reglab/housing_qa huggingface dataset:
MD. Insurance Code Ann. §  15-209 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 2 - Individual Health Insurance Policy Forms and Provisions|Section 15-209 - Grace Period

    (a)    (1)    Subject to subsection (b) of this section, each policy of health insurance shall contain the following provision:    “Grace period: A grace period of ........ (insert a number not less than ‘7’ days for weekly premium policies, ‘10’ days for monthly premium policies and ‘31’ days for all other policies) days will be granted for the payment of each premium falling due after the first premium, during which grace period this policy shall continue in force.”        (2)    A policy shall provide a grace period of 31 days if the policy:            (i)    allows the policyholder to choose any one of two or more modes of premium payment by remitting an amount stated in the policy for that particular mode of payment; and            (ii)    does not require a formal request by the policyholder to change the mode of premium payment.    (b)    A policy in which the insurer reserves the right to refuse renewal shall state the following provision at the beginning of the provision set forth in subsection (a)(1) of this section:    “Unless not less than thirty days prior to the premium due date the insurer has delivered to the insured or has mailed to his last address as shown by the records of the insurer written notice of its intention not to renew this policy beyond the period for which the premium has been accepted.”
MD. Insurance Code Ann. §  15-210 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 2 - Individual Health Insurance Policy Forms and Provisions|Section 15-210 - Reinstatement

    (a)    Each policy of health insurance shall contain the following provision:    “Reinstatement: If any renewal premium be not paid within the time granted the insured for payment, a subsequent acceptance of premium by the insurer or by any insurance producer duly authorized by the insurer to accept such premium, without requiring in connection therewith an application for reinstatement, shall reinstate the policy; provided, however, that if the insurer or such insurance producer requires an application for reinstatement and issues a conditional receipt for the premium tendered, the policy will be reinstated upon approval of such application by the insurer or, lacking such approval, upon the forty-fifth (45th) day following the date of such conditional receipt unless the insurer has previously notified the insured in writing of its disapproval of such application. The reinstated policy shall cover only loss resulting from such accidental injury as may be sustained after the date of reinstatement and loss due to such sickness as may begin more than ten days after such date. In all other respects the insured and insurer shall have the same rights thereunder as they had under the policy immediately before the due date of the defaulted premium, subject to any provisions endorsed hereon or attached hereto in connection with the reinstatement. Any premium accepted in connection with a reinstatement shall be applied to a period for which premium has not been previously paid, but not to any period more than sixty (60) days prior to the date of reinstatement.”    (b)    The last sentence of the provision set forth in subsection (a) of this section may be omitted from a policy that the insured may continue in effect subject to its terms by the timely payment of premiums:        (1)    until the insured is at least 50 years old; or        (2)    if the policy is issued after the insured is 44 years old, for at least 5 years after its date of issue.
MD. Insurance Code Ann. §  15-211 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 2 - Individual Health Insurance Policy Forms and Provisions|Section 15-211 - Notice of Claim

    (a)    Each policy of health insurance shall contain the following provision:    “Notice of claim: Written notice of claim must be given to the insurer within twenty (20) days after the occurrence or commencement of any loss covered by the policy, or as soon thereafter as is reasonably possible. Notice given by or on behalf of the insured or the beneficiary to the insurer at .......... (insert the location of such office as the insurer may designate for the purpose), or to any authorized insurance producer of the insurer, with information sufficient to identify the insured, shall be deemed notice to the insurer.”    (b)    In a policy that provides a loss-of-time benefit that may be payable for at least 2 years, an insurer may insert the following provision between the first and second sentences of the provision set forth in subsection (a) of this section:    “Subject to the qualifications set forth below, if the insured suffers loss of time on account of disability for which indemnity may be payable for at least two years, he shall, at least once in every six (6) months after having given notice of the claim, give to the insurer notice of continuance of the disability, except in the event of legal incapacity. The period of six (6) months following any filing of proof by the insured or any payment by the insurer on account of such claim or any denial of liability in whole or in part by the insurer shall be excluded in applying this provision. Delay in the giving of such notice shall not impair the insured’s right to any indemnity which would otherwise have accrued during the period of six (6) months preceding the date on which such notice is actually given.”
MD. Insurance Code Ann. §  15-212 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 2 - Individual Health Insurance Policy Forms and Provisions|Section 15-212 - Claim Forms

    Each policy of health insurance shall contain the following provision:    “Claim forms: The insurer, upon receipt of a notice of claim, will furnish to the claimant such forms as are usually furnished by it for filing proofs of loss. If such forms are not furnished within fifteen days after the giving of such notice the claimant shall be deemed to have complied with the requirements of this policy as to proof of loss upon submitting, within the time fixed in the policy for filing proofs of loss, written proof covering the occurrence, the character and the extent of the loss for which claim is made.”
MD. Insurance Code Ann. §  15-213 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 2 - Individual Health Insurance Policy Forms and Provisions|Section 15-213 - Proofs of Loss

    Except as provided in § 12–102(c) of this article, each policy of health insurance shall contain the following provision:    “Proofs of loss: Written proof of loss must be furnished to the insurer at its said office in case of claim for loss for which this policy provides any periodic payment contingent upon continuing loss within ninety (90) days after the termination of the period for which the insurer is liable and in case of claim for any other loss within ninety (90) days after the date of such loss. Failure to furnish such proof within the time required shall not invalidate nor reduce any claim if it was not reasonably possible to give proof within such time, provided such proof is furnished as soon as reasonably possible and in no event, except in the absence of legal capacity, later than one (1) year from the time proof is otherwise required.”
MD. Insurance Code Ann. §  15-214 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 2 - Individual Health Insurance Policy Forms and Provisions|Section 15-214 - Time of Payment of Claims

    (a)    Each policy of health insurance shall contain the following provision:    “Time of payment of claims: Indemnities payable under this policy for any loss other than loss for which this policy provides any periodic payment, will be paid immediately upon receipt of due written proof of such loss. Subject to due written proof of loss, all accrued indemnities for loss for which this policy provides periodic payment will be paid ........ (insert period for payment which must not be less frequently than monthly) and any balance remaining unpaid upon the termination of liability will be paid immediately upon receipt of due written proof.”    (b)    A policy is considered to provide for periodic payment for loss only if the policy contains a specific statement to that effect.
MD. Insurance Code Ann. §  15-215 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 2 - Individual Health Insurance Policy Forms and Provisions|Section 15-215 - Payment of Claims

    (a)    Each policy of health insurance shall contain the following provision:    “Payment of claims: Indemnity for loss of life will be payable in accordance with the beneficiary designation and the provisions respecting such payment which may be prescribed herein and effective at the time of payment. If no such designation or provision is then effective, such indemnity shall be payable to the estate of the insured. Any other accrued indemnities unpaid at the insured’s death may, at the option of the insurer, be paid either to such beneficiary or to such estate. All other indemnities will be payable to the insured.”    (b)    (1)    At the option of the insurer, a policy may include either or both of the provisions set forth in paragraphs (2) and (3) of this subsection with the provision set forth in subsection (a) of this section.        (2)    “If any indemnity of this policy shall be payable to the estate of the insured, or to an insured or beneficiary who is under eighteen years of age or otherwise not competent to give a valid release, the insurer may pay such indemnity, up to an amount not exceeding $ .......... (insert an amount which shall not exceed $1,000), to any relative by blood or connection by marriage of the insured or beneficiary who is deemed by the insurer to be equitably entitled thereto. Any payment made by the insurer in good faith pursuant to this provision shall fully discharge the insurer to the extent of such payment.”        (3)    “Subject to any written direction of the insured in the application or otherwise all or a portion of any indemnities provided by this policy on account of hospital, nursing, medical or surgical services may, at the insurer’s option and unless the insured requests otherwise in writing not later than the time of filing proof of such loss, be paid directly to the hospital or person rendering such services; but it is not required that the service be rendered by a particular hospital or person.”
MD. Insurance Code Ann. §  15-216 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 2 - Individual Health Insurance Policy Forms and Provisions|Section 15-216 - Physical Examinations and Autopsy

    Each policy of health insurance shall contain the following provision:    “Physical examinations and autopsy: The insurer at its own expense shall have the right and opportunity to examine the person of the insured when and as often as it may reasonably require during the pendency of a claim hereunder and to make an autopsy in case of death where it is not forbidden by law.”
MD. Insurance Code Ann. §  15-217 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 2 - Individual Health Insurance Policy Forms and Provisions|Section 15-217 - Time for Bringing Legal Actions

    Each policy of health insurance shall contain the following provision:    “Legal actions: No action at law or in equity shall be brought to recover on this policy prior to the expiration of sixty days after written proof of loss has been furnished in accordance with the requirements of this policy. No such action shall be brought after the expiration of three (3) years after the written proof of loss is required to be furnished.”
MD. Insurance Code Ann. §  15-218 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 2 - Individual Health Insurance Policy Forms and Provisions|Section 15-218 - Change of Beneficiary

    (a)    Subject to subsection (b) of this section, each policy of health insurance shall contain the following provision:    “Change of beneficiary: Unless the insured makes an irrevocable designation of beneficiary, the right to change a beneficiary is reserved to the insured and the consent of the beneficiary or beneficiaries shall not be requisite to surrender or assignment of this policy or to any change of beneficiary or beneficiaries, or to any other changes in this policy.”    (b)    An insurer may choose to omit from the provision set forth in subsection (a) of this section the clause:    “Unless the insured makes an irrevocable designation of beneficiary”.
MD. Insurance Code Ann. §  15-219 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 2 - Individual Health Insurance Policy Forms and Provisions|Section 15-219 - Change of Occupation

    A policy of health insurance may contain the following provision:    “Change of occupation: If the insured be injured or contract sickness after having changed his occupation to one classified by the insurer as more hazardous than that stated in this policy or while doing for compensation anything pertaining to an occupation so classified, the insurer will pay only such portion of the indemnities provided in this policy as the premium paid would have purchased at the rates and within the limits fixed by the insurer for such more hazardous occupation. If the insured changes his occupation to one classified by the insurer as less hazardous than that stated in this policy, the insurer, upon receipt of proof of such change of occupation, will reduce the premium rate accordingly, and will return the excess pro rata unearned premium from the date of change of occupation or from the policy anniversary date immediately preceding receipt of such proof, whichever is the more recent. In applying this provision, the classification of occupational risk and the premium rates shall be such as have been last filed by the insurer prior to the occurrence or the loss for which the insurer is liable or prior to date of proof of change in occupation with the state official having supervision of insurance in the state where the insured resided at the time this policy was issued; but if such filing was not required, then the classification of occupational risk and the premium rates shall be those last made effective by the insurer in such state prior to the occurrence of the loss or prior to the date of proof of change in occupation.”
MD. Insurance Code Ann. §  15-220 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 2 - Individual Health Insurance Policy Forms and Provisions|Section 15-220 - Misstatement of Age

    A policy of health insurance may contain the following provision:    “Misstatement of age: If the age of the insured has been misstated, all amounts payable under this policy shall be such as the premium paid would have purchased at the correct age.”
MD. Insurance Code Ann. §  15-221 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 2 - Individual Health Insurance Policy Forms and Provisions|Section 15-221 - Other Insurance With Insurer

    (a)    A policy of health insurance may contain the following provision:    “Other insurance in this insurer: If an accident or sickness or accident and sickness policy or policies previously issued by the insurer to the insured be in force concurrently herewith, making the aggregate indemnity for ........ (insert type of coverage or coverages) in excess of $ ........ (insert maximum limit of indemnity or indemnities) the excess insurance shall be void and all premiums paid for such excess shall be returned to the insured or to his estate.”    (b)    A policy of health insurance may substitute the following provision for the provision set forth in subsection (a) of this section:    “Insurance effective at any one time on the insured under a like policy or policies in this insurer is limited to the one such policy elected by the insured, his beneficiary or his estate, as the case may be, and the insurer will return all premiums paid for all other such policies.”
MD. Insurance Code Ann. §  15-222 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 2 - Individual Health Insurance Policy Forms and Provisions|Section 15-222 - Insurance With Other Insurers -- Expense Incurred Benefits

    (a)    A policy of health insurance may contain the following provision:    “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.”    (b)    The phrase “-- Expense incurred benefits” shall be added to the caption of the provision set forth in subsection (a) of this section if the provision is included in a policy that contains the policy provision set forth in § 15-223 of this subtitle.    (c)    (1)    A benefit provided for the insured under a compulsory benefit statute, including a workers’ compensation or employer’s liability statute, whether provided by a governmental unit or otherwise, shall be considered “other valid coverage” of which the insurer has had notice.        (2)    The insurer may include in the provision set forth in subsection (a) of this section a definition of “other valid coverage” if the definition:            (i)    is approved as to form by the Commissioner; and            (ii)    is limited to:                1.    coverage provided by organizations subject to regulation by insurance law or insurance authorities of this State, another state, or a province of Canada;                2.    coverage provided by hospital or medical service organizations; and                3.    any other coverage that the Commissioner may approve for inclusion.        (3)    Unless defined otherwise, “other valid coverage” does not include:            (i)    group insurance or automobile medical payments insurance;            (ii)    coverage provided by hospital or medical service organizations; or            (iii)    coverage provided by union welfare plans or by employer or employee benefit organizations.        (4)    “Other valid coverage” may not include third party liability coverage.
MD. Insurance Code Ann. §  15-223 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 2 - Individual Health Insurance Policy Forms and Provisions|Section 15-223 - Insurance With Other Insurers -- Other Benefits

    (a)    A policy of health insurance may contain the following provision:    “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.”    (b)    The phrase “-- Other benefits” shall be added to the caption of the provision set forth in subsection (a) of this section if the provision is included in a policy that contains the policy provision set out in § 15-222 of this subtitle.    (c)    (1)    A benefit provided for the insured under a compulsory benefit statute, including a workers’ compensation or employer’s liability statute, whether provided by a governmental unit or otherwise, shall be considered “other valid coverage” of which the insurer has had notice.        (2)    The insurer may include in the provision set forth in subsection (a) of this section a definition of “other valid coverage” if the definition:            (i)    is approved as to form by the Commissioner; and            (ii)    is limited to:                1.    coverage provided by organizations subject to regulation by insurance law or insurance authorities of this State, another state, or a province of Canada; and                2.    any other coverage the Commissioner may approve for inclusion.        (3)    Unless defined otherwise, “other valid coverage” does not include:            (i)    group insurance; or            (ii)    coverage provided by union welfare plans or by employer or employee benefit organizations.        (4)    “Other valid coverage” may not include third party liability coverage.