reglab/housing_qa huggingface dataset:
SD Codified L § 58-17-27 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-27 - Payment of claims--Optional provisions, insertion by insurer.

58-17-27. Payment of claims--Optional provisions, insertion by insurer.The following provisions, or either of them, may be included with the provision in §58-17-26 at the option of the insurer: "If any indemnity of this policy shall be payable to the estate of the insured, or to an insured or beneficiary who is a minor 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 one thousand dollars), 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.""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." Source: SL 1966, ch 111, ch 25, §12.
SD Codified L § 58-17-28 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-28 - Physical examination of insured--Autopsy in death claims--Provision required in policy.

58-17-28. Physical examination of insured--Autopsy in death claims--Provision required in policy.There shall be a provision as follows: "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." Source: SL 1966, ch 111, ch 25, §13.
SD Codified L § 58-17-29 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-29 - Action to recover under policy--Time for beginning.

58-17-29. Action to recover under policy--Time for beginning.There shall be a provision as follows: "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 years after the written proof of loss is required to be furnished." Source: SL 1966, ch 111, ch 25, §14.
SD Codified L § 58-17-30.1 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-30.1 - Continuation of coverage for child with intellectual or physical disability--Proof of dependency.

58-17-30.1. Continuation of coverage for child with intellectual or physical disability--Proof of dependency.An individual health insurance policy, which is delivered or issued for delivery in this state and which provides that coverage of a dependent child shall terminate upon attainment of the limiting age for dependent children specified in the policy, shall also provide that attainment of such limiting age shall not operate to terminate the coverage of such child while the child is and continues to be both (a) incapable of self-sustaining employment by reason of intellectual disability or physical disability and (b) chiefly dependent upon the policyholder for support and maintenance, provided proof of such incapacity and dependency is furnished to the insurer by the policyholder within thirty-one days of the child's attainment of the limiting age and subsequently as may be required by the insurer but not more frequently than annually after the two-year period following the child's attainment of the limiting age. Source: SL 1969, ch 140; SL 2013, ch 125, §18.
SD Codified L § 58-17-30.2 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-30.2 - Family coverage to include newborn or newly adopted children--Payment of claim not to be withheld during bonding period of adopted child.

58-17-30.2. Family coverage to include newborn or newly adopted children--Payment of claim not to be withheld during bonding period of adopted child.Any individual health insurance policy and individual or indemnity type contract issued by a nonprofit corporation which offers coverage for a family member of an insured or subscriber shall provide that the health insurance benefits applicable for children are payable with respect to a newly born child of the insured or subscriber from the moment of birth or to a newly adopted child of the insured or subscriber from the beginning of the six-month adoption bonding period. The newly born or newly adopted child shall be added to the policy without underwriting and without the imposition of any preexisting waiting period. Any policy or contract issued before July 1, 1974, shall, upon its next anniversary date, also provide that the health insurance benefits applicable for children are payable with respect to a newly born child of the insured or subscriber from the moment of birth or to a newly adopted child of the insured or subscriber from the beginning of the six-month adoption bonding period. Payment of any valid insurance claim may not be withheld during the bonding period of an adopted child. Source: SL 1974, ch 322; SL 1976, ch 313, §1; SL 1977, ch 408; SL 1983, ch 375, §1; SL 1988, ch 401; SL 1994, ch 387, §5.
SD Codified L § 58-17-30.3 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-30.3 - Premature birth and congenital defects covered--Applicability.

58-17-30.3. Premature birth and congenital defects covered--Applicability.The coverage for a newly born child from the moment of birth or for a newly adopted child, from the beginning of the six-month adoption bonding period, shall consist of coverage of injury or sickness including the necessary care and treatment of premature birth and medically diagnosed congenital defects and birth abnormalities. The provisions of §§58-17-30.2 to 58-17-30.4, inclusive, apply to any individually written health benefit plan issued or renewed by any health insurer, health carrier, health maintenance organization, fraternal benefit society, nonprofit medical and surgical plan, nonprofit hospital service plan, or other entity providing coverage through a health benefit plan subject to the provisions of this title. Source: SL 1974, ch 322; SL 1976, ch 313, §2; SL 1983, ch 375, §2; SL 1984, ch 327, §13; SL 2001, ch 274, §1; SL 2015, ch 249, §1.
SD Codified L § 58-17-30.4 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-30.4 - Notice of birth or adoption required for continued coverage.

58-17-30.4. Notice of birth or adoption required for continued coverage.An insurer may require notice that a newly born or newly adopted child is to be added to the policy or that coverage is to be changed from single or spousal coverage to family coverage. However, the insurer may not require notification sooner than the birth of the child or the start of the adoption bonding period. If the child is added or coverage changed to family coverage before the birth of the child or the start of the adoption bonding period, no additional premium may be charged by the insurer until the birth of the child or the start of the adoption bonding period. The insurer shall take reasonable steps to provide adequate notice to insureds of the need to alter coverage to ensure newborn or adopted children are covered and of the lack of premium adjustment until the birth of the child or the start of the adoption bonding period. An insurer is considered to have taken reasonable steps if prominent disclosure of the requirements of this section are included in a certificate, subscriber contract, evidence of coverage, or employee handbook if such are provided to all insureds.If payment of a specific premium or subscription fee is required to provide coverage for a child, the policy or contract may require that notification of birth of a newly born child or notification of the start of the six-month adoption bonding period for an adopted child and payment of the required premium or fees be furnished to the insurer or nonprofit service or indemnity corporation within thirty-one days after the date of birth or start of the bonding period in order to have the coverage continued beyond the thirty-one day period. Source: SL 1974, ch 322; SL 1983, ch 375, §3; SL 1994, ch 387, §6.
SD Codified L § 58-17-30.5 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-30.5 - Coverage for inpatient alcoholism treatment required.

58-17-30.5. Coverage for inpatient alcoholism treatment required.Any insurer which delivers or issues for delivery in this state any insurance policy under this chapter which provides coverage on an expense incurred basis shall offer, in writing, to include in such policy or contract issued or renewed on or after July 1, 1979, coverage for the inpatient treatment of alcoholism in licensed hospitals and residential primary treatment facilities approved by the State of South Dakota which are carrying out an approved program pursuant to the diagnosis and recommendation of a doctor of medicine. When coverage for inpatient treatment is included in any policy, such coverage shall include inpatient treatment at any South Dakota approved inpatient alcoholism treatment facility. Source: SL 1977, ch 410, §2; SL 1979, ch 344, §1.
SD Codified L § 58-17-30.6 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-30.6 - Alcoholism benefits provided--Days of care.

58-17-30.6. Alcoholism benefits provided--Days of care.The alcoholism coverage to be offered shall provide benefits on the same basis as benefits provided for the treatment of other sicknesses covered under the policy; however, the coverage by the insurance carrier need not exceed thirty days' care in any six-month period, and the total days care per recipient need not exceed ninety days during the life of the contract. Source: SL 1977, ch 410, §3.
SD Codified L § 58-17-30.7 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-30.7 - Policies excluded from alcoholism coverage requirements.

58-17-30.7. Policies excluded from alcoholism coverage requirements.Sections 58-17-30.5 and 58-17-30.6 do not apply to accident only, or limited or specified disease policies. Source: SL 1977, ch 410, §4; SL 1979, ch 344, §2; SL 1982, ch 362; SL 1999, ch 249, §1.
SD Codified L § 58-17-30.8 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-30.8 - Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited--Exception for sickness or injury caused in commission of felony.

58-17-30.8. Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited--Exception for sickness or injury caused in commission of felony.A policy or certificate of health insurance for an individual that is delivered, issued for delivery, or renewed in this state may not exclude the payment of benefits for injuries sustained by an insured person because the insured was under the influence of alcohol or drugs, as defined by §32-23-1.Nothing in this section precludes a health insurer from excluding coverage for an insured for any sickness or injury caused in the commission of a felony. Source: SL 1997, ch 290, §§1, 7.
SD Codified L § 58-17-30.9 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-30.9 - Notice that dependent is no longer eligible for coverage--Premium adjustment.

58-17-30.9. Notice that dependent is no longer eligible for coverage--Premium adjustment.For any insurer that chooses to automatically cover any newborn or newly adopted child as a dependent without requiring the notice in §58-17-30.4 and does not collect or track the demographic information on the dependent child, the insurer shall take reasonable steps to provide adequate notice of the insured's responsibility to advise the insurer when there is no longer any child eligible for dependent coverage. An insurer is considered to have taken reasonable steps if prominent disclosure of this responsibility is included in the policy or certificate, subscriber contract, evidence of coverage, or employee handbook if such are provided to all insureds and also provided to prospective insureds at the time of application for coverage. Upon receipt of a notice that a dependent is no longer eligible, the insurer shall adjust the coverage accordingly and, if applicable, return to the insured any unearned premium. This section applies to any policy or certificate subject to the provisions of chapters 58-17 and 58-18. Source: SL 2013, ch 247, §1.
SD Codified L § 58-17-31 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-31 - Optional policy provisions.

58-17-31. Optional policy provisions.Except as provided in §58-17-13, no policy of health insurance delivered or issued for delivery to any person in this state shall contain provisions respecting the matters set forth in §§58-17-32 to 58-17-40, inclusive, unless such provisions are in the words in which the same appear in the applicable section, except that the insurer may, at its option, use in lieu of any such provision a corresponding provision of different wording approved by the director which is not less favorable in any respect to the insured or the beneficiary. Any such provision contained in the policy shall be preceded individually by the applicable caption or, at the option of the insurer, by such appropriate individual or group captions or subcaptions as the director may approve. Source: SL 1966, ch 111, ch 25, §16.
SD Codified L § 58-17-32 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-32 - Occupational change--Policy provision for adjustment of premium or benefits.

58-17-32. Occupational change--Policy provision for adjustment of premium or benefits.There may be a provision as follows: "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 prorata 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 of 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." Source: SL 1966, ch 111, ch 25, §17.
SD Codified L § 58-17-33 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-33 - Misstatement of age--Policy provision for adjustment of benefits.

58-17-33. Misstatement of age--Policy provision for adjustment of benefits.There may be a provision as follows: "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." Source: SL 1966, ch 111, ch 25, §18.
SD Codified L § 58-17-34 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-34 - Earnings of insured--Policy provision for adjustment of benefits.

58-17-34. Earnings of insured--Policy provision for adjustment of benefits.There may be a provision as follows: "Relation of earnings to insurance: 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 his average monthly earnings for the period of two 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 two years as shall exceed the prorata 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 two hundred dollars 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." Source: SL 1966, ch 111, ch 25, §19 (1).
SD Codified L § 58-17-35 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-35 - Earnings adjustment clause to be coupled with insured's right to continue policy in force.

58-17-35. Earnings adjustment clause to be coupled with insured's right to continue policy in force.The policy provision in §58-17-34 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 until at least age fifty, or, in the case of a policy issued after age forty-four, for at least five years from its date of issue. Source: SL 1966, ch 111, ch 25, §19 (2).
SD Codified L § 58-17-36 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-36 - Option of insurer to define "valid loss of time coverage".

58-17-36. Option of insurer to define "valid loss of time coverage".The insurer may, at its option, include in the provision in §58-17-34 a definition of "valid loss of time coverage," approved as to form by the director, 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 director 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. Source: SL 1966, ch 111, ch 25, §19 (2).
SD Codified L § 58-17-37 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-37 - Unpaid premiums--Deduction from benefits.

58-17-37. Unpaid premiums--Deduction from benefits.There may be a provision as follows: "Unpaid premiums: 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." Source: SL 1966, ch 111, ch 25, §20.
SD Codified L § 58-17-38 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-38 - Conformity with state statutes of insured.

58-17-38. Conformity with state statutes of insured.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." Source: SL 1966, ch 111, ch 25, §21.
SD Codified L § 58-17-39 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-39 - Illegal occupation of insured.

58-17-39. Illegal occupation of insured.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." Source: SL 1966, ch 111, ch 25, §22.
SD Codified L § 58-17-40 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-40 - Renewal of policy at option of insurer.

58-17-40. Renewal of policy at option of insurer.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 clause making reference to lapse and reinstatement may be omitted at the insurer's option. Source: SL 1966, ch 111, ch 25, §23.
SD Codified L § 58-17-41 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-41 - Order of policy provisions.

58-17-41. Order of policy provisions.The provisions which are the subject of §§58-17-14 to 58-17-39, inclusive, 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. Source: SL 1966, ch 111, ch 25, §24.