reglab/housing_qa huggingface dataset:
NE Code § 44-7310 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7310 - Standard review of adverse determinations.

44-7310.  Standard review of adverse determinations.(1) A health carrier shall establish written procedures for a standard review of an adverse determination. Review procedures shall be available to a covered person and to the provider acting on behalf of a covered person. For purposes of this section, covered person includes the representative of a covered person.(2) When reasonably necessary or when requested by the provider acting on behalf of a covered person, standard reviews shall be evaluated by an appropriate clinical peer or peers in the same or similar specialty as would typically manage the case being reviewed. The clinical peer shall not have been involved in the initial adverse determination.(3) For standard reviews the health carrier shall notify in writing both the covered person and the attending or ordering provider of the decision within fifteen working days after the request for a review. The written decision shall contain the provisions required in subsection (3) of section 44-7308.(4) In any case in which the standard review process does not resolve a difference of opinion between the health carrier and the covered person or the provider acting on behalf of the covered person, the covered person or the provider acting on behalf of the covered person may submit a written grievance, unless the provider is prohibited from filing a grievance by federal or other state law.Source   Laws 1998, LB 1162, § 75;  Laws 2013, LB147, § 21.
NE Code § 44-7312 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7312 - Health carrier violations; notice; hearing.

44-7312.  Health carrier violations; notice; hearing.If the director finds that any health carrier doing business in this state is engaging in any violation of the Health Carrier Grievance Procedure Act and that a proceeding in respect thereto would be in the public interest, the director shall issue and serve upon such health carrier a statement of the charges in that respect and a notice of hearing thereon, which notice shall set a hearing date not less than ten days from the date of the notice.Source  Laws 1998, LB 1162, § 77.
NE Code § 44-7313 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7313 - Violation; penalty.

44-7313.  Violation; penalty.If, after the hearing, the director finds a health carrier has violated the Health Carrier Grievance Procedure Act, the director shall reduce his or her findings to writing and shall issue and cause to be served upon the health carrier charged with the violation a copy of the findings and an order requiring the health carrier to cease and desist from engaging in the violation and the director may order any one or more of the following:(1) Payment of a monetary penalty of not more than one thousand dollars for each violation, not to exceed an aggregate penalty of thirty thousand dollars, unless the violation was committed flagrantly and in conscious disregard of the Health Carrier Grievance Procedure Act, in which case the penalty shall not be more than fifteen thousand dollars for each violation, not to exceed an aggregate penalty of one hundred fifty thousand dollars; and(2) Suspension or revocation of the health carrier's certificate of authority if the health carrier knew or reasonably should have known it was in violation of the act.Source  Laws 1998, LB 1162, § 78.
NE Code § 44-7314 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7314 - Violation of cease and desist order; penalty.

44-7314.  Violation of cease and desist order; penalty.Any health carrier who violates a cease and desist order of the director under section 44-7313 may after notice and hearing and upon order of the director be subject to:(1) A monetary penalty of not more than thirty thousand dollars for each violation, not to exceed an aggregate penalty of one hundred fifty thousand dollars; and(2) Suspension or revocation of the health carrier's certificate of authority.Source  Laws 1998, LB 1162, § 79.
NE Code § 44-7315 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7315 - Rules and regulations.

44-7315.  Rules and regulations.The director may adopt and promulgate rules and regulations to carry out the Health Carrier Grievance Procedure Act.Source  Laws 1998, LB 1162, § 80.
NE Code § 44-7401 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7401 - Act, how cited.

44-7401.  Act, how cited.Sections 44-7401 to 44-7410 shall be known and may be cited as the Unfair Discrimination Against Subjects of Abuse in Insurance Act.Source  Laws 1998, LB 1035, § 14.
NE Code § 44-7403 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7403 - Purpose of act.

44-7403.  Purpose of act.The purpose of the Unfair Discrimination Against Subjects of Abuse in Insurance Act is to prohibit unfair discrimination by insurers on the basis of abuse.Source  Laws 1998, LB 1035, § 16.
NE Code § 44-7404 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7404 - Applicability of act.

44-7404.  Applicability of act.The Unfair Discrimination Against Subjects of Abuse in Insurance Act applies to all insurers issuing, providing, delivering, arranging for, or renewing in this state any policy of insurance.Source  Laws 1998, LB 1035, § 17.
NE Code § 44-7405 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7405 - Subject of abuse; prohibited acts.

44-7405.  Subject of abuse; prohibited acts.An insurer shall not engage in an unfairly discriminatory act or practice against a subject of abuse.Source  Laws 1998, LB 1035, § 18.
NE Code § 44-7407 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7407 - Adverse effect on subject of abuse; explanation required.

44-7407.  Adverse effect on subject of abuse; explanation required.An insurer that takes an action that adversely affects a subject of abuse on the basis of a medical condition or on the basis of claims history or other underwriting information that the insurer knows or has reason to know is abuse-related shall explain the reason for its action to the applicant or insured in writing and shall be able to demonstrate that its action, and any applicable policy provision:(1) Does not treat abuse status as a medical condition or underwriting criterion;(2) Is otherwise permissible by law and applies in the same manner and to the same extent to all applicants and insureds with a similar medical condition or a similar claim or claims history without regard to whether the condition is or the claims are abuse-related; and(3) Except for claims actions, is based on a determination, made in conformance with sound actuarial principles or otherwise supported by actual or reasonably anticipated experience, that there is a correlation between the medical condition and a material increase in insurance risk.Source  Laws 1998, LB 1035, § 20.
NE Code § 44-7408 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7408 - Violation of act; unfair trade practice.

44-7408.  Violation of act; unfair trade practice.In addition to any other remedies available under the laws of this state, each violation of the Unfair Discrimination Against Subjects of Abuse in Insurance Act and any rules and regulations adopted and promulgated thereunder shall be an unfair trade practice in the business of insurance subject to the Unfair Insurance Trade Practices Act.Source  Laws 1998, LB 1035, § 21. Cross References  Unfair Insurance Trade Practices Act, see section 44-1521.
NE Code § 44-7409 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7409 - Rules and regulations.

44-7409.  Rules and regulations.The director may adopt and promulgate rules and regulations to carry out the Unfair Discrimination Against Subjects of Abuse in Insurance Act.Source  Laws 1998, LB 1035, § 22.
NE Code § 44-7410 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7410 - Applicability to actions on or after July 15, 1998.

44-7410.  Applicability to actions on or after July 15, 1998.The Unfair Discrimination Against Subjects of Abuse in Insurance Act applies to all actions taken on or after July 15, 1998, except as otherwise explicitly stated. Nothing in the act shall require an insurer to conduct a comprehensive search of its contract files existing on July 15, 1998, solely to determine which applicants or insureds are subjects of abuse.Source  Laws 1998, LB 1035, § 23.
NE Code § 44-7501 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7501 - Act, how cited.

44-7501.  Act, how cited.Sections 44-7501 to 44-7535 shall be known and may be cited as the Property and Casualty Insurance Rate and Form Act.Source  Laws 2000, LB 1119, § 1;  Laws 2001, LB 444, § 1;  Laws 2003, LB 216, § 18.
NE Code § 44-7502 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7502 - Purposes of act.

44-7502.  Purposes of act.The purposes of the Property and Casualty Insurance Rate and Form Act are:(1) To prohibit price-fixing agreements and other anticompetitive behavior by insurers;(2) To protect policyholders and the public against excessive rates and the adverse effects of inadequate or unfairly discriminatory rates;(3) To regulate insurance contracts so they: (a) Are not unjust, unfair, ambiguous, inconsistent, inequitable, misleading, deceptive, or contrary to public policy; (b) are not written so as to encourage the misrepresentation of coverage; (c) reasonably provide the general coverage for policies of that type; (d) comply with the provisions and the intent of the laws of this state; and (e) do not provide coverage contrary to the public interest;(4) To promote rates that reflect the benefits of competition;(5) To provide appropriate data reporting systems;(6) To provide regulatory oversight in the absence of competition;(7) To authorize essential cooperative action among insurers in the development of policy forms, prospective loss costs, and other information and to regulate such activity to prevent practices that tend to substantially lessen competition or create a monopoly; and(8) To promote the dissemination of price and other information to enable consumers to purchase insurance suitable for their needs and to foster competitive insurance markets.Source Laws 2000, LB 1119, § 2.
NE Code § 44-7503 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7503 - Competition and uniformity; construction of act.

44-7503.  Competition and uniformity; construction of act.Nothing in the Property and Casualty Insurance Rate and Form Act shall prohibit or discourage reasonable competition or prohibit or discourage uniformity in policy forms, rating systems, or underwriting practices except to the extent necessary to accomplish the purposes of the act. The act shall be liberally interpreted to carry into effect the purposes of the act.Source Laws 2000, LB 1119, § 3.
NE Code § 44-7505 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7505 - Applicability of act.

44-7505.  Applicability of act.(1) The Property and Casualty Insurance Rate and Form Act applies to any insurer holding a certificate of authority issued by the director to transact insurance business in this state for the lines of insurance specified in subdivisions (5) through (14) and (16) through (20) of section 44-201 and to any combination of any of the foregoing on risks or operations in this state.(2) The act does not apply to:(a) Reinsurance, except as provided in section 44-7525 for joint reinsurance pools;(b) Ocean marine insurance;(c) Rating systems for insurance against loss or damage to aircraft or against liability, other than workers' compensation and employers liability, arising out of the ownership, maintenance, or use of aircraft;(d) Rating systems or policy forms used by insurers to provide warranties or service contracts, or rating systems or policy forms used by insurers to provide coverage for the risk assumed by businesses that provide warranties or service contracts for their customers;(e) Rating systems or policy forms for financial guaranty insurance as defined in subdivision (19) of section 44-201, except that the act applies to financial guaranty coverage for loss of value for motor vehicles leased or sold on credit to private parties;(f) Rating systems for the lines of insurance specified in subdivisions (5), (7), and (18) of section 44-201 for insurance written by domestic assessment associations doing business under Chapter 44, article 8; and(g) Policy forms or rates for contracts of suretyship, except that policy forms and prospective loss costs developed or filed by advisory organizations are subject to the act.Source  Laws 2000, LB 1119, § 5;  Laws 2002, LB 1139, § 49.
NE Code § 44-7506 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7506 - Rating systems and prospective loss costs; filing required.

44-7506.  Rating systems and prospective loss costs; filing required.(1) All rating systems and prospective loss costs shall be filed with the director in accordance with section 44-7508, except that filings for the following shall be filed in accordance with sections 44-7510 and 44-7511:(a) Filings made by advisory organizations;(b) Medical professional liability insurance;(c) Insurance in noncompetitive markets as determined pursuant to section 44-7507;(d) Liability and physical damage coverages relating to the rental of private passenger automobiles on a nonfleet basis;(e) Insurance written by joint underwriting pools or joint reinsurance pools;(f) Insurance written in an assigned risk plan; and(g) Insurance covering risks of a personal nature written for business entities if the costs for the insurance are charged to individuals. This does not include coverage provided without a separate charge by business entities for their customers.(2)(a) If the director, after notice and hearing in accordance with the Administrative Procedure Act, finds that an insurer has made filings pursuant to section 44-7508 that have failed to meet the filing standards contained in that section with such frequency as to indicate a general business practice that disregards the requirements of that section, the director shall order that the insurer's filings be made subject to the requirements of sections 44-7510 and 44-7511.(b) Upon application by an insurer affected by an order issued pursuant to subdivision (2)(a) of this section, demonstrating that its filings made subsequent to the order have been in compliance with section 44-7508 without the need for the director to request that the original filings be amended, the director shall vacate such order. The director shall consider any such application within thirty days after its receipt for any order that has been in effect for more than nine months since its inception or since it was last reviewed by the director pursuant to an application by the insurer.(c) For insurers whose rating system filings that would otherwise be subject to this section have been made subject to the prior approval requirements of section 44-7511 through the application of this subsection, the percentage rating flexibilities provided in section 44-7509 shall apply to such rating system filings made by such insurers once the rating system filing has been approved pursuant to section 44-7511.Source  Laws 2000, LB 1119, § 6;  Laws 2005, LB 119, § 25.  Cross References  Administrative Procedure Act, see section 84-920.
NE Code § 44-7508.01 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7508.01 - Policy forms and related rules of attachment; filing; contents; failure to file; effect.

44-7508.01.  Policy forms and related rules of attachment; filing; contents; failure to file; effect.(1) All policy forms and related rules of attachment shall be filed with the director in accordance with section 44-7508.02, except that an insurer may at its option file policy forms and related rules of attachment in accordance with section 44-7513 and filings for the following shall be filed in accordance with section 44-7513:(a) Filings made by advisory organizations;(b) Workers' compensation and employers liability insurance;(c) Excess workers' compensation and employers liability insurance;(d) Medical professional liability insurance;(e) Insurance in noncompetitive markets as determined pursuant to section 44-7507;(f) Liability and physical damage coverages relating to the rental of private passenger automobiles on a nonfleet basis;(g) Insurance written by joint underwriting pools or joint reinsurance pools;(h) Insurance written in an assigned risk plan; and(i) Insurance covering risks of a personal nature written for business entities if the costs for the insurance are charged to individuals. This does not include coverage provided without a separate charge by business entities for their customers.(2)(a) If the director, after notice and hearing in accordance with the Administrative Procedure Act, finds that an insurer has made filings pursuant to section 44-7508.02 that have failed to meet the filing standards contained in such section with such frequency as to indicate a general business practice that disregards the requirements of such section or finds that the insurer committed one or more egregious acts relating to the filing standards, the director shall order that the insurer's filings be made subject to the requirements of section 44-7513.(b) Upon application by an insurer affected by an order issued pursuant to subdivision (2)(a) of this section demonstrating that its filings made subsequent to the order have been in compliance with section 44-7508.02 without the need for the director to request that the original filings be amended, the director may vacate such order. The director shall consider any such application within thirty days after its receipt for any order that has been in effect for more than nine months since its inception or since it was last reviewed by the director pursuant to an application by the insurer.Source  Laws 2003, LB 216, § 19;  Laws 2005, LB 119, § 26.  Cross References  Administrative Procedure Act, see section 84-920.
NE Code § 44-7509 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7509 - Premium adjustments.

44-7509.  Premium adjustments.(1) For medical professional liability insurance and for insurance subject to section 44-7508, insurers may increase or decrease premiums on an individual risk basis up to forty percent based on any factor except:(a) The rate adjustment cannot be based upon the race, creed, national origin, or religion of the insured;(b) The rate adjustment cannot violate the Unfair Discrimination Against Subjects of Abuse in Insurance Act;(c) The rate adjustment cannot apply to (i) insurance covering risks of a personal nature, including insurance for homeowners, tenants, private passenger nonfleet automobiles, mobile homes, and other property and casualty insurance for personal, family, or household needs or (ii) insurance covering farms and ranches, including crop insurance; and(d) The rate adjustment cannot be based solely upon the fact that the insured is deployed in the military on Title 10 orders that require the insured to be mobilized outside of the United States, United States territories, and the District of Columbia for a period of six months or greater.(2) If the director finds after a hearing that (a) the utilization of this section by the insurance industry has produced a significant number of rate modifications at or near the upper limit and at the lower limit of the allowable range of modification and (b) the modifiers at and near the upper and lower limits of the allowable range of modification appear to be predominantly correlated with individual risk factors that relate to expected losses and expenses, the director may, by rules and regulations, broaden the range of plus or minus forty percent for any line or type of insurance subject to section 44-7508.(3) If the director finds after a hearing that modifiers at or near the upper or lower limits of the allowable range of modification are not predominantly correlated with individual risk factors that relate to expected losses and expenses, the director may, by rules and regulations, reduce the range of plus or minus forty percent for any line or type of insurance subject to section 44-7508, but such reduction shall not be to less than plus or minus twenty-five percent.Source  Laws 2000, LB 1119, § 9;  Laws 2002, LB 1139, § 50;  Laws 2005, LB 119, § 28;  Laws 2021, LB77, § 2.   Effective Date: August 28, 2021  Cross References  Unfair Discrimination Against Subjects of Abuse in Insurance Act, see section 44-7401.
NE Code § 44-7514 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7514 - Policy form approval requirements applying to qualifying multistate commercial policyholder; exemption.

44-7514.  Policy form approval requirements applying to qualifying multistate commercial policyholder; exemption.(1) The policy form approval requirements set forth in section 44-7513 shall not apply to policies written for individual commercial risks of a qualifying multistate commercial policyholder. For the purposes of this section, a qualifying multistate commercial policyholder is an entity that meets the following qualifications:(a) The policyholder is commercial in nature;(b) If the policyholder is comprised of multiple corporations or other entities, there is common or majority ownership of each of the members by the same parent entity. Qualifying multistate commercial policyholder does not include franchise arrangements or other groups where individual members of the group are under different ownership; and(c) The office with the largest number of the officers and senior management of the policyholder is located outside of Nebraska. If this criteria is not meaningful or is ambiguous for a policyholder, then the total premiums for lines of insurance subject to the Property and Casualty Insurance Rate and Form Act that are attributable to another jurisdiction must exceed those premiums attributable to Nebraska.(2) Policy forms for commercial risks exempted by this section may include language that conflicts with sections 44-357, 44-358, and 44-501.02. If a conflict results between a policy form and the requirements of such sections, such sections shall apply.(3) Policy forms for commercial risks exempted by this section may include language that conflicts with sections 44-349, 44-350, 44-501, 44-514 to 44-518, 44-520 to 44-523, and 44-6408 and the provision of section 44-601 that prohibits policies with a term longer than five years. If a conflict results between a policy form and the requirements of any of these sections, the language in the policy form shall apply to the extent that it is inconsistent with such sections.(4) Except as set forth in subsections (2) and (3) of this section, the policy forms exempted from policy form approval requirements shall not violate any law of this state.Source  Laws 2000, LB 1119, § 14;  Laws 2019, LB469, § 8.