reglab/housing_qa huggingface dataset:
VA Code § 38.2-3566 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35.1 - Health Carrier Internal Appeal Process and External Review|§ 38.2-3566. Approval of independent review organizations

A. Each independent review organization that wishes to be eligible to conduct external reviews shall submit an application to the Commission for approval or reapproval. The Commission may charge a reasonable fee for initial approval and each reapproval.B. The Commission shall approve independent review organizations that meet the minimum qualifications to conduct external reviews. Such approval is not subject to the Virginia Public Procurement Act (§ 2.2-4300 et seq.).C. An independent review organization is eligible for approval if it is accredited by a nationally recognized private accrediting entity that the Commission has determined has standards that are equivalent to or at least meet the minimum qualifications for independent review organizations.D. An approval or reapproval is effective for two years, unless the Commission determines before its expiration that the independent review organization is not satisfying the minimum qualifications or its decisions have been consistently unclear or incomplete. Whenever the Commission determines that an independent review organization has lost its accreditation or does not meet the requirements of this subsection, the Commission shall terminate the approval of the independent review organization and remove it from the list of independent review organizations approved to conduct external reviews.E. The Commission shall maintain and periodically update a list of approved independent review organizations.F. The assignment by the Commission of an approved independent review organization shall be done on a random basis, taking into consideration the nature of the health care service or treatment.2011, c. 788.
VA Code § 38.2-3567 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35.1 - Health Carrier Internal Appeal Process and External Review|§ 38.2-3567. Independent review organizations to be held harmless

No independent review organization or clinical reviewer working on behalf of an independent review organization or an employee, agent, or contractor of an independent review organization shall be liable in damages to any person for any opinions rendered or acts or omissions performed within the scope of the organization's or person's duties under the law during or upon completion of an external review, unless the opinion was rendered or act or omission performed in bad faith or involved gross negligence.2011, c. 788.
VA Code § 38.2-3568 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35.1 - Health Carrier Internal Appeal Process and External Review|§ 38.2-3568. External review reporting requirements

A. An independent review organization shall maintain written records, in the aggregate by state and by health carrier, on all external review requests and external reviews conducted during each calendar year. Each independent review organization shall submit a report to the Commission. The report shall be submitted to the Commission by April 1 of the following calendar year. The report shall include in the aggregate by state, and for each health carrier: the total number of requests for external review; the number of requests for external review resolved and, of those resolved, the number upholding the adverse determination or final adverse determination, and the number reversing the adverse determination or final adverse determination; the average length of time for resolution; a summary of the types of coverages or cases for which an external review was sought; the number of external reviews that were terminated as the result of a reconsideration by the health carrier; and any other information the Commission may request or require. The independent review organization shall retain required written records for at least three years.B. Each health carrier shall maintain written records, in the aggregate by state and for each type of health benefit plan offered, on all requests for external review. Each health carrier shall submit a report to the Commission. The report shall be submitted to the Commission by April 1 of the following calendar year. The report shall include in the aggregate by state, and by type of health benefit plan: the total number of requests for external review, the number of requests determined eligible for external review, the number of external reviews completed, and any other information the Commission may request or require. The health carrier shall retain required written record for at least three years.2011, c. 788.
VA Code § 38.2-3569 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35.1 - Health Carrier Internal Appeal Process and External Review|§ 38.2-3569. Funding of external review

The health carrier against which a request for an external review is filed shall pay the cost incurred by the independent review organization in conducting the external review.2011, c. 788.
VA Code § 38.2-3570 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35.1 - Health Carrier Internal Appeal Process and External Review|§ 38.2-3570. Disclosure requirements

Each health carrier shall include a description of the external review procedures in or attached to the policy, certificate, membership booklet, outline of coverage, or other evidence of coverage it provides to covered persons. The description shall include a statement that informs the covered person of his right to file a request for an external review of an adverse determination or final adverse determination with the Commission. The statement shall explain that external review is available when the adverse determination or final adverse determination involves an issue of medical necessity, appropriateness, health care setting, level of care, or effectiveness. The statement shall include the telephone number and address of the Commission. The statement shall inform the covered person that, when filing a request for an external review, the covered person will be required to authorize the release of any medical records of the covered person that may be required to be reviewed for the purpose of reaching a decision on the external review.2011, c. 788.
VA Code § 38.2-3571 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35.1 - Health Carrier Internal Appeal Process and External Review|§ 38.2-3571. Regulations

Pursuant to the authority granted by § 38.2-223, the Commission may adopt such rules and regulations as it may deem necessary to implement this chapter.2011, c. 788.
VA Code § 38.2-3600 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 36 - Medicare Supplement Policies|§ 38.2-3600. Medicare supplement policy; definition

Medicare supplement policy means an individual or group accident and sickness insurance policy or certificate, or a health maintenance organization subscription contract or evidence of coverage, issued or issued for delivery in this Commonwealth which is (i) designed primarily to supplement Medicare by providing benefits for payment of hospital, medical or surgical expenses, or (ii) advertised, marketed or otherwise purported to be a supplement to Medicare.For group policies, the term does not include a policy or contract of one or more employers or labor organizations, or of the trustees of a fund established by one or more employers or labor organizations, or a combination of employees and labor organizations, for employees, former employees, or a combination of employees and labor organizations or for members or former members, or combination thereof, of the labor organizations.1979, c. 726, § 38.1-362.7; 1986, c. 562; 1992, c. 225; 1996, c. 11.
VA Code § 38.2-3601 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 36 - Medicare Supplement Policies|§ 38.2-3601. Medicare supplement policies; minimum return for group policies generally

Group Medicare supplement policies shall be expected to return to policyholders in the form of aggregate benefits at least seventy-five percent of the aggregate amount of premiums collected.1981, c. 575, § 38.1-362.8:1; 1986, c. 562.
VA Code § 38.2-3603 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 36 - Medicare Supplement Policies|§ 38.2-3603. Same; minimum return for individual policies

Medicare supplement policies sold on an individual basis shall be expected to return to policyowners in the form of aggregate benefits at least sixty-five percent of the aggregate amount of premiums collected.1981, c. 575, § 38.1-362.8:3; 1986, c. 562; 1991, c. 120.
VA Code § 38.2-3604 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 36 - Medicare Supplement Policies|§ 38.2-3604. Free look notice required

Notwithstanding the provisions of § 38.2-3502, Medicare supplement policies shall have printed on the policy a notice stating substantially: "RIGHT TO RETURN POLICY WITHIN THIRTY DAYS. If for any reason you are not satisfied with your policy you may return this policy to the company within thirty days of the date you received it and the premium paid will be promptly refunded."A policy returned pursuant to the notice shall be void upon the mailing or delivery of the policy to the insurer.Nothing in this section shall prohibit an insurer from extending the right to examine period to more than thirty days if the period is specified in the policy.1980, c. 204, § 38.1-362.13; 1981, c. 575; 1986, c. 562; 1989, c. 151.
VA Code § 38.2-3605 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 36 - Medicare Supplement Policies|§ 38.2-3605. Coverage of preexisting conditions; Medicare supplement policies

Notwithstanding subdivision 2 (b) of § 38.2-3503 or the provisions of § 38.2-3514.1, an insurer that issues a Medicare supplement policy shall not deny a claim for losses incurred more than six months from the effective date of coverage on the grounds that a condition existed prior to the effective date of coverage regardless of the application form used. Except as so provided, the policy or contract shall not include wording that would permit a defense based upon preexisting conditions.1980, c. 204, § 38.1-362.15; 1981, c. 575; 1986, c. 562; 1995, c. 522.
VA Code § 38.2-3606 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 36 - Medicare Supplement Policies|§ 38.2-3606. Outline of coverage

Pursuant to the authority granted in § 38.2-223, the Commission may issue rules and regulations that may (i) require that an outline of coverage for Medicare supplement policies be delivered to the insured at the time the application is made and (ii) prescribe the format and content of the outline of coverage.1980, c. 204, § 38.1-362.16; 1986, c. 562; 1996, c. 11.
VA Code § 38.2-3607 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 36 - Medicare Supplement Policies|§ 38.2-3607. Group or individual Medicare supplement policies; minimum standards

A. The provisions of §§ 38.2-3418.1, 38.2-3604, 38.2-3605, 38.2-3606 and 38.2-3516 through 38.2-3520 shall be applicable to group Medicare supplement policies. The term "policy" as used in this article shall include a certificate issued under a group Medicare supplement policy which has been delivered or issued for delivery in this Commonwealth.B. The provisions of § 38.2-3418.1 shall be applicable to individual Medicare supplement policies.C. No Medicare supplement policy or certificate in force in this Commonwealth shall contain benefits that duplicate benefits provided by Medicare.1981, c. 575, § 38.1-362.17; 1986, c. 562; 1989, c. 646; 1996, c. 11.
VA Code § 38.2-3608 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 36 - Medicare Supplement Policies|§ 38.2-3608. Regulations establishing minimum standards

A. The Commission may issue regulations to establish minimum standards for payment of claims under Medicare supplement policies and for marketing practices, compensation arrangements, requirements for loss ratio refunds or credits, Medicare select policies and certificates, and reporting practices of insurers providing such policies.B. The Commission may revise or amend such regulations and may increase the scope of the regulations only to the extent necessary to maintain federal approval of the Commonwealth's program for regulation of Medicare supplement insurance pursuant to the requirements established by the United States Department of Health and Human Services.C. The Commission shall annually advise the standing committees of the General Assembly having jurisdiction over insurance matters of revisions and amendments made pursuant to subsection B.1989, c. 151; 1990, c. 268; 1992, c. 225; 1996, c. 11.
VA Code § 38.2-3609 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 36 - Medicare Supplement Policies|§ 38.2-3609. Insurer to file copy of advertisement with Commission

Every insurer, health service plan or health maintenance organization providing Medicare supplement insurance or benefits in this Commonwealth shall file with the Commission a copy of any Medicare supplement advertisement intended for use in this Commonwealth whether through written, radio or television medium.1989, c. 151.
VA Code § 38.2-3610 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 36 - Medicare Supplement Policies|§ 38.2-3610. Medicare supplement policies for persons eligible by reason of disability

A. An insurer, health services plan, or health maintenance organization issuing Medicare supplement policies or certificates in the Commonwealth, including policies or certificates issued on an individual or group basis or through a group trust, shall offer the opportunity of enrolling in at least one of its issued Medicare supplement policies or certificates to any individual who resides in the Commonwealth, is under 65 years of age, is eligible for Medicare by reason of disability, as defined by 42 U.S.C. § 426(b), and is enrolled in Medicare Part A and B, or will be so enrolled by the effective date of coverage. Such Medicare supplement policies or certificates shall be issued on a guaranteed renewable basis under which the insurer shall be required to continue coverage as long as premiums are paid on the policy or certificate. Such Medicare supplement policies or certificates shall be offered:1. Upon the request of the individual during the six-month period beginning with the first month in which the individual is eligible for Medicare by reason of a disability. For those persons who are retroactively enrolled in Medicare Part B due to a retroactive eligibility decision made by the Social Security Administration, the application must be submitted within a six-month period beginning with the month in which the person receives notification of the retroactive eligibility decision; or2. Upon the request of the individual during the 63-day period following voluntary or involuntary termination of coverage under a group health plan.B. The six-month period to enroll in a Medicare supplement policy or certificate for an individual who is under 65 years of age and is eligible for Medicare by reason of disability and otherwise eligible under subsection A and first enrolled in Medicare Part B before January 1, 2021, shall begin on January 1, 2021.C. A Medicare supplement policy or certificate issued to an individual under subsection A shall not exclude benefits based on a preexisting condition if the individual has a continuous period of creditable coverage of at least six months as of the effective date of coverage.D. An insurer may develop premium rates specific to the class of individuals described in subsection A.E. For purposes of this section, "creditable coverage" and "group health plan" have the same meanings ascribed to the terms in § 38.2-3431.2020, c. 1161.
VA Code § 38.2-3717 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 37.1 - Credit Life Insurance and Credit Accident and Sickness Insurance|§ 38.2-3717. Scope

All life insurance and all accident and sickness insurance issued or sold in connection with loans or other credit transactions shall be subject to the provisions of this chapter except:1. Such insurance issued in connection with a loan or other credit transaction of more than ten years duration;2. Such insurance written in connection with a credit transaction that is:a. Secured by a first mortgage or deed of trust; andb. Made to finance the purchase of real property or the construction of a dwelling thereon, or to refinance a prior credit transaction made for such a purpose;3. Where the issuance of such insurance is an isolated transaction on the part of the insurer not related to an agreement or a plan for insuring debtors of the creditor.1960, c. 67, § 38.1-482.1; 1972, c. 527, § 38.2-3700; 1982, c. 223; 1986, c. 562; 1990, c. 236; 1992, c. 586.
VA Code § 38.2-3718 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 37.1 - Credit Life Insurance and Credit Accident and Sickness Insurance|§ 38.2-3718. Definitions

For the purposes of this chapter:"Commission" means the State Corporation Commission."Creditor" means the lender of money or vendor or lessor of goods, services, or property, rights or privileges, for which payment is arranged through a credit transaction, or any successor to the right, title or interest of any such lender, vendor, or lessor and an affiliate, associate or subsidiary of any of them or any other person in any way associated with them."Credit transaction" means any transaction by the terms of which the repayment of money loaned or loan commitment made, or payment for goods, services or properties sold or leased is to be made at a future date or dates."Critical period coverage" means a death benefit or an accident and sickness insurance benefit in which the benefit is equal to a specified number of monthly payments or the remaining payments on the loan, whichever is less."Debtor" means a borrower of money or a purchaser or lessee of goods, services, property, rights or privileges for which payment is arranged through a credit transaction."Form" means any policy, contract, rider, endorsement, amendment, certificate, application, enrollment request, or notice of proposed insurance pertaining to credit life insurance or credit accident and sickness insurance. For the purpose of administering §§ 38.2-3726, 38.2-3727 and 38.2-3730, (i) the earned premiums and incurred claims of all credit accident and sickness insurance forms issued in this Commonwealth with the same waiting period will be combined to determine the loss ratio in this Commonwealth regardless of differences in the contractual terms of each form and, (ii) the earned premiums and incurred claims of all credit life insurance forms issued in this Commonwealth will be combined to determine the loss ratio in this Commonwealth regardless of differences in the contractual terms or coverage types."Indebtedness" means the total amount payable by a debtor to a creditor in connection with a loan or other credit transaction."Open-end credit" means credit extended under an agreement in which:1. The creditor reasonably contemplates repeated transactions;2. The creditor imposes a finance charge from time to time on an outstanding unpaid balance; and3. The amount of credit that may be extended to the debtor during the term of the agreement (up to any limit set by the creditor) is generally made available to the extent that any outstanding balance is repaid."Truncated coverage" means a credit life insurance benefit or a credit accident and sickness insurance benefit with a term of insurance coverage that is less than the term of the loan.1960, c. 67, § 38.1-482.2; 1982, c. 223, § 38.2-3701; 1986, c. 562; 1992, c. 586.
VA Code § 38.2-3719 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 37.1 - Credit Life Insurance and Credit Accident and Sickness Insurance|§ 38.2-3719. Forms of credit life insurance and credit accident and sickness insurance

A. Credit life insurance and credit accident and sickness insurance shall be issued only in the following forms:1. Individual policies of life insurance issued to debtors on the term plan;2. Individual policies of accident and sickness insurance issued to debtors on a term plan or disability benefit provisions in individual policies of credit life insurance;3. Group policies of life insurance issued to creditors providing insurance upon the lives of debtors on the term plan;4. Group policies of accident and sickness insurance issued to creditors on a term plan insuring debtors or disability benefit provisions in group credit life insurance policies to provide such coverage.B. A policy of group credit life insurance or group credit accident and sickness insurance may be issued to a creditor or its parent holding company or to a trustee, trustees or agent designated by two or more creditors, which creditor, holding company, affiliate, trustee, trustees or agent shall be deemed the policyholder, to insure debtors of the creditor or creditors, subject to the following requirements:1. The debtors eligible for insurance under the policy shall be all of the debtors of the creditor or creditors, or all of any class or classes of the group. The policy may provide that the term "debtors" shall include (i) borrowers of money or purchasers of goods, services or property for which payment is arranged through a credit transaction; (ii) the debtors of one or more subsidiary corporations; and (iii) the debtors of one or more affiliated corporations, proprietors or partnerships if the business of the policyholder and of such affiliated corporations, proprietors or partnerships is under common control.2. The premium for the policy shall be paid by the policyholder, either from the creditor's funds, or from charges collected from the insured debtors, or from both. Except as provided in subdivision 3 of this subsection, a policy on which no part of the premium is to be derived from the collection of such identifiable charges must insure all eligible debtors.3. Credit life insurance and credit accident and sickness insurance must be offered to all eligible debtors of a creditor except those for whom evidence of individual insurability is not satisfactory to the insurer.Code 1950, § 38-428(6); 1950, p. 1001; 1952, c. 317, § 38.1-480; 1960, c. 272, § 38.2-3702; 1962, c. 154; 1975, c. 69; 1982, c. 223, § 38.1-482.3:1; 1983, c. 182; 1986, c. 562; 1987, c. 520; 1992, c. 586.
VA Code § 38.2-3720 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 37.1 - Credit Life Insurance and Credit Accident and Sickness Insurance|§ 38.2-3720. Amount of credit life insurance and credit accident and sickness insurance

A. Credit life insurance. 1. Where an indebtedness is repayable in substantially equal installments, the amount of credit life insurance shall at no time exceed the actual amount of unpaid indebtedness.2. Notwithstanding the provisions of subdivision A 1, insurance on agricultural credit transaction commitments not exceeding one year in duration may be written up to the amount of the loan commitment, on a nondecreasing or level-term plan.3. Notwithstanding the provisions of subdivision A 1 of this subsection, or any other subsection, insurance on educational credit transaction commitments may be written for the amount of the loan commitment.B. Credit accident and sickness insurance. -- The total amount of periodic indemnity payable by credit accident and sickness insurance in the event of disability, as defined in the policy, shall not exceed the aggregate of the periodic scheduled unpaid installments of the indebtedness; and the amount of each periodic indemnity payment shall not exceed the original indebtedness divided by the number of periodic installments.C. Maximum aggregate provisions. -- A provision in a credit life insurance or credit accident and sickness insurance policy or certificate issued thereunder that sets a maximum limit on total benefits payable thereunder shall apply only to that specific indebtedness for which such policy or certificate was issued.D. The amount of credit life insurance on an indebtedness of any debtor shall not exceed $70,000 with any one insurance company.1960, c. 67, § 38.1-482.4; 1972, c. 527, §§ 38.2-3703, 38.2-3704; 1982, c. 223; 1986, c. 562; 1992, c. 586.