reglab/housing_qa huggingface dataset:
24-A ME Rev Stat § 2722 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2722. Insurance with other insurers, provision of service or expense incurred basis

 §2722. Insurance with other insurers, provision of service or expense incurred basis 1.  There may be a provision as follows:Insurance with other insurers: If there be other valid coverage, not with this insurer, providing benefits for the same loss on a provision of service basis or on an expense incurred basis and of which this insurer has not been given written notice prior to the occurrence or commencement of loss, the only liability under any expense incurred coverage of this policy shall be for such proportion of the loss as the amount which would otherwise have been payable hereunder plus the total of the like amounts under all such other valid coverages for the same loss of which this insurer had notice bears to the total like amounts under all valid coverages for such loss, and for the return of such portion of the premiums paid as shall exceed the pro rata portion for the amount so determined. For the purpose of applying this provision when other coverage is on a provision of service basis, the "like amount" of such other coverage shall be taken as the amount which the services rendered would have cost in the absence of such coverage.  [PL 1969, c. 132, §1 (NEW).] 2.  If the foregoing policy provision is included in a policy which also contains the policy provision set out in section 2723 there shall be added to the caption of the foregoing provision the phrase "-- expense incurred benefits." The insurer may, at its option, include in this provision a definition of "other valid coverage," approved as to form by the superintendent, which definition shall be limited in subject matter to coverage provided by organizations subject to regulation by insurance law or by insurance authorities of this or any other state of the United States or any province of Canada, and by hospital or medical service organizations, and to any other coverage the inclusion of which may be approved by the superintendent. In the absence of such definition such term shall not include group insurance, automobile medical payments insurance, or coverage provided by hospital or medical service organization or by union welfare plans or employer or employee benefit organizations. For the purpose of applying the foregoing policy provision with respect to any insured, any amount of benefit provided for such insured pursuant to any compulsory benefit statute, including any workers' compensation or employer's liability statute, whether provided by a governmental agency or otherwise shall in all cases be deemed to be "other valid coverage" of which the insurer has had notice. In applying the foregoing policy provision no third party liability coverage shall be included as "other valid coverage."   [PL 1989, c. 502, Pt. A, §95 (AMD).] SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1973, c. 585, §12 (AMD). PL 1989, c. 502, §A95 (AMD).
24-A ME Rev Stat § 2723 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2723. Insurance with other insurers -- other benefits

 §2723. Insurance with other insurers -- other benefits 1.  There may be a provision as follows:Insurance with other insurers: If there be other valid coverage, not with this insurer, providing benefits for the same loss on other than an expense incurred basis and of which this insurer has not been given written notice prior to the occurrence or commencement of loss, the only liability for such benefits under this policy shall be for such proportion of the indemnities otherwise provided hereunder for such loss as the like indemnities of which the insurer had notice, including the indemnities under this policy, bear to the total amount of all like indemnities for such loss, and for the return of such portion of the premium paid as shall exceed the pro rata portion for the indemnities thus determined.  [PL 1969, c. 132, §1 (NEW).] 2.  If the foregoing policy provision is included in a policy which also contains the policy provision set out in section 2722, there shall be added to the caption of the foregoing provision the phrase "other benefits." The insurer may, at its option, include in this provision a definition of "other valid coverage," approved as to form by the superintendent, which definition shall be limited in subject matter to coverage provided by organizations subject to regulation by insurance law or by insurance authorities of this or any other state of the United States or any province of Canada, and to any other coverage the inclusion of which may be approved by the superintendent. In the absence of such definition such term shall not include group insurance, or benefits provided by union welfare plans or by employer or employee benefit organizations. For the purpose of applying the foregoing policy provision with respect to any insured, any amount of benefit provided for such insured pursuant to any compulsory benefit statute, including any workers' compensation or employer's liability statute, whether provided by a governmental agency or otherwise shall in all cases be deemed to be "other valid coverage" of which the insurer has had notice. In applying the foregoing policy provision no third party liability coverage shall be included as "other valid coverage."   [PL 1989, c. 502, Pt. A, §96 (AMD).] SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1973, c. 585, §12 (AMD). PL 1989, c. 502, §A96 (AMD).
24-A ME Rev Stat § 2724 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2724. Relation of earnings to insurance

 §2724. Relation of earnings to insurance There may be a provision as follows:If the total monthly amount of loss of time benefits promised for the same loss under all valid loss of time coverage upon the insured, whether payable on a weekly or monthly basis, shall exceed the monthly earnings of the insured at the time disability commenced or the average monthly earnings for the period of 2 years immediately preceding a disability for which claim is made, whichever is the greater, the insurer will be liable only for such proportionate amount of such benefits under this policy as the amount of such monthly earnings or such average monthly earnings of the insured bears to the total amount of monthly benefits for the same loss under all such coverage upon the insured at the time such disability commences and for the return of such part of the premiums paid during such 2 years as shall exceed the pro rata amount of the premiums for the benefits actually paid hereunder; but this shall not operate to reduce the total monthly amount of benefits payable under all such coverage upon the insured below the sum of $200 or the sum of the monthly benefits specified in such coverages, whichever is the lesser, nor shall it operate to reduce benefits other than those payable for loss of time. The foregoing policy provision may be inserted only in a policy which the insured has the right to continue in force subject to its terms by the timely payment of premiums (A.) until at least age 50 or, (B.) in the case of a policy issued after age 44, for at least 5 years from its date of issue. The insurer may, at its option, include in this provision a definition of "valid loss of time coverage", approved as to form by the superintendent, which definition shall be limited in subject matter to coverage provided by governmental agencies or by organizations subject to regulation by insurance law or by insurance authorities of this or any other state of the United States or any province of Canada, or to any other coverage the inclusion of which may be approved by the superintendent or any combination of such coverages. In the absence of such definition such term shall not include any coverage provided for such insured pursuant to any compulsory benefit statute, including any workers' compensation or employer's liability statute, or benefits provided by union welfare plans or by employer or employee benefit organizations.  [PL 1989, c. 502, Pt. A, §97 (AMD).]SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1973, c. 585, §12 (AMD). PL 1989, c. 502, §A97 (AMD).
24-A ME Rev Stat § 2725 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2725. Unpaid premiums

 §2725. Unpaid premiums There may be a provision as follows:Unpaid premium: Upon the payment of a claim under this policy, any premium then due and unpaid or covered by any note or written order may be deducted therefrom.  [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2726 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2726. Conformity with state statutes

 §2726. Conformity with state statutes There may be a provision as follows:Conformity with state statutes: Any provision of this policy which, on its effective date is in conflict with the statutes of the state in which the insured resides on such date is hereby amended to conform to the minimum requirements of such statutes.  [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2727 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2727. Illegal occupation

 §2727. Illegal occupation There may be a provision as follows:Illegal occupation: The insurer shall not be liable for any loss to which a contributing cause was the insured's commission of or attempt to commit a felony or to which a contributing cause was the insured's being engaged in an illegal occupation  [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2728 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2728. Intoxicants and narcotics

 §2728. Intoxicants and narcotics 1.  Intoxicants; narcotics.  A policy under this chapter may not include the following provision:"Intoxicants and narcotics. The insurer is not liable for any loss sustained or contracted in consequence of the insured's being intoxicated or under the influence of any narcotic or of any hallucinogenic drug, unless administered on the advice of a physician."  [PL 2007, c. 216, §1 (NEW).] 2.  Exemption.  This section does not apply to the following types of insurance or any combination of the following types of insurance: accidental injury, specified disease, hospital indemnity, dental, vision, disability income, long-term care, Medicare supplement or other limited benefit health insurance.   [PL 2007, c. 216, §1 (NEW).] SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 2007, c. 216, §1 (RPR).
24-A ME Rev Stat § 2729 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2729. Renewability

 §2729. Renewability Health insurance policies, other than accident insurance only policies, in which the insurer reserves the right to refuse renewal on an individual basis, shall provide in substance in a provision thereof or in an endorsement thereon or rider attached thereto that subject to the right to terminate the policy upon nonpayment of premium when due, such right to refuse renewal may not be exercised so as to take effect before the renewal date occurring on, or after and nearest, each policy anniversary (or in the case of lapse and reinstatement, at the renewal date occurring on, or after and nearest, each anniversary of the last reinstatement), and that any refusal of renewal shall be without prejudice to any claim originating while the policy is in force. The parenthetic reference to lapse and reinstatement may be omitted at the insurer's option.   [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2729-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2729-A. Limits on priority liens

 §2729-A. Limits on priority liens No policy for health insurance shall provide for priority over the insured of payment for any hospital, nursing, medical or surgical services or of any expenses paid or reimbursed under the policy, in the event the insured is entitled to receive payment reimbursement from any other person as a result of legal action or claim, except as provided herein.   [PL 1975, c. 471, §1 (NEW).]A policy may contain a provision that allows such payments, if that provision is approved by the superintendent, and if that provision requires the prior written approval of the insured and allows such payments only on a just and equitable basis and not on the basis of a priority lien. A just and equitable basis shall mean that any factors that diminish the potential value of the insured's claim shall likewise reduce the share in the claim for those claiming payment for services or reimbursement. Such factors shall include, but are not limited to:   [PL 1975, c. 471, §1 (NEW).]1.  Legal defenses.  Questions of liability and comparative negligence or other legal defenses;   [PL 1975, c. 471, §1 (NEW).] 2.  Exigencies of trial.  Exigencies of trial that reduce a settlement or award in order to resolve the claim; and   [PL 1975, c. 471, §1 (NEW).] 3.  Limits of coverage.  Limits on the amount of applicable insurance coverage that reduce the claim to an amount recoverable by the insured.   [PL 1975, c. 471, §1 (NEW).] In the event of a dispute as to the application of any such provision or the amount available for payment to those claiming payment for services or reimbursement, the dispute shall be determined if the action is pending, before the court in which it is pending; or if no action is pending, by filing an action in any court for determination of the dispute.   [PL 1975, c. 471, §1 (NEW).]SECTION HISTORY PL 1975, c. 471, §1 (NEW).
24-A ME Rev Stat § 2730 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2730. Order of certain provisions

 §2730. Order of certain provisions The provisions which are the subject of sections 2704 to 2716, and 2718 to 2728, or any corresponding provisions which are used in lieu thereof in accordance with such sections shall be printed in the consecutive order of the provisions in such 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.   [PL 1969, c. 177, §47 (AMD).]SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1969, c. 177, §47 (AMD).
24-A ME Rev Stat § 2731 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2731. Third party ownership

 §2731. Third party ownership The word "insured", as used in this chapter, shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under such a policy to any indemnities, benefits and rights provided therein.   [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2731-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2731-A. "Medically necessary mastectomy surgery" defined (REPEALED)

 §2731-A. "Medically necessary mastectomy surgery" defined (REPEALED)SECTION HISTORY PL 1991, c. 333, §1 (NEW). PL 1995, c. 295, §2 (RP).
24-A ME Rev Stat § 2732 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2732. Requirements of other jurisdictions

 §2732. Requirements of other jurisdictions 1.  Any policy of a foreign or alien insurer, when delivered or issued for delivery to any person in this State, may contain any provision which is not less favorable to the insured or the beneficiary than the provisions of this chapter and which is prescribed or required by the law of the state or country under which the insurer is organized.   [PL 1969, c. 132, §1 (NEW).] 2.  Any policy of a domestic insurer may, when issued for delivery in any other state or country, contain any provision permitted or required by the laws of such other state or country.   [PL 1969, c. 132, §1 (NEW).] SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2733 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2733. Policies issued for delivery in another state

 §2733. Policies issued for delivery in another state If any policy is issued by a domestic insurer for delivery to a person residing in another state, and if the insurance superintendent or corresponding public official of such other state has informed the superintendent that any such policy is not subject to approval or disapproval by such official, the superintendent may by ruling require that the policy meet the standards set forth in sections 2703 to 2732.   [PL 1973, c. 585, §12 (AMD).]SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1973, c. 585, §12 (AMD).
24-A ME Rev Stat § 2734 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2734. Conforming to statute

 §2734. Conforming to statute 1.  No policy provision which is not subject to this chapter shall make a policy, or any portion thereof, less favorable in any respect to the insured or the beneficiary than the provisions thereof which are subject to this chapter.   [PL 1969, c. 132, §1 (NEW).] 2.  A policy delivered or issued for delivery to any person in this State in violation of this chapter shall be held valid but shall be construed as provided in this chapter. When any provision in a policy subject to this chapter is in conflict with any provision of this chapter, the rights, duties, and obligations of the insurer, the insured and the beneficiary shall be governed by the provisions of this chapter.   [PL 1969, c. 132, §1 (NEW).] SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2735 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2735. Age limit

 §2735. Age limit If any such policy contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective, and if such date falls within a period for which premium is accepted by the insurer or if the insurer accepts a premium after such date, the coverage provided by the policy will continue in force, subject to any right of termination, until the end of the period for which premium has been accepted. In the event the age of the insured has been misstated and if, according to the correct age of the insured, the coverage provided by the policy would not have become effective, or would have ceased prior to the acceptance of such premium or premiums, then the liability of the insurer shall be limited to the refund, upon request, of all premiums paid for the period not covered by the policy.   [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2735-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2735-A. Notice of rate filing and rate increase

 §2735-A. Notice of rate filing and rate increase 1.  Notice of rate filing or rate increase on existing policies.  An insurer offering individual health plans as defined in section 2736-C must provide written notice by first class mail of a rate filing to all affected policyholders at least 60 days before the effective date of any proposed increase in premium rates or any proposed rating formula, classification of risks or modification of any formula or classification of risks. Except as otherwise provided in section 2736‑C, subsection 2‑B, the notice must also inform policyholders of their right to request a hearing pursuant to section 229. The notice must show the proposed rate and, unless otherwise provided in section 2736‑C, subsection 2‑B, state that the rate is subject to regulatory approval. Except as otherwise provided in section 2736‑C, subsection 2‑B, the superintendent may not take final action on a rate filing until 40 days after the date notice is mailed by an insurer. An increase in premium rates may not be implemented until 60 days after the notice is provided or until the effective date under section 2736, whichever is later.   [PL 2011, c. 364, §1 (AMD).] 1-A.  Notice of rate filings or rate increase on existing policies renewed in calendar year 2006.   [PL 2005, c. 400, Pt. A, §1 (NEW); MRSA T. 24-A §2735-A, sub-§1-A (RP).] 2.  Notice of rate increase on new business.  When an insurer offering individual health plans as defined in section 2736-C quotes a rate for new business, it must disclose any rate increase that the insurer anticipates implementing within the following 90 days. If the quote is in writing, the disclosure must also be in writing. If the increase is pending approval at the time of notice, the disclosure must include the proposed rate and state that it is subject to regulatory approval. If disclosure required by this subsection is not provided, an increase may not be implemented until at least 90 days after the date the quote is provided or the effective date under section 2736, whichever is later.   [PL 2001, c. 432, §4 (NEW).] 3.  Notice of rate increase on new business for calendar year 2006.   [PL 2005, c. 400, Pt. A, §1 (NEW); MRSA T. 24-A §2735-A, sub-§3 (RP).] SECTION HISTORY PL 2001, c. 432, §4 (NEW). PL 2005, c. 400, §A1 (AMD). PL 2009, c. 244, Pt. C, §4 (AMD). PL 2011, c. 364, §1 (AMD).