reglab/housing_qa huggingface dataset:
VA Code § 38.2-3515 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3515. Required coverage on connecting or returning planes

In each airtrip accident policy, issued in this Commonwealth through a mechanical vending machine or otherwise, the coverage of the policy, according to its terms and provisions, shall extend to an accident on a connecting or returning plane on which the insured's initial airtrip ticket entitles him to ride, if it is shown that the insured would be entitled to recover under the policy had the accident occurred while the insured was riding on the initial plane designated on the ticket.1952, c. 317, § 38.1-349; 1958, c. 452; 1966, c. 101; 1986, c. 562.
VA Code § 38.2-3516 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3516. Purpose

The purpose of this article is to authorize the Commission, pursuant to the authority granted in § 38.2-223, to issue rules and regulations to:1. Provide reasonable standardization and simplification of terms and coverages of individual accident and sickness insurance policies;2. Facilitate public understanding and comparison;3. Eliminate provisions contained in individual accident and sickness insurance policies which may be misleading or unreasonably confusing in connection either with the purchase of coverages or with the settlement of claims; and4. Provide for full disclosure in the sale of individual accident and sickness policies.1980, c. 204, § 38.1-362.11; 1986, c. 562.
VA Code § 38.2-3517 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3517. Definitions

As used in this article:"Form" means policies, contracts, riders, endorsements, and applications."Policy" means the entire contract between the insurer and the insured, including the policy riders, endorsements, and the application, if attached.1980, c. 204, § 38.1-362.12; 1986, c. 562.
VA Code § 38.2-3518 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3518. Standards for policy provisions

A. Pursuant to the authority granted in § 38.2-223, the Commission may issue rules and regulations to establish specific standards, including standards of full and fair disclosure, for the sale of individual accident and sickness insurance policies. These rules and regulations shall be in addition to and in accordance with applicable laws of this Commonwealth, including Chapter 34 (§ 38.2-3400 et seq.) and Articles 1 (§ 38.2-3500 et seq.) and 2 (§ 38.2-3516 et seq.) of this chapter which may cover but shall not be limited to:1. Terms of renewability;2. Initial and subsequent conditions of eligibility;3. Nonduplication of coverage provisions;4. Coverage of dependents;5. Coverage of persons eligible for Medicare by reason of age;6. Preexisting conditions;7. Termination of insurance;8. Probationary periods;9. Limitations;10. Exceptions;11. Reductions;12. Elimination periods;13. Requirements for replacement;14. Recurrent conditions; and15. Definition of terms including but not limited to the following: hospital, accident, sickness, injury, physician, accidental means, total disability, partial disability, nervous disorder, guaranteed renewable, and noncancellable.For the purposes of this article, "licensed health care practitioners", to the extent required by law, shall be deemed physicians.B. Pursuant to the authority granted in § 38.2-223, the Commission may issue rules and regulations that specify prohibited policies or policy provisions not otherwise specifically authorized by statute that in the opinion of the Commission are unjust, unfair, or unfairly discriminatory to the policyowner, beneficiary, or any person insured under the policy.1980, c. 204, § 38.1-362.13; 1981, c. 575; 1986, c. 562.
VA Code § 38.2-3519 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3519. Minimum standards for benefits

A. Pursuant to the authority granted in § 38.2-223, the Commission may issue rules and regulations establishing minimum standards for benefits under each of the following categories of coverage in individual policies of accident and sickness insurance:1. Basic hospital expense coverage;2. Basic medical-surgical expense coverage;3. Hospital confinement indemnity coverage;4. Major medical expense coverage;5. Disability income protection coverage;6. Accident only coverage;7. Specified disease or specified accident coverage;8. Medicare supplement coverage; and9. Limited benefit health coverage.B. Nothing in this section shall preclude the issuance of any policy that combines two or more of the categories of coverage enumerated in subdivisions 1 through 6 of subsection A of this section.C. No policy shall be delivered or issued for delivery in this Commonwealth that does not meet the prescribed minimum standards for the categories of coverage listed in subdivisions 1 through 9 of subsection A of this section or does not meet the requirements set forth in § 38.2-3501.D. The Commission may prescribe the method of identification of policies based upon coverages provided.1980, c. 204, § 38.1-362.14; 1986, c. 562.
VA Code § 38.2-3520 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3520. Coverage of preexisting conditions

A. Notwithstanding the provisions of § 38.2-3503, if an insurer elects to use a simplified application form, with or without a specific question as to the applicant's health, but without any detailed questions concerning the insured's health history or medical treatment history, the policy shall cover any loss occurring after twelve months from the effective date of coverage from any preexisting condition not specifically excluded from coverage by terms of the policy. Except as so provided, the policy shall not include wording that would permit a defense based upon preexisting conditions.B. The provisions of this section shall not apply in any instance in which the provisions of this section are inconsistent or in conflict with a provision of Article 6 (§ 38.2-3438 et seq.) of Chapter 34.1980, c. 204, § 38.1-362.15; 1981, c. 575; 1986, c. 562; 2013, c. 751.
VA Code § 38.2-3523.1 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3523.1. Review of records

The Commission may review the records of any insurer to determine that the insurer's policies have been issued in compliance with the requirements set forth in this article. Insurers issuing coverage not complying with the provisions of § 38.2-3521.1 and not complying with the provisions of § 38.2-3522.1 shall be deemed to have committed a knowing and willful violation of this article, and shall be punished as set forth in subsection A of § 38.2-218.1998, c. 154.
VA Code § 38.2-3523.2 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3523.2. Policies issued outside of the Commonwealth of Virginia

A group accident and sickness insurance policy issued outside of this Commonwealth, providing coverage to residents of this Commonwealth, that does not qualify under § 38.2-3521.1 or § 38.2-3522.1 shall be subject to the statutory requirements of this title and may subject the insurer issuing such policy to the penalties available under this title for violation of such requirements.1998, c. 154.
VA Code § 38.2-3523.3 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3523.3. Requirements for those marketing group accident and sickness insurance

Insurance marketed to certificate holders of a group which does not qualify under § 38.2-3521.1 or § 38.2-3522.1 must be marketed by a person holding a valid life and health insurance agent license as required by Chapter 18 (§ 38.2-1800 et seq.) of this title.1998, c. 154; 1999, c. 86.
VA Code § 38.2-3523.4 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3523.4. Minimum number of persons covered

A. A group accident and sickness insurance policy shall on the issue date and at each policy anniversary date, cover at least two persons, other than spouses or minor children, unless such spouse or minor child is determined to be an eligible employee as defined in § 38.2-3431.B. The provisions of this section shall not apply in any instance in which the provisions of this section are inconsistent or in conflict with a provision of Article 6 (§ 38.2-3438 et seq.) of Chapter 34.1998, c. 154; 2013, c. 751.
VA Code § 38.2-3525 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3525. Group accident and sickness insurance coverages of spouses, dependent children or other persons

A. Coverage under a group accident and sickness insurance policy, except a policy issued pursuant to subsection B of § 38.2-3521.1, may be extended to insure:1. The spouse and any child who is (i) under the age of 19 years, (ii) who is a dependent and under the age of 25 years, or (iii) who is a dependent and a full-time student under 25 years of age, without regard to whether such child resides in the same household as the insured group member, or any class of spouse and dependent children, of each insured group member who so elects; and2. Any other class of persons as may mutually be agreed upon by the insurer and the group policyholder.B. The amount of accident and sickness insurance for the spouse, dependent child or other person shall not exceed the amount of accident and sickness insurance for the insured group member.C. At the insurer's option and subject to the policyholder's election, the coverage for children of the insured group member may be extended beyond the ages established in subsection A. Any such extension of coverage shall be as mutually agreed upon by the insurer and the group policyholder.D. Notwithstanding the provisions of § 38.2-3538, one certificate may be issued for each insured group member if a statement concerning any spouse's, dependent child's, or other person's coverage is included in the certificate.E. When a policy provides coverage for a dependent child who is enrolled based upon the child's status as a full-time student and such child is unable due to a medical condition to continue as a full-time student, coverage under the policy for such child nevertheless shall continue in force provided the child's treating physician certifies to the insurer at the time the child withdraws as a full-time student that the child's absence is medically necessary. Coverage for such child shall continue in force until the earlier of (i) the date that is 12 months from the date the child ceases to be a full-time student or (ii) the date the child no longer qualifies as a dependent child under the terms of the group policy. A child's status as a full-time student shall be determined in accordance with the criteria specified by the institution in which the child is enrolled.F. The provisions of this section shall not apply in any instance in which the provisions of this section are inconsistent or in conflict with a provision of Article 6 (§ 38.2-3438 et seq.) of Chapter 34.1986, c. 562; 1993, c. 306; 1998, c. 154; 2004, c. 771; 2005, c. 871; 2007, c. 428; 2008, c. 209; 2011, c. 882.
VA Code § 38.2-3526 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3526. Standard provisions required; exceptions

A. No group accident and sickness insurance policy shall be delivered or issued for delivery in this Commonwealth unless it contains the standard provisions prescribed in this article.B. The provisions of § 38.2-3531, subsection A of §§ 38.2-3533 and 38.2-3538 shall not apply to policies issued pursuant to subsection B of § 38.2-3522.1.1986, c. 562; 1998, c. 154.
VA Code § 38.2-3527 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3527. Grace period

Each group accident and sickness insurance policy shall contain a provision that the policyowner is entitled to a grace period of not less than thirty-one days for the payment of any premium due except the first premium. The provision shall also state that during the grace period the accident and sickness coverage shall continue in force unless the policyowner has given the insurer written notice of discontinuance in accordance with the terms of the policy and in advance of the date of discontinuance. The policy may provide that the policyowner shall be liable to the insurer for the payment of a pro rata premium for the time the policy was in force during the grace period.1986, c. 562.
VA Code § 38.2-3528 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3528. Incontestability

A. Each group accident and sickness insurance policy shall contain a provision that the validity of the policy shall not be contested, except for nonpayment of premiums, after it has been in force for two years from its date of issue.B. The provision shall also state that no statement made by any person insured under the policy relating to his insurability or the insurability of his insured dependents shall be used in contesting the validity of the insurance with respect to which such statement was made:1. After the insurance has been in force prior to the contest for a period of two years during the lifetime of the person about whom the statement was made; and2. Unless the statement is contained in a written instrument signed by him.C. This provision shall not preclude the assertion at any time of defenses based on the person's ineligibility for coverage under the policy or upon other provisions in the policy.1986, c. 562.
VA Code § 38.2-3529 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3529. Entire contract; statements deemed representations

A. Each group accident and sickness insurance policy shall contain a provision that the policy, and any application of the policyowner, and any individual applications of the persons insured shall constitute the entire contract between the parties.B. The provision shall also state that:1. A copy of any application of the policyowner shall be attached to the policy when issued;2. All statements made by the policyowner or by the persons insured shall be deemed representations and not warranties; and3. No written statement made by any person insured shall be used in any contest unless a copy of the statement is furnished to the person or to his beneficiary or personal representative.1986, c. 562.
VA Code § 38.2-3530 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3530. Evidence of individual insurability

Each group accident and sickness insurance policy shall contain a provision setting forth any conditions under which the insurer reserves the right to require a person eligible for insurance to furnish evidence of individual insurability satisfactory to the insurer as a condition to part or all of his coverage.1986, c. 562.
VA Code § 38.2-3531 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3531. Additional exclusions and limitations

A. Each group accident and sickness insurance policy shall contain a provision specifying all additional exclusions or limitations applicable under the policy for any disease or physical condition of a person, not otherwise excluded from the person's coverage by name or specific description effective on the date of the person's loss, which existed prior to the effective date of the person's coverage under the policy.B. Any such exclusion or limitation may only apply to a disease or physical condition for which medical advice or treatment was received by the person during the twelve months prior to the effective date of the person's coverage. The exclusion or limitation shall not apply to loss incurred or disability commencing after the earlier of (i) the end of a continuous period of twelve months commencing on or after the effective date of the person's coverage during which the person receives no medical advice or treatment in connection with the disease or physical condition, or (ii) the end of the two-year period commencing on the effective date of the person's coverage.C. This section shall not apply to group accident and sickness policies providing hospital, medical and surgical or major medical coverage on an expense incurred basis to an employer's employees and their dependents.1986, c. 562; 1998, c. 24.
VA Code § 38.2-3532 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3532. Misstatement of age

Each group accident and sickness insurance policy where the premiums or benefits vary by age shall contain a provision that an equitable adjustment of premiums, benefits or both shall be made if the age of a person insured has been misstated. The provision shall contain a clear statement of the method of adjustment to be used.1986, c. 562.
VA Code § 38.2-3533 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3533. Individual certificates

A. Each group accident and sickness insurance policy shall contain a provision that the insurer will issue to the policyholder for delivery to each person insured a certificate setting forth:1. The insured person's insurance protection, including any limitations, reductions, and exclusions applicable to the coverage provided;2. To whom the insurance benefits are payable;3. Any family member's or dependent's coverage; and4. The rights and conditions set forth in § 38.2-3541.B. Each group policy issued pursuant to § 38.2-3522.1 B, where any part of the premium is paid by debtors from identifiable charges collected from the insured debtors not required of an uninsured debtor, shall contain a provision that the insurer will furnish to the policyholder for each debtor insured under the policy a form that will contain a statement describing the debtor's coverage and that the benefits payable shall be applied to reduce or extinguish the indebtedness.1986, c. 562; 1998, c. 154.
VA Code § 38.2-3534 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3534. Notice of claim

Each group accident and sickness insurance policy shall contain a provision that written notice of a claim shall be given to the insurer within twenty days after the occurrence or commencement of any loss covered by the policy. Failure to give notice within that time shall not invalidate or reduce any claim if it can be shown that notice was given as soon as reasonably possible.1986, c. 562.
VA Code § 38.2-3535 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3535. Claim forms

Each group accident and sickness insurance policy shall contain a provision that the insurer will furnish forms for filing proof of loss to the person making a claim or to the policyholder for delivery to that person. If the forms are not furnished within fifteen days after the insurer received notice of any claim under the policy, the person making the claim shall be deemed to have complied with the requirements of the policy as to proof of loss upon submitting within the time fixed in the policy of filing proof of loss, written proof covering the occurrence, character, and extent of the loss for which a claim is made.1986, c. 562.
VA Code § 38.2-3536 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3536. Proofs of loss

A. Each group accident and sickness insurance policy shall contain a provision that written proof of the loss shall be furnished to the insurer within ninety days after the date of the loss. In the case of a claim for loss of time for disability, each group accident and sickness insurance policy shall contain a provision that written proof of the loss shall be furnished to the insurer within ninety days after the commencement of the period for which the insurer is liable. Subsequent written proof of the continuance of the disability shall be furnished to the insurer at reasonable intervals required by the insurer.B. Failure to furnish such proof within the prescribed time shall not invalidate or reduce any claim if it was not reasonably possible to furnish the proof within that time and the proof is furnished as soon as reasonably possible. In no event, except in the absence of legal capacity of the claimant, shall such proof be furnished later than one year from the time proof is otherwise required.1986, c. 562.
VA Code § 38.2-3537 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3537. Time of payment of claims

Each group accident and sickness insurance policy shall contain a provision that all benefits payable under the policy other than benefits for loss of time shall be payable within sixty days after receipt of proof of loss. The provision shall also state that, subject to proof of loss, all accrued benefits payable under the policy for loss of time shall be paid at least monthly during the continuance of the period for which the insurer is liable, and that any balance remaining unpaid at the termination of such period will be paid as soon as possible.1986, c. 562.
VA Code § 38.2-3538 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3538. Payment of benefits

Each group accident and sickness insurance policy shall contain a provision that benefits for loss of life of the person insured shall be payable to the beneficiary designated by the person insured. However, if the policy contains conditions pertaining to family status, the beneficiary may be the family member specified by the policy terms. In either case, payment of those benefits is subject to the provisions of the policy in the event no such designated or specified beneficiary is living at the death of the person insured. The policy may also provide that if any benefit is payable to the estate of a person, or to a person who is a minor or otherwise not competent to give a valid release, the insurer may pay the benefit, up to an amount not exceeding $5,000, to any relative by blood or connection by marriage of the person who is deemed by the insurer to be equitably entitled to the benefit. The policy may also provide that all or any portion of any benefits provided for health care services may be paid to the health care services provider. All other benefits of the policy shall be payable to the person insured.1986, c. 562; 1991, c. 87.
VA Code § 38.2-3539 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3539. Physical examinations and autopsy

Each group accident and sickness insurance policy shall contain a provision that the insurer shall have the right (i) to examine the person for whom a claim is made when and as often as it may reasonably require during the pendency of claim under the policy and (ii) to make an autopsy where it is not prohibited by law.1986, c. 562.
VA Code § 38.2-3540 (2021)
2021 Code of Virginia|Title 38.2 - Insurance|Chapter 35 - Accident and Sickness Insurance Policies|§ 38.2-3540. Legal actions

Each group accident and sickness insurance policy shall contain a provision that no action at law or in equity shall be brought to recover on the policy within sixty days after proof of loss has been filed in accordance with the policy requirements and that no such action shall be brought after the expiration of three years from the time that proof of loss was required to be filed.1986, c. 562.