021.
Acts 1991, ch. 440, § 1.
Tenn. Code Ann. § 56-61-115 — TN Code / Title 56 / Chapter 61 / Section 56-61-115
Exhaustion of internal grievance process
Status: in_force

(a) Except as provided in subsection (b), a request for an external review pursuant to § 56-61-116 or § 56-61-118 shall not be made until the aggrieved person has exhausted the health carrier's internal grievance process as set forth in this chapter. (1) An aggrieved person shall be considered to have exhausted the health carrier's internal grievance process for purposes of this section, if the aggrieved person: (A) Has filed a grievance involving an adverse determination pursuant to § 56-61-107 ; and (B) Has not received a written decision on the grievance from the health carrier within thirty (30) days for prospective review determinations and sixty (60) days for retrospective review determinations following the date that the aggrieved person filed the grievance with the health carrier unless the aggrieved person requested or agreed to a delay. (2) Notwithstanding subdivision (a)(1)(B), an aggrieved person may not file a request for an external review of an adverse determination involving a retrospective review determination until the covered person has exhausted the health carrier's internal grievance process. (b) A request for an external review of an adverse determination may be filed before the covered person has exhausted the health carrier's internal grievance procedures, as set forth in § 56-61-107 , whenever the health carrier agrees to waive the exhaustion requirement. (c) If the requirement to exhaust the health carrier's internal grievance procedures is waived pursuant to subsection (b), the aggrieved person may file a request in writing for a standard external review as set forth in § 56-61-116 or § 56-61-118 . Acts 2010, ch. 980, § 16.
(a) Except as provided in subsection (b), a request for an external review pursuant to § 56-61-116 or § 56-61-118 shall not be made until the aggrieved person has exhausted the health carrier's internal grievance process as set forth in this chapter. (1) An aggrieved person shall be considered to have exhausted the health carrier's internal grievance process for purposes of this section, if the aggrieved person: (A) Has filed a grievance involving an adverse determination pursuant to § 56-61-107 ; and (B) Has not received a written decision on the grievance from the health carrier within thirty (30) days for prospective review determinations and sixty (60) days for retrospective review determinations following the date that the aggrieved person filed the grievance with the health carrier unless the aggrieved person requested or agreed to a delay. (2) Notwithstanding subdivision (a)(1)(B), an aggrieved person may not file a request for an external review of an adverse determination involving a retrospective review determination until the covered person has exhausted the health carrier's internal grievance process.
(1) An aggrieved person shall be considered to have exhausted the health carrier's internal grievance process for purposes of this section, if the aggrieved person: (A) Has filed a grievance involving an adverse determination pursuant to § 56-61-107 ; and (B) Has not received a written decision on the grievance from the health carrier within thirty (30) days for prospective review determinations and sixty (60) days for retrospective review determinations following the date that the aggrieved person filed the grievance with the health carrier unless the aggrieved person requested or agreed to a delay.
(A) Has filed a grievance involving an adverse determination pursuant to § 56-61-107 ; and
(B) Has not received a written decision on the grievance from the health carrier within thirty (30) days for prospective review determinations and sixty (60) days for retrospective review determinations following the date that the aggrieved person filed the grievance with the health carrier unless the aggrieved person requested or agreed to a delay.
(2) Notwithstanding subdivision (a)(1)(B), an aggrieved person may not file a request for an external review of an adverse determination involving a retrospective review determination until the covered person has exhausted the health carrier's internal grievance process.
(b) A request for an external review of an adverse determination may be filed before the covered person has exhausted the health carrier's internal grievance procedures, as set forth in § 56-61-107 , whenever the health carrier agrees to waive the exhaustion requirement.
(c) If the requirement to exhaust the health carrier's internal grievance procedures is waived pursuant to subsection (b), the aggrieved person may file a request in writing for a standard external review as set forth in § 56-61-116 or § 56-61-118 .
Acts 2010, ch. 980, § 16.
Tenn. Code Ann. § 56-3-901 — TN Code / Title 56 / Chapter 3 / Section 56-3-901
Purpose
Status: in_force

The purpose of this part is to authorize insurance companies to utilize modern systems for holding and transferring securities without physical delivery of securities certificates, subject to rules and regulations promulgated by the commissioner pursuant to this part. Acts 2012, ch. 680, § 4.
The purpose of this part is to authorize insurance companies to utilize modern systems for holding and transferring securities without physical delivery of securities certificates, subject to rules and regulations promulgated by the commissioner pursuant to this part.
Acts 2012, ch. 680, § 4.
Tenn. Code Ann. § 56-7-1406 — TN Code / Title 56 / Chapter 7 / Section 56-7-1406
Group insurance not included
Status: in_force

The requirements in the amendments and enactments in this part in § 56-7-1405(b)(1)(D)-(G) and (b)(2)(A) and (B) are not applicable to the issuance and delivery of group medicare supplement insurance. Acts 1988, ch. 989, § 12.
The requirements in the amendments and enactments in this part in § 56-7-1405(b)(1)(D)-(G) and (b)(2)(A) and (B) are not applicable to the issuance and delivery of group medicare supplement insurance.
Acts 1988, ch. 989, § 12.
Tenn. Code Ann. § 56-31-127 — TN Code / Title 56 / Chapter 31 / Section 56-31-127
Form of subscription certificate
Status: in_force

In every subscription certificate or descriptive brochure referred to in this chapter: (1) All printed portions shall be plainly printed in type of which the face is not smaller than ten-point type; (2) There shall be a brief description of the subscription certificate on its first page and on the back in type not smaller than fourteen-point type. The description shall not be broader than the coverage granted in the contract; (3) The exceptions of the contract shall appear with the same prominence in the certificate as the benefits of the contract, and reference to the exceptions shall be specifically made in the insuring clause; and (4) If the contract contains any provisions purporting to make any portion of the articles of incorporation or of the bylaws of the corporation a part of the contract, that portion shall be set forth in full in the subscription certificate. Acts 1969, ch. 118, § 27; T.C.A., § 56-3727.
In every subscription certificate or descriptive brochure referred to in this chapter:
(1) All printed portions shall be plainly printed in type of which the face is not smaller than ten-point type;
(2) There shall be a brief description of the subscription certificate on its first page and on the back in type not smaller than fourteen-point type. The description shall not be broader than the coverage granted in the contract;
(3) The exceptions of the contract shall appear with the same prominence in the certificate as the benefits of the contract, and reference to the exceptions shall be specifically made in the insuring clause; and
(4) If the contract contains any provisions purporting to make any portion of the articles of incorporation or of the bylaws of the corporation a part of the contract, that portion shall be set forth in full in the subscription certificate.
Acts 1969, ch. 118, § 27; T.C.A., § 56-3727.
Tenn. Code Ann. § 56-3-307 — TN Code / Title 56 / Chapter 3 / Section 56-3-307
Investments or loans of domestic life insurance companies limited
Status: in_force

No domestic life insurance company shall invest or loan its funds in any manner except as provided in §§ 56-3-301 - 56-3-306, except that investments of domestic life insurance companies may include electronic computer or data processing machines or systems heretofore or hereafter purchased for use in connection with the business of the insurer; provided, that the machine or system shall have an original cost of at least fifty thousand dollars ($50,000), and that the amortized value of the machine or system at the end of any calendar year shall not be greater than the original purchase price less ten percent (10%) for each completed year after purchase. Acts 1907, ch. 458, § 4; Shan., § 3348a32; Code 1932, § 6207; T.C.A. (orig. ed.), § 56-220; Acts 1959, ch. 83, § 1; T.C.A. (orig. ed.), § 56-309.
No domestic life insurance company shall invest or loan its funds in any manner except as provided in §§ 56-3-301 - 56-3-306, except that investments of domestic life insurance companies may include electronic computer or data processing machines or systems heretofore or hereafter purchased for use in connection with the business of the insurer; provided, that the machine or system shall have an original cost of at least fifty thousand dollars ($50,000), and that the amortized value of the machine or system at the end of any calendar year shall not be greater than the original purchase price less ten percent (10%) for each completed year after purchase.
Acts 1907, ch. 458, § 4; Shan., § 3348a32; Code 1932, § 6207; T.C.A. (orig. ed.), § 56-220; Acts 1959, ch. 83, § 1; T.C.A. (orig. ed.), § 56-309.
Tenn. Code Ann. § 56-54-101 — TN Code / Title 56 / Chapter 54 / Section 56-54-101
[Repealed]
Status: repealed

Repealed by 2021 Tenn. Acts, ch. 537, s 8, eff. 5/25/2021. Acts 2008 , ch. 1009, § 2; 2012 , ch. 798, § 27.
Repealed by 2021 Tenn. Acts, ch. 537, s 8, eff. 5/25/2021.
Acts 2008 , ch. 1009, § 2; 2012 , ch. 798, § 27.
Tenn. Code Ann. § 56-6-115 — TN Code / Title 56 / Chapter 6 / Section 56-6-115
Appointments
Status: in_force

(a) An insurance producer shall not act as an agent of an insurer unless the insurance producer becomes an appointed agent of that insurer. An insurance producer who is not acting as an agent of an insurer is not required to become appointed. (b) An insurance producer who solicits or negotiates an application for insurance shall be regarded, in any controversy arising from the application for insurance or any policy issued in connection with the application between the insured or insured's beneficiary and the insurer, as the agent of the insurer and not the insured or insured's beneficiary. This subsection (b) shall not affect the apparent authority of an agent. (c) To appoint a producer as its agent, the appointing insurer shall file, in a format approved by the commissioner, a notice of appointment within fifteen (15) days from the date the agency contract is executed or the first insurance application is submitted. An insurer may also elect to appoint a producer to all or some insurers within the insurer's holding company system or group by the filing of a single appointment request. (d) Upon receipt of the notice of appointment, the commissioner shall verify within a reasonable time, not to exceed thirty (30) days, that the insurance producer is eligible for appointment. If the insurance producer is determined to be ineligible for appointment, the commissioner shall notify the insurer within five (5) days of the determination. (e) An insurer shall pay an appointment fee, in the amount set in § 56-6-121 , for each insurance producer appointed by the insurer. The fees under this section may be paid by the insurer on a quarterly basis. (f) Any insurance producer may place excess or rejected risks with an insurer lawfully doing business within this state, and shall not be required to enter into an agency contract or agreement with the insurer accepting such excess or rejected risks or be appointed by such insurer; provided, that only that portion of the risk in excess of the limits which the insurer will write may be placed as an excess risk, and: (1) The insurance producer has an agency contract or agreement with an insurer that actually engages in the writing of the insurance; and (2) The insurer has deemed the risk to be in excess of, or in noncompliance with, its underwriting standards. (g) No insurance producer may place an application for insurance with any residual market mechanism, as defined by § 56-5-102 , unless the insurance producer: (1) Has an agency contract or agreement with an insurer that actually engages in the writing of the insurance; and (2) Makes a diligent effort to place the application for insurance with the insurer. (h) It is unlawful for any insurer to accept applications from, or pay commissions to, an insurance producer or limited lines producer except in accordance with this section. Any insurer who unlawfully accepts applications from, or pays commissions to, any insurance producer shall be deemed to have accepted and acknowledged the person as its insurance producer or limited lines producer. (i) An individual not duly licensed as an insurance producer or limited lines producer who solicits a policy of insurance on behalf of an insurer shall become liable for all the duties, requirements, liabilities and penalties to which an insurance producer of the insurer is subject. Acts 2002, ch. 798, § 16.
(a) An insurance producer shall not act as an agent of an insurer unless the insurance producer becomes an appointed agent of that insurer. An insurance producer who is not acting as an agent of an insurer is not required to become appointed.
(b) An insurance producer who solicits or negotiates an application for insurance shall be regarded, in any controversy arising from the application for insurance or any policy issued in connection with the application between the insured or insured's beneficiary and the insurer, as the agent of the insurer and not the insured or insured's beneficiary. This subsection (b) shall not affect the apparent authority of an agent.
(c) To appoint a producer as its agent, the appointing insurer shall file, in a format approved by the commissioner, a notice of appointment within fifteen (15) days from the date the agency contract is executed or the first insurance application is submitted. An insurer may also elect to appoint a producer to all or some insurers within the insurer's holding company system or group by the filing of a single appointment request.
(d) Upon receipt of the notice of appointment, the commissioner shall verify within a reasonable time, not to exceed thirty (30) days, that the insurance producer is eligible for appointment. If the insurance producer is determined to be ineligible for appointment, the commissioner shall notify the insurer within five (5) days of the determination.
(e) An insurer shall pay an appointment fee, in the amount set in § 56-6-121 , for each insurance producer appointed by the insurer. The fees under this section may be paid by the insurer on a quarterly basis.
(f) Any insurance producer may place excess or rejected risks with an insurer lawfully doing business within this state, and shall not be required to enter into an agency contract or agreement with the insurer accepting such excess or rejected risks or be appointed by such insurer; provided, that only that portion of the risk in excess of the limits which the insurer will write may be placed as an excess risk, and: (1) The insurance producer has an agency contract or agreement with an insurer that actually engages in the writing of the insurance; and (2) The insurer has deemed the risk to be in excess of, or in noncompliance with, its underwriting standards.
(1) The insurance producer has an agency contract or agreement with an insurer that actually engages in the writing of the insurance; and
(2) The insurer has deemed the risk to be in excess of, or in noncompliance with, its underwriting standards.
(g) No insurance producer may place an application for insurance with any residual market mechanism, as defined by § 56-5-102 , unless the insurance producer: (1) Has an agency contract or agreement with an insurer that actually engages in the writing of the insurance; and (2) Makes a diligent effort to place the application for insurance with the insurer.
(1) Has an agency contract or agreement with an insurer that actually engages in the writing of the insurance; and
(2) Makes a diligent effort to place the application for insurance with the insurer.
(h) It is unlawful for any insurer to accept applications from, or pay commissions to, an insurance producer or limited lines producer except in accordance with this section. Any insurer who unlawfully accepts applications from, or pays commissions to, any insurance producer shall be deemed to have accepted and acknowledged the person as its insurance producer or limited lines producer.
(i) An individual not duly licensed as an insurance producer or limited lines producer who solicits a policy of insurance on behalf of an insurer shall become liable for all the duties, requirements, liabilities and penalties to which an insurance producer of the insurer is subject.
Acts 2002, ch. 798, § 16.
Tenn. Code Ann. § 56-43-103 — TN Code / Title 56 / Chapter 43 / Section 56-43-103
Chapter definitions
Status: in_force

As used in this chapter, unless the context otherwise requires: (1) "Commissioner" means the commissioner of commerce and insurance; (2) "Contractual obligation" in subdivision (4)(A) includes any arrangement in which those persons for whom services are to be provided under the arrangement have reasonable expectations of enforceable rights; (3) "Insurer" means any person who obtains a certificate of authority under this chapter; (4) (A) "Legal insurance" means the assumption of a contractual obligation to provide specified legal services or reimbursement for legal expenses in consideration of a specified payment for an interval of time, regardless of whether the payment is made by the beneficiaries individually or by a third person for them, in such a manner that the total cost incurred by assuming the obligation is to be spread directly or indirectly among a group of persons; (B) "Legal insurance" does not include the provision of or reimbursement for legal services incidental to other insurance coverages; and (C) The following are not considered "legal insurance" under the insurance laws of this state: (i) Retainer contracts and contingent fee contracts made with individual clients with the fees based on estimates of the nature and amount of services that will be provided to the specific client and similar contracts made with a group of clients involved in the same or closely related legal matters, such as class actions; (ii) Legal services provided by unions or employee associations to their members in matters relating to employment or occupation; (iii) Legal services provided by an agency of the federal or state government or subdivision thereof to its employees; (iv) Services of a lawyer referral service operated, sponsored or approved by a bar association representative of the general bar of the geographical area in which the association exists; or (v) A plan entered into by a person and an intermediary organization as defined by, and that is registered in compliance with, the rules of the Tennessee Supreme Court whereby: (a) The person pays a fee and is eligible to receive legal services specified in the plan; (b) The intermediary organization contracts with a licensed attorney or a law firm that includes one (1) or more attorneys licensed to practice law in this state, where the attorney or law firm agrees to provide, or facilitate arrangements with other licensed attorneys to provide, the legal services specified in the plan; and (c) The intermediary organization does not assume any risk or obligation to pay or reimburse for the cost of the legal services specified in the plan, and the payment of a fixed administrative fee from the intermediary organization to the attorney or law firm is not considered payment or reimbursement for the legal services specified in the plan; and (5) "Person" means any natural or artificial person including, but not limited to, an individual, partnership, association, trust or corporation. Amended by 2021 Tenn. Acts, ch. 428, s 1, eff. 5/13/2021. Acts 1989, ch. 423, § 2.
As used in this chapter, unless the context otherwise requires:
(1) "Commissioner" means the commissioner of commerce and insurance;
(2) "Contractual obligation" in subdivision (4)(A) includes any arrangement in which those persons for whom services are to be provided under the arrangement have reasonable expectations of enforceable rights;
(3) "Insurer" means any person who obtains a certificate of authority under this chapter;
(4) (A) "Legal insurance" means the assumption of a contractual obligation to provide specified legal services or reimbursement for legal expenses in consideration of a specified payment for an interval of time, regardless of whether the payment is made by the beneficiaries individually or by a third person for them, in such a manner that the total cost incurred by assuming the obligation is to be spread directly or indirectly among a group of persons; (B) "Legal insurance" does not include the provision of or reimbursement for legal services incidental to other insurance coverages; and (C) The following are not considered "legal insurance" under the insurance laws of this state: (i) Retainer contracts and contingent fee contracts made with individual clients with the fees based on estimates of the nature and amount of services that will be provided to the specific client and similar contracts made with a group of clients involved in the same or closely related legal matters, such as class actions; (ii) Legal services provided by unions or employee associations to their members in matters relating to employment or occupation; (iii) Legal services provided by an agency of the federal or state government or subdivision thereof to its employees; (iv) Services of a lawyer referral service operated, sponsored or approved by a bar association representative of the general bar of the geographical area in which the association exists; or (v) A plan entered into by a person and an intermediary organization as defined by, and that is registered in compliance with, the rules of the Tennessee Supreme Court whereby: (a) The person pays a fee and is eligible to receive legal services specified in the plan; (b) The intermediary organization contracts with a licensed attorney or a law firm that includes one (1) or more attorneys licensed to practice law in this state, where the attorney or law firm agrees to provide, or facilitate arrangements with other licensed attorneys to provide, the legal services specified in the plan; and (c) The intermediary organization does not assume any risk or obligation to pay or reimburse for the cost of the legal services specified in the plan, and the payment of a fixed administrative fee from the intermediary organization to the attorney or law firm is not considered payment or reimbursement for the legal services specified in the plan; and
(A) "Legal insurance" means the assumption of a contractual obligation to provide specified legal services or reimbursement for legal expenses in consideration of a specified payment for an interval of time, regardless of whether the payment is made by the beneficiaries individually or by a third person for them, in such a manner that the total cost incurred by assuming the obligation is to be spread directly or indirectly among a group of persons;
(B) "Legal insurance" does not include the provision of or reimbursement for legal services incidental to other insurance coverages; and
(C) The following are not considered "legal insurance" under the insurance laws of this state: (i) Retainer contracts and contingent fee contracts made with individual clients with the fees based on estimates of the nature and amount of services that will be provided to the specific client and similar contracts made with a group of clients involved in the same or closely related legal matters, such as class actions; (ii) Legal services provided by unions or employee associations to their members in matters relating to employment or occupation; (iii) Legal services provided by an agency of the federal or state government or subdivision thereof to its employees; (iv) Services of a lawyer referral service operated, sponsored or approved by a bar association representative of the general bar of the geographical area in which the association exists; or (v) A plan entered into by a person and an intermediary organization as defined by, and that is registered in compliance with, the rules of the Tennessee Supreme Court whereby: (a) The person pays a fee and is eligible to receive legal services specified in the plan; (b) The intermediary organization contracts with a licensed attorney or a law firm that includes one (1) or more attorneys licensed to practice law in this state, where the attorney or law firm agrees to provide, or facilitate arrangements with other licensed attorneys to provide, the legal services specified in the plan; and (c) The intermediary organization does not assume any risk or obligation to pay or reimburse for the cost of the legal services specified in the plan, and the payment of a fixed administrative fee from the intermediary organization to the attorney or law firm is not considered payment or reimbursement for the legal services specified in the plan; and
(i) Retainer contracts and contingent fee contracts made with individual clients with the fees based on estimates of the nature and amount of services that will be provided to the specific client and similar contracts made with a group of clients involved in the same or closely related legal matters, such as class actions;
(ii) Legal services provided by unions or employee associations to their members in matters relating to employment or occupation;
(iii) Legal services provided by an agency of the federal or state government or subdivision thereof to its employees;
(iv) Services of a lawyer referral service operated, sponsored or approved by a bar association representative of the general bar of the geographical area in which the association exists; or
(v) A plan entered into by a person and an intermediary organization as defined by, and that is registered in compliance with, the rules of the Tennessee Supreme Court whereby: (a) The person pays a fee and is eligible to receive legal services specified in the plan; (b) The intermediary organization contracts with a licensed attorney or a law firm that includes one (1) or more attorneys licensed to practice law in this state, where the attorney or law firm agrees to provide, or facilitate arrangements with other licensed attorneys to provide, the legal services specified in the plan; and (c) The intermediary organization does not assume any risk or obligation to pay or reimburse for the cost of the legal services specified in the plan, and the payment of a fixed administrative fee from the intermediary organization to the attorney or law firm is not considered payment or reimbursement for the legal services specified in the plan; and
(a) The person pays a fee and is eligible to receive legal services specified in the plan;
(b) The intermediary organization contracts with a licensed attorney or a law firm that includes one (1) or more attorneys licensed to practice law in this state, where the attorney or law firm agrees to provide, or facilitate arrangements with other licensed attorneys to provide, the legal services specified in the plan; and
(c) The intermediary organization does not assume any risk or obligation to pay or reimburse for the cost of the legal services specified in the plan, and the payment of a fixed administrative fee from the intermediary organization to the attorney or law firm is not considered payment or reimbursement for the legal services specified in the plan; and
(5) "Person" means any natural or artificial person including, but not limited to, an individual, partnership, association, trust or corporation.
Amended by 2021 Tenn. Acts, ch. 428, s 1, eff. 5/13/2021.
Acts 1989, ch. 423, § 2.
Tenn. Code Ann. § 56-13-207 — TN Code / Title 56 / Chapter 13 / Section 56-13-207
Application of rehabilitation and liquidation provisions
Status: in_force

(a) Except as otherwise provided in this section, chapter 9 of this title shall apply to a protected cell captive insurance company. (b) Upon any order of supervision, rehabilitation, or liquidation of a protected cell captive insurance company, the receiver shall manage the assets and liabilities of the protected cell captive insurance company pursuant to this part. (c) Notwithstanding chapter 9 of this title: (1) No assets of a protected cell shall be used to pay any expenses or claims other than those attributable to such protected cell; and (2) A protected cell captive insurance company's capital and surplus shall at all times be available to pay any expenses of or claims against the protected cell captive insurance company. Acts 2011, ch. 468, § 1.
(a) Except as otherwise provided in this section, chapter 9 of this title shall apply to a protected cell captive insurance company.
(b) Upon any order of supervision, rehabilitation, or liquidation of a protected cell captive insurance company, the receiver shall manage the assets and liabilities of the protected cell captive insurance company pursuant to this part.
(c) Notwithstanding chapter 9 of this title: (1) No assets of a protected cell shall be used to pay any expenses or claims other than those attributable to such protected cell; and (2) A protected cell captive insurance company's capital and surplus shall at all times be available to pay any expenses of or claims against the protected cell captive insurance company.
(1) No assets of a protected cell shall be used to pay any expenses or claims other than those attributable to such protected cell; and
(2) A protected cell captive insurance company's capital and surplus shall at all times be available to pay any expenses of or claims against the protected cell captive insurance company.
Acts 2011, ch. 468, § 1.
Tenn. Code Ann. § 56-32-104 — TN Code / Title 56 / Chapter 32 / Section 56-32-104
Issuance of certificate of authority
Status: in_force

(a) Issuance of a certificate of authority shall be granted upon payment of the application fee prescribed in § 56-32-119 , if the commissioner is satisfied that the following conditions are met: (1) Persons responsible for the conduct of the affairs of the applicant are competent, trustworthy and possess good reputations; (2) The HMO will effectively provide or arrange for the provision of basic health care service on a prepaid basis through insurance or otherwise, except to the extent of reasonable enrollee cost sharing requirements such as copayments, deductibles or coinsurance; provided, however, that for basic health care services through participating network providers, the amount of coinsurance paid by the enrollee shall not exceed twenty percent (20%); (3) The HMO is financially responsible, and may reasonably be expected to meet its obligations to enrollees and prospective enrollees. In making this determination, the commissioner may consider: (A) The financial soundness of the arrangements for health care services in the schedule of charges used in connection with the health care service; (B) The adequacy of working capital; (C) Any agreement with an insurer, a hospital medical services corporation, a government, or any other organization for insuring the payment of cost for health care services or the provisions for automatic applicability of an alternative coverage in the event of discontinuance of the HMO; (D) Any agreement with providers for the provision of health care services; (E) In the event the HMO enters into an agreement with any physician-hospital organization, or any other provider, provider group, or provider network, for the provision of healthcare services on a prepayment basis or other risk sharing basis, the commissioner may not disallow the agreement on the basis that it transfers risk to the physician-hospital organization or other provider, provider group or provider network; or transfers the risk of payment for services to the physician-hospital organization or other provider, provider group or provider network; provided, that the HMO shall: (i) Remain contractually responsible to its enrollees; (ii) Enter into contractual arrangements utilizing contract provisions and arrangements that ensure compliance with applicable federal law, rule, regulation or waivers, including federal requirements; and (iii) Assure the physician-hospital organizations, providers, provider groups, or provider networks that are at substantial financial risk obtain either aggregate or per-patient stop-loss protection insurance coverage for the healthcare services included in the scope of the arrangement; or the HMO remains contractually responsible to the subcontracted providers and provides a system for reserving for its continued liability; and (F) Any deposit of cash or security submitted in accordance with § 56-32-112 ; and (4) Nothing in the proposed method of operation, as shown by the information submitted pursuant to § 56-32-103 , or by independent investigation, is contrary to the public interest. (b) A certificate of authority shall be denied only after compliance with the requirements of § 56-32-118 . Acts 1986, ch. 713, § 4; 1995, ch. 221, §§ 4, 5; 2001, ch. 151, § 2; 2002, ch. 518, § 1; T.C.A. § 56-32-204; Acts 2013, ch. 409, §1; Acts 2016, ch. 724, §1.
(a) Issuance of a certificate of authority shall be granted upon payment of the application fee prescribed in § 56-32-119 , if the commissioner is satisfied that the following conditions are met: (1) Persons responsible for the conduct of the affairs of the applicant are competent, trustworthy and possess good reputations; (2) The HMO will effectively provide or arrange for the provision of basic health care service on a prepaid basis through insurance or otherwise, except to the extent of reasonable enrollee cost sharing requirements such as copayments, deductibles or coinsurance; provided, however, that for basic health care services through participating network providers, the amount of coinsurance paid by the enrollee shall not exceed twenty percent (20%); (3) The HMO is financially responsible, and may reasonably be expected to meet its obligations to enrollees and prospective enrollees. In making this determination, the commissioner may consider: (A) The financial soundness of the arrangements for health care services in the schedule of charges used in connection with the health care service; (B) The adequacy of working capital; (C) Any agreement with an insurer, a hospital medical services corporation, a government, or any other organization for insuring the payment of cost for health care services or the provisions for automatic applicability of an alternative coverage in the event of discontinuance of the HMO; (D) Any agreement with providers for the provision of health care services; (E) In the event the HMO enters into an agreement with any physician-hospital organization, or any other provider, provider group, or provider network, for the provision of healthcare services on a prepayment basis or other risk sharing basis, the commissioner may not disallow the agreement on the basis that it transfers risk to the physician-hospital organization or other provider, provider group or provider network; or transfers the risk of payment for services to the physician-hospital organization or other provider, provider group or provider network; provided, that the HMO shall: (i) Remain contractually responsible to its enrollees; (ii) Enter into contractual arrangements utilizing contract provisions and arrangements that ensure compliance with applicable federal law, rule, regulation or waivers, including federal requirements; and (iii) Assure the physician-hospital organizations, providers, provider groups, or provider networks that are at substantial financial risk obtain either aggregate or per-patient stop-loss protection insurance coverage for the healthcare services included in the scope of the arrangement; or the HMO remains contractually responsible to the subcontracted providers and provides a system for reserving for its continued liability; and (F) Any deposit of cash or security submitted in accordance with § 56-32-112 ; and (4) Nothing in the proposed method of operation, as shown by the information submitted pursuant to § 56-32-103 , or by independent investigation, is contrary to the public interest.
(1) Persons responsible for the conduct of the affairs of the applicant are competent, trustworthy and possess good reputations;
(2) The HMO will effectively provide or arrange for the provision of basic health care service on a prepaid basis through insurance or otherwise, except to the extent of reasonable enrollee cost sharing requirements such as copayments, deductibles or coinsurance; provided, however, that for basic health care services through participating network providers, the amount of coinsurance paid by the enrollee shall not exceed twenty percent (20%);
(3) The HMO is financially responsible, and may reasonably be expected to meet its obligations to enrollees and prospective enrollees. In making this determination, the commissioner may consider: (A) The financial soundness of the arrangements for health care services in the schedule of charges used in connection with the health care service; (B) The adequacy of working capital; (C) Any agreement with an insurer, a hospital medical services corporation, a government, or any other organization for insuring the payment of cost for health care services or the provisions for automatic applicability of an alternative coverage in the event of discontinuance of the HMO; (D) Any agreement with providers for the provision of health care services; (E) In the event the HMO enters into an agreement with any physician-hospital organization, or any other provider, provider group, or provider network, for the provision of healthcare services on a prepayment basis or other risk sharing basis, the commissioner may not disallow the agreement on the basis that it transfers risk to the physician-hospital organization or other provider, provider group or provider network; or transfers the risk of payment for services to the physician-hospital organization or other provider, provider group or provider network; provided, that the HMO shall: (i) Remain contractually responsible to its enrollees; (ii) Enter into contractual arrangements utilizing contract provisions and arrangements that ensure compliance with applicable federal law, rule, regulation or waivers, including federal requirements; and (iii) Assure the physician-hospital organizations, providers, provider groups, or provider networks that are at substantial financial risk obtain either aggregate or per-patient stop-loss protection insurance coverage for the healthcare services included in the scope of the arrangement; or the HMO remains contractually responsible to the subcontracted providers and provides a system for reserving for its continued liability; and (F) Any deposit of cash or security submitted in accordance with § 56-32-112 ; and
(A) The financial soundness of the arrangements for health care services in the schedule of charges used in connection with the health care service;
(B) The adequacy of working capital;
(C) Any agreement with an insurer, a hospital medical services corporation, a government, or any other organization for insuring the payment of cost for health care services or the provisions for automatic applicability of an alternative coverage in the event of discontinuance of the HMO;
(D) Any agreement with providers for the provision of health care services;
(E) In the event the HMO enters into an agreement with any physician-hospital organization, or any other provider, provider group, or provider network, for the provision of healthcare services on a prepayment basis or other risk sharing basis, the commissioner may not disallow the agreement on the basis that it transfers risk to the physician-hospital organization or other provider, provider group or provider network; or transfers the risk of payment for services to the physician-hospital organization or other provider, provider group or provider network; provided, that the HMO shall: (i) Remain contractually responsible to its enrollees; (ii) Enter into contractual arrangements utilizing contract provisions and arrangements that ensure compliance with applicable federal law, rule, regulation or waivers, including federal requirements; and (iii) Assure the physician-hospital organizations, providers, provider groups, or provider networks that are at substantial financial risk obtain either aggregate or per-patient stop-loss protection insurance coverage for the healthcare services included in the scope of the arrangement; or the HMO remains contractually responsible to the subcontracted providers and provides a system for reserving for its continued liability; and
(i) Remain contractually responsible to its enrollees;
(ii) Enter into contractual arrangements utilizing contract provisions and arrangements that ensure compliance with applicable federal law, rule, regulation or waivers, including federal requirements; and
(iii) Assure the physician-hospital organizations, providers, provider groups, or provider networks that are at substantial financial risk obtain either aggregate or per-patient stop-loss protection insurance coverage for the healthcare services included in the scope of the arrangement; or the HMO remains contractually responsible to the subcontracted providers and provides a system for reserving for its continued liability; and
(F) Any deposit of cash or security submitted in accordance with § 56-32-112 ; and
(4) Nothing in the proposed method of operation, as shown by the information submitted pursuant to § 56-32-103 , or by independent investigation, is contrary to the public interest.
(b) A certificate of authority shall be denied only after compliance with the requirements of § 56-32-118 .
Acts 1986, ch. 713, § 4; 1995, ch. 221, §§ 4, 5; 2001, ch. 151, § 2; 2002, ch. 518, § 1; T.C.A. § 56-32-204; Acts 2013, ch. 409, §1; Acts 2016, ch. 724, §1.
Tenn. Code Ann. § 56-51-135 — TN Code / Title 56 / Chapter 51 / Section 56-51-135
Agent licensing
Status: in_force

(a) With respect to a prepaid limited health services contract, a person may not, unless licensed and appointed as a health insurance agent in accordance with the applicable provisions of the insurance code: (1) Solicit contracts or procure applications; or (2) Engage or hold out as engaging in the business of analyzing or abstracting prepaid limited health services contracts or of counseling or advising or giving opinions to persons relative to the contracts other than as a consulting actuary advising a prepaid limited health service organization or as a salaried bona fide full-time employee so counseling and advising the employee's employer relative to coverage for the employer and the employer's employees. (b) All qualifications, disciplinary provisions, licensing and appointment procedures, fees, and related matters contained in the insurance code that apply to the appointment of health insurance agents by insurers also apply to prepaid limited health service organizations and to persons appointed by prepaid limited health service organizations as their agents. (c) Examination, licensure, or appointment is not required of any regular salaried officer or employee of a prepaid limited health service organization who devotes substantially all of the regular salaried officer's or employee's services to activities other than the solicitation of prepaid limited health service organization contracts from the public, and who receives no commission or other compensation directly dependent upon the solicitation of the contracts. (d) As used in this section, the term "salaried" refers to basic remuneration and does not include commissions, bonuses, or any other compensatory measures. Acts 2000, ch. 948, § 35.
(a) With respect to a prepaid limited health services contract, a person may not, unless licensed and appointed as a health insurance agent in accordance with the applicable provisions of the insurance code: (1) Solicit contracts or procure applications; or (2) Engage or hold out as engaging in the business of analyzing or abstracting prepaid limited health services contracts or of counseling or advising or giving opinions to persons relative to the contracts other than as a consulting actuary advising a prepaid limited health service organization or as a salaried bona fide full-time employee so counseling and advising the employee's employer relative to coverage for the employer and the employer's employees.
(1) Solicit contracts or procure applications; or
(2) Engage or hold out as engaging in the business of analyzing or abstracting prepaid limited health services contracts or of counseling or advising or giving opinions to persons relative to the contracts other than as a consulting actuary advising a prepaid limited health service organization or as a salaried bona fide full-time employee so counseling and advising the employee's employer relative to coverage for the employer and the employer's employees.
(b) All qualifications, disciplinary provisions, licensing and appointment procedures, fees, and related matters contained in the insurance code that apply to the appointment of health insurance agents by insurers also apply to prepaid limited health service organizations and to persons appointed by prepaid limited health service organizations as their agents.
(c) Examination, licensure, or appointment is not required of any regular salaried officer or employee of a prepaid limited health service organization who devotes substantially all of the regular salaried officer's or employee's services to activities other than the solicitation of prepaid limited health service organization contracts from the public, and who receives no commission or other compensation directly dependent upon the solicitation of the contracts.
(d) As used in this section, the term "salaried" refers to basic remuneration and does not include commissions, bonuses, or any other compensatory measures.
Acts 2000, ch. 948, § 35.
Tenn. Code Ann. § 56-6-118 — TN Code / Title 56 / Chapter 6 / Section 56-6-118
Reciprocity
Status: in_force

(a) The commissioner shall waive any requirements for a nonresident license applicant with a valid license from the applicant's home state, except the requirements imposed by § 56-6-108 , if the applicant's home state awards nonresident licenses to residents of this state on the same basis. Notwithstanding any other provision of this part, after a public hearing the commissioner may waive any of the limitations or requirements imposed by § 56-6-108 if the applicant's home state awards nonresident licenses to residents of this state on the same basis. However, nothing contained in this subsection (a) shall prevent the commissioner from denying, suspending or revoking a license issued under this part pursuant to § 56-6-112 . (b) A nonresident producer's satisfaction of the producer's home state's continuing education requirements for licensed insurance producers shall constitute satisfaction of this state's continuing education requirements if the nonresident producer's home state recognizes the satisfaction of its continuing education requirements imposed upon producers from this state on the same basis. Acts 2002, ch. 798, § 19; 2008, ch. 1192, § 3.
(a) The commissioner shall waive any requirements for a nonresident license applicant with a valid license from the applicant's home state, except the requirements imposed by § 56-6-108 , if the applicant's home state awards nonresident licenses to residents of this state on the same basis. Notwithstanding any other provision of this part, after a public hearing the commissioner may waive any of the limitations or requirements imposed by § 56-6-108 if the applicant's home state awards nonresident licenses to residents of this state on the same basis. However, nothing contained in this subsection (a) shall prevent the commissioner from denying, suspending or revoking a license issued under this part pursuant to § 56-6-112 .
(b) A nonresident producer's satisfaction of the producer's home state's continuing education requirements for licensed insurance producers shall constitute satisfaction of this state's continuing education requirements if the nonresident producer's home state recognizes the satisfaction of its continuing education requirements imposed upon producers from this state on the same basis.
Acts 2002, ch. 798, § 19; 2008, ch. 1192, § 3.
Tenn. Code Ann. § 56-7-1301 — TN Code / Title 56 / Chapter 7 / Section 56-7-1301
Part definitions - Application of part
Status: in_force

(a) As used in this part: (1) "Nonpayment of premium" means failure of the named insured to discharge when due any obligations in connection with the payment of premiums on a policy of automobile liability insurance or any installment of the premium, whether the premium is payable directly to the insurer or its agent or indirectly under any premium finance plan or extension of credit; and (2) "Private passenger automobile liability insurance policy" means a policy delivered or issued for delivery in this state, insuring a natural person as named insured, or one (1) or more related individuals resident of the same household, and under which the insured vehicles therein designated are of the following types only: (A) A motor vehicle of the private passenger or station wagon type that is not used as a public or livery conveyance for passengers, nor rented to others; or (B) Any other four (4) wheel motor vehicle with a load capacity of one thousand five hundred pounds (1,500 lbs.) or less that is not used in the occupation, profession or business of the insured, other than driving to and from the insured's place of employment or used in the occupation of farming. (b) This part does not apply to: (1) Policies of automobile liability insurance issued under an automobile assigned risk plan; (2) Any policy insuring more than four (4) automobiles; (3) Any policy covering garage, automobile sales agency, repair shop, service station or public parking place operation hazards; or (4) Any policy of insurance issued principally to cover personal or premises liability of an insured even though the insurance may also provide some incidental coverage for liability arising out of the ownership, maintenance or use of a motor vehicle on the premises of the insured or on the ways immediately adjoining the premises. (c) This part applies only to that portion of an automobile liability policy insuring against bodily injury and property damage liability and to the provisions in the policy, if any, relating to medical payments and/or uninsured motorist coverage. Acts 1968, ch. 582, § 2; 1977, ch. 359, § 2; T.C.A., § 56-1155; Acts 1981, ch. 291, § 1.
(a) As used in this part: (1) "Nonpayment of premium" means failure of the named insured to discharge when due any obligations in connection with the payment of premiums on a policy of automobile liability insurance or any installment of the premium, whether the premium is payable directly to the insurer or its agent or indirectly under any premium finance plan or extension of credit; and (2) "Private passenger automobile liability insurance policy" means a policy delivered or issued for delivery in this state, insuring a natural person as named insured, or one (1) or more related individuals resident of the same household, and under which the insured vehicles therein designated are of the following types only: (A) A motor vehicle of the private passenger or station wagon type that is not used as a public or livery conveyance for passengers, nor rented to others; or (B) Any other four (4) wheel motor vehicle with a load capacity of one thousand five hundred pounds (1,500 lbs.) or less that is not used in the occupation, profession or business of the insured, other than driving to and from the insured's place of employment or used in the occupation of farming.
(1) "Nonpayment of premium" means failure of the named insured to discharge when due any obligations in connection with the payment of premiums on a policy of automobile liability insurance or any installment of the premium, whether the premium is payable directly to the insurer or its agent or indirectly under any premium finance plan or extension of credit; and
(2) "Private passenger automobile liability insurance policy" means a policy delivered or issued for delivery in this state, insuring a natural person as named insured, or one (1) or more related individuals resident of the same household, and under which the insured vehicles therein designated are of the following types only: (A) A motor vehicle of the private passenger or station wagon type that is not used as a public or livery conveyance for passengers, nor rented to others; or (B) Any other four (4) wheel motor vehicle with a load capacity of one thousand five hundred pounds (1,500 lbs.) or less that is not used in the occupation, profession or business of the insured, other than driving to and from the insured's place of employment or used in the occupation of farming.
(A) A motor vehicle of the private passenger or station wagon type that is not used as a public or livery conveyance for passengers, nor rented to others; or
(B) Any other four (4) wheel motor vehicle with a load capacity of one thousand five hundred pounds (1,500 lbs.) or less that is not used in the occupation, profession or business of the insured, other than driving to and from the insured's place of employment or used in the occupation of farming.
(b) This part does not apply to: (1) Policies of automobile liability insurance issued under an automobile assigned risk plan; (2) Any policy insuring more than four (4) automobiles; (3) Any policy covering garage, automobile sales agency, repair shop, service station or public parking place operation hazards; or (4) Any policy of insurance issued principally to cover personal or premises liability of an insured even though the insurance may also provide some incidental coverage for liability arising out of the ownership, maintenance or use of a motor vehicle on the premises of the insured or on the ways immediately adjoining the premises.
(1) Policies of automobile liability insurance issued under an automobile assigned risk plan;
(2) Any policy insuring more than four (4) automobiles;
(3) Any policy covering garage, automobile sales agency, repair shop, service station or public parking place operation hazards; or
(4) Any policy of insurance issued principally to cover personal or premises liability of an insured even though the insurance may also provide some incidental coverage for liability arising out of the ownership, maintenance or use of a motor vehicle on the premises of the insured or on the ways immediately adjoining the premises.
(c) This part applies only to that portion of an automobile liability policy insuring against bodily injury and property damage liability and to the provisions in the policy, if any, relating to medical payments and/or uninsured motorist coverage.
Acts 1968, ch. 582, § 2; 1977, ch. 359, § 2; T.C.A., § 56-1155; Acts 1981, ch. 291, § 1.
Tenn. Code Ann. § 56-35-119 — TN Code / Title 56 / Chapter 35 / Section 56-35-119
Rebates prohibited
Status: in_force

(a) It is unlawful for any applicant for a policy of title insurance, or any person, firm or corporation, on behalf of the applicant, or any other person, firm or corporation whomsoever, to request, receive or obtain from a title insurance agent, or a title insurance company, any commission, discount, rebate, special favor, advantage or inducement, or to engage or participate in any collusion with respect thereto, or for any title insurance company, or agent, to give, grant or rebate any part of a premium for title insurance to any lender, mortgage broker or real estate agent or broker or real estate builder or developer, and no person shall engage in business as a title insurance agent in this state, nor accept or hold a certificate of agency for the chief and primary purpose of securing some special advantage, rebates, commissions or concessions on title insurance written for the person, or some person, firm, corporation or lending institution in which the person is interested, or with which the person is connected or associated, and all of which acts and things are expressly prohibited and forbidden by this chapter. (b) Nothing in this chapter shall be construed to make unlawful the distribution of profits or dividends to the owner or owners or shareholders of a title insurance company, agency, or agent; provided, that the distribution is made in the ordinary course of business and in accordance with sound accounting principles. Acts 1955, ch. 173, § 13; T.C.A., § 56-3419; Acts 1980, ch. 857, § 5.
(a) It is unlawful for any applicant for a policy of title insurance, or any person, firm or corporation, on behalf of the applicant, or any other person, firm or corporation whomsoever, to request, receive or obtain from a title insurance agent, or a title insurance company, any commission, discount, rebate, special favor, advantage or inducement, or to engage or participate in any collusion with respect thereto, or for any title insurance company, or agent, to give, grant or rebate any part of a premium for title insurance to any lender, mortgage broker or real estate agent or broker or real estate builder or developer, and no person shall engage in business as a title insurance agent in this state, nor accept or hold a certificate of agency for the chief and primary purpose of securing some special advantage, rebates, commissions or concessions on title insurance written for the person, or some person, firm, corporation or lending institution in which the person is interested, or with which the person is connected or associated, and all of which acts and things are expressly prohibited and forbidden by this chapter.
(b) Nothing in this chapter shall be construed to make unlawful the distribution of profits or dividends to the owner or owners or shareholders of a title insurance company, agency, or agent; provided, that the distribution is made in the ordinary course of business and in accordance with sound accounting principles.
Acts 1955, ch. 173, § 13; T.C.A., § 56-3419; Acts 1980, ch. 857, § 5.
Tenn. Code Ann. § 56-53-106 — TN Code / Title 56 / Chapter 53 / Section 56-53-106
Administrative penalties
Status: in_force

(a) (1) Any practitioner determined by the court to have violated § 56-53-102 shall be deemed to have committed an act involving moral turpitude that is inimical to the public well being. The court or prosecutor shall notify the appropriate licensing authority in this state of the judgment for appropriate disciplinary action, including revocation of the professional license, and may notify appropriate licensing authorities in any other jurisdictions where the practitioner is licensed. Any victim may notify the appropriate licensing authorities in this state and any other jurisdiction where the practitioner is licensed, of the conviction. (2) Upon notification of a conviction of the crimes enumerated in § 56-53-102 or a substantially similar crime under the laws of another state or the United States, this state's appropriate licensing authority may hold an administrative hearing, or take other appropriate administrative action authorized by state law, to consider the imposition of the administrative sanctions as provided by law against the practitioner. Where the practitioner has been convicted of a felony violation of § 56-53-102 or a substantially similar crime under the laws of another state or of the United States, this state's appropriate licensing authority may hold an administrative hearing, or take other appropriate administrative action authorized by state law, and may summarily and permanently revoke the license or take other action against the licensee as deemed appropriate. It is recommended by the legislature that the supreme court shall summarily and permanently disbar any attorney found guilty of such felony. (3) The referrals to the appropriate licensing or other agencies, and all dispositive actions of the referral, shall be a matter of public record. (b) (1) A person convicted of a felony involving dishonesty or breach of trust shall not participate in the business of insurance unless a waiver is granted by the commissioner. (2) A person in the business of insurance shall not knowingly or intentionally permit a person convicted of a felony involving dishonesty or breach of trust to participate in the business of insurance unless a waiver has been granted by the commissioner pursuant to subdivision (b)(1). Acts 2001, ch. 356, § 7.
(a) (1) Any practitioner determined by the court to have violated § 56-53-102 shall be deemed to have committed an act involving moral turpitude that is inimical to the public well being. The court or prosecutor shall notify the appropriate licensing authority in this state of the judgment for appropriate disciplinary action, including revocation of the professional license, and may notify appropriate licensing authorities in any other jurisdictions where the practitioner is licensed. Any victim may notify the appropriate licensing authorities in this state and any other jurisdiction where the practitioner is licensed, of the conviction. (2) Upon notification of a conviction of the crimes enumerated in § 56-53-102 or a substantially similar crime under the laws of another state or the United States, this state's appropriate licensing authority may hold an administrative hearing, or take other appropriate administrative action authorized by state law, to consider the imposition of the administrative sanctions as provided by law against the practitioner. Where the practitioner has been convicted of a felony violation of § 56-53-102 or a substantially similar crime under the laws of another state or of the United States, this state's appropriate licensing authority may hold an administrative hearing, or take other appropriate administrative action authorized by state law, and may summarily and permanently revoke the license or take other action against the licensee as deemed appropriate. It is recommended by the legislature that the supreme court shall summarily and permanently disbar any attorney found guilty of such felony. (3) The referrals to the appropriate licensing or other agencies, and all dispositive actions of the referral, shall be a matter of public record.
(1) Any practitioner determined by the court to have violated § 56-53-102 shall be deemed to have committed an act involving moral turpitude that is inimical to the public well being. The court or prosecutor shall notify the appropriate licensing authority in this state of the judgment for appropriate disciplinary action, including revocation of the professional license, and may notify appropriate licensing authorities in any other jurisdictions where the practitioner is licensed. Any victim may notify the appropriate licensing authorities in this state and any other jurisdiction where the practitioner is licensed, of the conviction.
(2) Upon notification of a conviction of the crimes enumerated in § 56-53-102 or a substantially similar crime under the laws of another state or the United States, this state's appropriate licensing authority may hold an administrative hearing, or take other appropriate administrative action authorized by state law, to consider the imposition of the administrative sanctions as provided by law against the practitioner. Where the practitioner has been convicted of a felony violation of § 56-53-102 or a substantially similar crime under the laws of another state or of the United States, this state's appropriate licensing authority may hold an administrative hearing, or take other appropriate administrative action authorized by state law, and may summarily and permanently revoke the license or take other action against the licensee as deemed appropriate. It is recommended by the legislature that the supreme court shall summarily and permanently disbar any attorney found guilty of such felony.
(3) The referrals to the appropriate licensing or other agencies, and all dispositive actions of the referral, shall be a matter of public record.
(b) (1) A person convicted of a felony involving dishonesty or breach of trust shall not participate in the business of insurance unless a waiver is granted by the commissioner. (2) A person in the business of insurance shall not knowingly or intentionally permit a person convicted of a felony involving dishonesty or breach of trust to participate in the business of insurance unless a waiver has been granted by the commissioner pursuant to subdivision (b)(1).
(1) A person convicted of a felony involving dishonesty or breach of trust shall not participate in the business of insurance unless a waiver is granted by the commissioner.
(2) A person in the business of insurance shall not knowingly or intentionally permit a person convicted of a felony involving dishonesty or breach of trust to participate in the business of insurance unless a waiver has been granted by the commissioner pursuant to subdivision (b)(1).
Acts 2001, ch. 356, § 7.
Tenn. Code Ann. § 56-9-318 — TN Code / Title 56 / Chapter 9 / Section 56-9-318
Claims of creditors
Status: in_force

(a) No claims of a creditor who has received or acquired a preference, lien, conveyance, transfer, assignment or encumbrance voidable under this chapter shall be allowed unless the creditor surrenders the preference, lien, conveyance, transfer, assignment or encumbrance. If the avoidance is effected by a proceeding in which a final judgment has been entered, the claim shall not be allowed unless the money is paid or the property is delivered to the liquidator within thirty (30) days from the date of the entering of the final judgment, except that the court having jurisdiction over the liquidation may allow further time if there is an appeal or other continuation of the proceeding. (b) A claim allowable under subsection (a) by reason of the avoidance, whether voluntary or involuntary, or a preference, lien, conveyance, transfer, assignment or encumbrance, may be filed as an excused late filing under § 56-9-323 , if filed within thirty (30) days from the date of the avoidance, or within the further time allowed by the court under subsection (a). Acts 1991, ch. 142, § 4.
(a) No claims of a creditor who has received or acquired a preference, lien, conveyance, transfer, assignment or encumbrance voidable under this chapter shall be allowed unless the creditor surrenders the preference, lien, conveyance, transfer, assignment or encumbrance. If the avoidance is effected by a proceeding in which a final judgment has been entered, the claim shall not be allowed unless the money is paid or the property is delivered to the liquidator within thirty (30) days from the date of the entering of the final judgment, except that the court having jurisdiction over the liquidation may allow further time if there is an appeal or other continuation of the proceeding.
(b) A claim allowable under subsection (a) by reason of the avoidance, whether voluntary or involuntary, or a preference, lien, conveyance, transfer, assignment or encumbrance, may be filed as an excused late filing under § 56-9-323 , if filed within thirty (30) days from the date of the avoidance, or within the further time allowed by the court under subsection (a).
Acts 1991, ch. 142, § 4.
Tenn. Code Ann. § 56-5-111 — TN Code / Title 56 / Chapter 5 / Section 56-5-111
Registration of advisory organizations - Activities and services
Status: in_force

(a) Registration Required. No advisory organization shall provide any service relating to the rates of any insurer subject to this part, and no insurer shall utilize the services of the organization for those purposes unless the organization has registered under subsection (d). (b) Authorized Activities. A registered advisory organization may perform any of the authorized activities enumerated in § 56-5-110(b) except no advisory organization may make any filings on behalf of insurers. (c) Availability of Services. No advisory organization shall refuse to supply any authorized services for which it is registered in this state to any insurer authorized to do business in this state and offering to pay the fair and usual compensation for the services, nor shall an advisory organization require the purchase of any specific services as a condition to obtaining the services sought; provided, that the furnishing of the requested services does not place an unreasonable burden on the advisory organization. (d) Form of Registration. (1) Registration. An advisory organization shall submit, at the time of registration: (A) A copy of its constitution, articles of association or incorporation, bylaws, and any other rules or regulations governing the conduct of its business; (B) A list of its members and subscribers; (C) A service and acknowledgment of service of process as provided for insurance companies under § 56-2-501 ; (D) An agreement that the commissioner may examine each advisory organization in accordance with § 56-5-115 ; and (E) A fee for registration in the amount of one hundred dollars ($100). (2) Prohibited Activities. If after a hearing the commissioner finds that any activity or practice of any advisory organization is unfair, unreasonable or otherwise inconsistent with this part, the commissioner shall specify the finding in an order requiring the discontinuance of the activity or practice. Acts 1983, ch. 66, § 12.
(a) Registration Required. No advisory organization shall provide any service relating to the rates of any insurer subject to this part, and no insurer shall utilize the services of the organization for those purposes unless the organization has registered under subsection (d).
(b) Authorized Activities. A registered advisory organization may perform any of the authorized activities enumerated in § 56-5-110(b) except no advisory organization may make any filings on behalf of insurers.
(c) Availability of Services. No advisory organization shall refuse to supply any authorized services for which it is registered in this state to any insurer authorized to do business in this state and offering to pay the fair and usual compensation for the services, nor shall an advisory organization require the purchase of any specific services as a condition to obtaining the services sought; provided, that the furnishing of the requested services does not place an unreasonable burden on the advisory organization.
(d) Form of Registration. (1) Registration. An advisory organization shall submit, at the time of registration: (A) A copy of its constitution, articles of association or incorporation, bylaws, and any other rules or regulations governing the conduct of its business; (B) A list of its members and subscribers; (C) A service and acknowledgment of service of process as provided for insurance companies under § 56-2-501 ; (D) An agreement that the commissioner may examine each advisory organization in accordance with § 56-5-115 ; and (E) A fee for registration in the amount of one hundred dollars ($100). (2) Prohibited Activities. If after a hearing the commissioner finds that any activity or practice of any advisory organization is unfair, unreasonable or otherwise inconsistent with this part, the commissioner shall specify the finding in an order requiring the discontinuance of the activity or practice.
(1) Registration. An advisory organization shall submit, at the time of registration: (A) A copy of its constitution, articles of association or incorporation, bylaws, and any other rules or regulations governing the conduct of its business; (B) A list of its members and subscribers; (C) A service and acknowledgment of service of process as provided for insurance companies under § 56-2-501 ; (D) An agreement that the commissioner may examine each advisory organization in accordance with § 56-5-115 ; and (E) A fee for registration in the amount of one hundred dollars ($100).
(A) A copy of its constitution, articles of association or incorporation, bylaws, and any other rules or regulations governing the conduct of its business;
(B) A list of its members and subscribers;
(C) A service and acknowledgment of service of process as provided for insurance companies under § 56-2-501 ;
(D) An agreement that the commissioner may examine each advisory organization in accordance with § 56-5-115 ; and
(E) A fee for registration in the amount of one hundred dollars ($100).
(2) Prohibited Activities. If after a hearing the commissioner finds that any activity or practice of any advisory organization is unfair, unreasonable or otherwise inconsistent with this part, the commissioner shall specify the finding in an order requiring the discontinuance of the activity or practice.
Acts 1983, ch. 66, § 12.