reglab/statecodes huggingface dataset:
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 3. Mutual Life and Accident─formation › 27-8-3-25. Fees

Sec. 25. The fees to be paid by each such corporation, association, or society to the insurance commissioner for the authority to such corporation, association, or society, and its insurance producers under the license granted by him to each corporation, association, or society, to transact business in the state of Indiana shall be as follows:
For filing copy of charter or articles of incorporation, twenty-five dollars ($25).
For filing each annual statement, twenty dollars ($20).
For issuing certificate of authority or license to company, corporation, association or society, one dollar ($1).
For issuing license to each insurance producer, one dollar ($1).
For affixing seal and certifying to any paper, one dollar ($1).
For renewal of license, each such corporation, association, or society shall file with the commissioner its annual statement, for which it shall pay the sum of twenty dollars ($20).
For the privilege of transacting business in this state, a foreign or alien company, association, or society, admitted and licensed under this chapter, shall pay an annual tax upon premiums or assessments derived from business written within this state, such tax to be as defined and determined under IC 27-1-18-2, which is declared to be applicable in its terms and provisions to such a company, association, or society; provided also, that when any other state or country shall impose any obligations in excess of those imposed by this chapter upon any such corporation, association, or society of this state, a like obligation shall be imposed on similar corporations and their agents of such state or country doing business in this state; and provided also, that such corporation, association, or society, in transacting business in this state, shall be subject only to the provisions of this chapter.
Formerly: Acts 1897, c.195, s.25; Acts 1955, c.55, s.1. As amended by P.L.252-1985, SEC.293; P.L.178-2003, SEC.59.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 3. Mutual Life and Accident─formation › 27-8-3-26. Exempt Organizations

Sec. 26. Nothing contained in sections 1 through 25 of this chapter shall be construed to apply to secret or fraternal societies, lodges or councils that are now organized, or that may hereafter be organized, which conduct their business and secure members on the lodge system, exclusively, having ritualistic work and ceremonies in their societies, lodges or councils, and which are under the supervision of a grand or supreme body, nor to any association organized solely for benevolent purposes and not for profit; nor to any association of religious or secret societies, nor to any class of mechanics, express, telegraph or railroad employees or veterans described in IC 10-17-5-2 or IC 10-17-5-1 (before their repeal) or any existing societies now doing business and formed for the mutual benefit of the members thereof and their families exclusively.
Formerly: Acts 1897, c.195, s.26. As amended by Acts 1980, P.L.38, SEC.18; P.L.2-2003, SEC.70; P.L.42-2020, SEC.18.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 3. Mutual Life and Accident─formation › 27-8-3-27. Legal Reserves; Compulsory Deposits; Filing of Forms; Exceptions

Sec. 27. (a) Notwithstanding any of the provisions of sections 1 through 26 of this chapter, every corporation or association organized and operating under the provisions of this chapter shall on or before July 1, 1970, comply with the provisions of IC 27-1 relative to the maintenance of legal reserves required on all life insurance and health and accident insurance policies issued in this state, and relative to compulsory deposit of assets by life insurance companies, and relative to filing of forms, with particular reference to but not limited to IC 27-1-12-11 through IC 27-1-12-13, IC 27-1-12.8, IC 27-1-13-8, and IC 27-1-20-1 through IC 27-1-20-11.
(b) Provided, that this section shall not apply to any corporation or association that has prior to July 1, 1970, reorganized and accepted the provisions of IC 27-1, as provided in IC 27-1-11. Nor shall this section apply to any insurance policies issued or sold prior to July 1, 1970, or prior to any such reorganization under IC 27-1, whichever occurs earlier.
(c) Provided, further, that with respect to insurance policies issued by any corporation or association on a pure assessment basis, no premiums having been collected in advance, which corporation or association is incorporated and operating under this chapter as of August 18, 1969, and which has had in force between August 18, 1964, and August 18, 1969, insurance policies covering not less than fifteen thousand (15,000) members, such company or association shall maintain, beginning January 1, 1971, a legal reserve on its life assessment business on the basis of monthly renewable term insurance, and said monthly unearned premium reserve shall be calculated at one dollar and thirty cents ($1.30) per member.
(d) Such legal reserve shall be deposited with the insurance department under compulsory deposit provisions referred to in subsection (a).
Formerly: Acts 1897, c.195, s.26a; Acts 1969, c.236, s.1. As amended by P.L.252-1985, SEC.294; P.L.276-2013, SEC.29.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 4. Credit Life and Credit Accident and Health Insurance › 27-8-4-0.1. Application of Certain Amendments to Chapter

Sec. 0.1. The addition of section 9.5 of this chapter by P.L.226-1993 applies to policies issued after June 30, 1993.
As added by P.L.220-2011, SEC.434.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 4. Credit Life and Credit Accident and Health Insurance › 27-8-4-1. Purpose

Sec. 1. The purpose of this chapter is to promote the public welfare through the establishment of unified and consistent rules relating to the implementation and administration of the laws of this state pertaining to credit life insurance and credit accident and health insurance, as such insurances are defined and limited in this chapter.
Formerly: Acts 1961, c.47, s.1. As amended by P.L.252-1985, SEC.295.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 4. Credit Life and Credit Accident and Health Insurance › 27-8-4-2. Citation; Scope; Definitions

Sec. 2. (a) Citation and Scope:
(1) This chapter may be cited as the Model Act for the Regulation of Credit Life Insurance and Credit Accident and Health Insurance.
(2) All life insurance and all accident and health insurance of the nature in this chapter defined in connection with loans or other credit transactions shall be subject to the provisions of this chapter, except such insurance issued in relation to an isolated transaction on the part of the insurer not related to an agreement or a plan for insuring debtors of the creditor.
(b) Definitions. For the purpose of this chapter:
(1) "Credit life insurance" means insurance on the life of a debtor pursuant to or in connection with a specific loan or other credit transaction.
(2) "Credit accident and health insurance" means insurance on a debtor to provide funds for payments becoming due on a specific loan or other credit transaction while the debtor is disabled as defined in the policy.
(3) "Creditor" means the lender of money or vendor or lessor of goods, services, property, rights, or privileges, for which payment is arranged through a credit transaction, or any successor to the right, title, or interest of any such lender, vendor, or lessor, and any affiliate, associate, or subsidiary of any of them or any director, officer, or employee of any of them or any other person in any way associated with any of them.
(4) "Debtor" means a borrower of money or a purchaser or lessee of goods, services, property, rights, or privileges for which payment is arranged through a credit transaction. The term includes the following:
(A) A joint debtor.
(B) A co-maker.
(C) An endorser.
(D) A guarantor.
(5) "Indebtedness" means the total amount payable by a debtor to a creditor in connection with a loan or other credit transaction.
(6) "Commissioner" means insurance commissioner of Indiana.
(7) The term "accident and health insurance" has the same meaning as "accident and sickness insurance" sometimes used in other statutes relating to insurance against accident and sickness.
Formerly: Acts 1961, c.47, s.2. As amended by P.L.252-1985, SEC.296; P.L.153-1986, SEC.4; P.L.132-1994, SEC.2.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 4. Credit Life and Credit Accident and Health Insurance › 27-8-4-3. Forms of Insurance

Sec. 3. Credit life insurance and credit accident and health insurance shall be issued only in the following forms:
A. Individual policies of life insurance issued to debtors on the term plan;
B. Individual policies of accident and health insurance issued to debtors on a term plan or disability benefit provisions in individual policies of credit life insurance;
C. Group policies of life insurance issued to creditors providing insurance upon the lives of debtors on the term plan;
D. Group policies of accident and health insurance issued to creditors on a term plan insuring debtors or disability benefit provisions in group credit life insurance policies to provide such coverage.
Formerly: Acts 1961, c.47, s.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 4. Credit Life and Credit Accident and Health Insurance › 27-8-4-4. Limitations on Amount of Insurance

Sec. 4. A. Credit Life Insurance. The initial amount of credit life insurance shall not exceed the total amount repayable under the contract of indebtedness and, when an indebtedness is repayable in substantially equal installments, the amount of insurance shall at no time exceed the scheduled or actual amount of unpaid indebtedness, whichever is greater. Notwithstanding the provisions of this paragraph, insurance on agriculture credit transaction commitments, not exceeding one (1) year in duration, may be written up to the amount of the loan commitment on a non-decreasing or level term plan.
B. Credit Accident and Health Insurance. The aggregate amount of periodic benefits payable by credit accident and health insurance in the event of disability, as defined in the policy, shall not, in the case of an indebtedness payable in installments, exceed the aggregate of the periodic scheduled unpaid installments of the indebtedness or in the case of an indebtedness payable in one sum, the unpaid amount of such indebtedness; and the amount of each periodic benefit payment shall not exceed the original indebtedness divided by the number of periodic installments.
Formerly: Acts 1961, c.47, s.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 4. Credit Life and Credit Accident and Health Insurance › 27-8-4-5. Term of Insurance

Sec. 5. The term of any credit life insurance or credit accident and health insurance shall, subject to acceptance by the insurer, commence on the date when the debtor becomes obligated to the creditor, except that, where a group policy provides coverage with respect to existing obligations, the insurance on a debtor with respect to such indebtedness shall commence on the effective date of the policy. This rule shall apply when no evidence of insurability is required and, as well, when such evidence is required and is furnished within the period of thirty (30) days after the date when the debtor becomes obligated to the creditor; but should such evidence of insurability be furnished after such thirty (30) day period, the term of the insurance may commence on the date on which the insurance company determines the evidence to be satisfactory, and in such event there shall be an appropriate refund or adjustment of any charge to the debtor for insurance. The term of such insurance shall not extend more than fifteen (15) days beyond the scheduled maturity date of the indebtedness except when extended without additional cost to the debtor. If the indebtedness is discharged due to renewal or refinancing prior to the scheduled maturity date, the insurance in force shall be terminated before any new insurance may be issued in connection with the renewed or refinanced indebtedness. In all cases of termination prior to scheduled maturity, a refund shall be paid or credited as provided in section 8 of this chapter.
Formerly: Acts 1961, c.47, s.5. As amended by P.L.252-1985, SEC.297.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 4. Credit Life and Credit Accident and Health Insurance › 27-8-4-8. Revision of Rate Schedules; Credit or Refund of Premiums

Sec. 8. A. Any insurer may revise its schedules of premium rates from time to time, and shall file such revised schedules with the commissioner. No insurer shall issue any credit life insurance policy or credit accident and health insurance policy for which the premium rate exceeds that determined by the schedules of such insurer as then on file with the commissioner.
B. Each individual policy, or group certificate shall provide that in the event of termination of the insurance prior to the scheduled maturity date of the indebtedness, any refund of an amount paid by the debtor for insurance shall be paid or credited promptly to the person entitled thereto; Provided, however, That the commissioner shall prescribe a minimum refund and no refund which would be less than such minimum need be made. The formula to be used in computing such refund shall be filed with and approved by the commissioner.
C. If a creditor requires a debtor to make any payment for credit life insurance or credit accident and health insurance and an individual policy or group certificate of insurance is not issued, the creditor shall immediately give written notice to such debtor and shall promptly make an appropriate credit to the account.
D. The amount charged to a debtor for any credit life or credit health and accident insurance shall not exceed the premiums charged by the insurer, as computed at the time the charge to the debtor is determined.
Formerly: Acts 1961, c.47, s.8.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 4. Credit Life and Credit Accident and Health Insurance › 27-8-4-9. Persons Authorized to Issue or Deliver Policies

Sec. 9. All policies of credit life insurance and credit accident and health insurance shall be delivered or issued for delivery in this state only by an insurer authorized to do an insurance business in this state, and shall be issued only through holders of licenses issued by the commissioner.
Formerly: Acts 1961, c.47, s.9. As amended by P.L.136-2018, SEC.194.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 4. Credit Life and Credit Accident and Health Insurance › 27-8-4-9.5. Debtor's Right to Cancel Policy; Required Provisions in Application Form; Time Limit

Sec. 9.5. (a) An individual or group policy of credit life insurance or credit accident and health insurance may not be delivered or issued for delivery in Indiana unless the application or authorized form:
(1) provides the debtor with a right to cancel the policy not more than fourteen (14) days after the policy is issued; and
(2) informs the debtor of the right to cancel in plain and conspicuous language.
(b) The language informing the debtor of the right to cancel under subsection (a)(2) must explain the way in which the debtor may cancel the policy and, if applicable, the address to which the debtor may mail the notice of cancellation.
(c) After the debtor cancels a policy under a provision required by subsection (a), the insurer or creditor shall return to the debtor the premium paid by the debtor.
As added by P.L.226-1993, SEC.1.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 4. Credit Life and Credit Accident and Health Insurance › 27-8-4-10. Report, Adjustment, and Settlement of Claims

Sec. 10. A. All claims shall be promptly reported to the insurer or its designated claim representative, and the insurer shall maintain adequate claim files. All claims shall be settled as soon as possible and in accordance with the terms of the insurance contract.
B. All claims shall be paid either by draft drawn upon the insurer or by check of the insurer to the order of the claimant to whom payment of the claim is due pursuant to the policy provisions, or upon direction of such claimant to one specified.
C. No plan or arrangement shall be used whereby any person, firm or corporation other than the insurer or its designated claim representative shall be authorized to settle or adjust claims. The creditor shall not be designated as claim representative for the insurer in adjusting claims; Provided, That a group policyholder may, by arrangement with the group insurer, draw drafts or checks in payment of claims due to the group policyholder subject to audit and review by the insurer.
Formerly: Acts 1961, c.47, s.10.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 4. Credit Life and Credit Accident and Health Insurance › 27-8-4-11. Debtor's Choice of Insurer; Use of Existing Policies

Sec. 11. When life insurance or accident and health insurance is required as additional security for any indebtedness, the debtor shall have the option of furnishing the required amount of insurance through existing policies of insurance owned or controlled by him or of procuring and furnishing the required coverage through any insurer authorized to transact an insurance business within this state. As used in this section, "life insurance" and "accident and health insurance" includes any form and any amount of life insurance or accident and health insurance that affords security to the creditor for the indebtedness involved.
Formerly: Acts 1961, c.47, s.11.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 4. Credit Life and Credit Accident and Health Insurance › 27-8-4-12. Rules; Order for Compliance

Sec. 12. The commissioner may, after notice and hearing, issue such rules as he deems appropriate for the supervision of this chapter. Whenever the commissioner finds that there has been a violation of this chapter or any rules issued pursuant to this chapter and after written notice thereof and hearing given to the insurer or other person authorized or licensed by the commissioner, he shall set forth the details of his findings together with an order for compliance by a specified date. Such order shall be binding on the insurer and other person authorized or licensed by the commissioner on the date specified unless sooner withdrawn by the commissioner or a stay thereof has been ordered by a court of competent jurisdiction. The provisions of sections 5, 6, 7, and 8 of this chapter shall not be operative until October 4, 1961, and the commissioner in his discretion may extend until not later than January 2, 1962, the initial period within which the provisions of sections 5, 6, 7, and 8 shall not be operative.
Formerly: Acts 1961, c.47, s.12. As amended by P.L.252-1985, SEC.300.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 4. Credit Life and Credit Accident and Health Insurance › 27-8-4-13. Judicial Review

Sec. 13. Any party to the proceeding affected by an order of the commissioner shall be entitled to judicial review under IC 4-21.5-5.
Formerly: Acts 1961, c.47, s.13. As amended by P.L.252-1985, SEC.301; P.L.7-1987, SEC.153.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 4. Credit Life and Credit Accident and Health Insurance › 27-8-4-14. Violations; Civil Penalty; Revocation or Suspension of License or Certificate of Authority

Sec. 14. In addition to any other penalty provided by law, any person, firm, or corporation which violates an order of the commissioner after it has become final, and while such order is in effect, shall, upon proof thereof to the satisfaction of the court, forfeit and pay to the state of Indiana a sum not to exceed two hundred fifty dollars ($250), which may be recovered in a civil action, except that if such violation is found to be willful, the amount of such penalty shall be a sum not to exceed one thousand dollars ($1000). The commissioner, in his discretion, may revoke or suspend the license or certificate of authority of the person, firm, or corporation guilty of such violation. Such order for suspension or revocation shall be upon notice and hearing, and shall be subject to judicial review as provided in section 13 of this chapter.
Formerly: Acts 1961, c.47, s.14. As amended by P.L.252-1985, SEC.302.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 4.9. Accident and Sickness Insurance: Consent to Electronic Communication › 27-8-4.9-1. "Covered Individual"

Sec. 1. As used in this chapter, "covered individual" means an individual entitled to coverage under a health benefit plan.
As added by P.L.226-2023, SEC.23.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 4.9. Accident and Sickness Insurance: Consent to Electronic Communication › 27-8-4.9-2. "Health Benefit Plan"

Sec. 2. (a) As used in this chapter, "health benefit plan" means a policy, contract, certificate, or agreement that is entered into, offered by, or issued by an insurer to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services.
(b) The term includes a health benefit plan that provides:
(1) vision coverage; or
(2) dental coverage.
As added by P.L.226-2023, SEC.23.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 4.9. Accident and Sickness Insurance: Consent to Electronic Communication › 27-8-4.9-3. "Plan Sponsor"

Sec. 3. (a) As used in this chapter, "plan sponsor" means a person that establishes, adopts, or maintains a health benefit plan that covers individuals in Indiana.
(b) The term includes a health benefit plan established, adopted, or maintained:
(1) by an employer;
(2) jointly by an employer and one (1) or more employee organizations; or
(3) by an association, committee, joint board of trustees, or any similar group of representatives.
(c) The term does not include an entity regulated under this title.
As added by P.L.226-2023, SEC.23.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 4.9. Accident and Sickness Insurance: Consent to Electronic Communication › 27-8-4.9-4. Plan Sponsor's Consent to Electronic Delivery

Sec. 4. (a) Subject to subsection (b), the plan sponsor of a health benefit plan may, on behalf of all covered individuals of the health benefit plan, provide consent:
(1) to the mailing to covered individuals by electronic means otherwise required by IC 27-1-43-3 of all communications related to the health benefit plan; and
(2) to the electronic delivery to a covered individual of any health insurance identification card.
(b) Before providing consent on behalf of a covered individual under subsection (a), the plan sponsor of a health benefit plan must confirm that the covered individual routinely uses electronic communications during the normal course of the covered individual's employment.
As added by P.L.226-2023, SEC.23.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 4.9. Accident and Sickness Insurance: Consent to Electronic Communication › 27-8-4.9-5. Covered Individual's Opportunity to Opt Out

Sec. 5. Before providing delivery by electronic means to a covered individual for whom the plan sponsor of a health benefit plan has provided consent under section 4 of this chapter, the insurer that entered into, offered, or issued the policy, contract, certificate, or agreement constituting the health benefit plan must provide the covered individual an opportunity to opt out of the mailing by electronic means of communications related to the health benefit plan and the electronic delivery of health insurance identification cards.
As added by P.L.226-2023, SEC.23.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 5. Accident and Sickness Insurance─policy Provisions › 27-8-5-0.1. Application of Certain Amendments to Chapter

Sec. 0.1. The following amendments to this chapter apply as follows:
(1) The amendments made to section 1 of this chapter by P.L.257-1985 apply to insurance policies issued after December 31, 1985.
(2) The amendments made to section 21 of this chapter by P.L.98-1990 apply to a policy issued for delivery in Indiana after June 30, 1990.
(3) The addition of section 23 of this chapter by P.L.152-1990 applies to a statute or rule mandating the offering of health care coverage enacted or adopted after December 31, 1990.
(4) The amendments made to section 23 of this chapter by P.L.119-1991 apply to an insurance policy that is issued or renewed after June 30, 1991.
(5) The addition of section 2.5 of this chapter by P.L.93-1995 applies to all individual accident and sickness policies issued or renewed after December 31, 1997.
(6) The addition of section 2.6 of this chapter (before its repeal) by P.L.93-1995 applies to all individual accident and sickness policies issued or renewed after December 31, 1995.
(7) The amendments made to sections 3 and 19 of this chapter by P.L.91-1998 apply to all accident and sickness policies in force on April 1, 1998.
(8) The amendments made to section 26 of this chapter by P.L.204-2003 apply to a policy of accident and sickness insurance that is issued, delivered, amended, or renewed after June 30, 2003.
(9) The amendments made to section 15.6 of this chapter by P.L.226-2003 apply to a policy of accident and sickness insurance that is issued, delivered, amended, or renewed after June 30, 2003.
(10) The amendments made to section 2.5 of this chapter by P.L.127-2006 apply to a certificate of coverage under a nonemployer based association group policy of accident and sickness insurance that is issued, delivered, amended, or renewed after June 30, 2006.
(11) The amendments made to section 16.5 of this chapter by P.L.127-2006 apply to a certificate of coverage under a nonemployer based association group policy of accident and sickness insurance that is issued, delivered, amended, or renewed after June 30, 2006.
(12) The amendments made to section 19 of this chapter by P.L.127-2006 apply to a certificate of coverage under a nonemployer based association group policy of accident and sickness insurance that is issued, delivered, amended, or renewed after June 30, 2006.
(13) The amendments made to section 3 of this chapter by P.L.98-2007 apply to a policy of accident and sickness insurance that is issued, delivered, amended, or renewed after December 31, 2007.
(14) The amendments made to section 2 of this chapter by P.L.218-2007 apply to a policy of accident and sickness insurance that is issued, delivered, amended, or renewed after June 30, 2007.
(15) The addition of section 28 of this chapter by P.L.218-2007 applies to a policy of accident and sickness insurance that is issued, delivered, amended, or renewed after June 30, 2007.
As added by P.L.220-2011, SEC.435.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 5. Accident and Sickness Insurance─policy Provisions › 27-8-5-1. Policy of Accident and Sickness Insurance; Filing; Review; Conformity With Federal Act

Sec. 1. (a) The term "policy of accident and sickness insurance", as used in this chapter, includes any policy or contract covering one (1) or more of the kinds of insurance described in Class 1(b) or 2(a) of IC 27-1-5-1. Such policies may be on the individual basis under this section and sections 2 through 9 of this chapter, on the group basis under this section and sections 16 through 19 of this chapter, on the franchise basis under this section and section 11 of this chapter, or on a blanket basis under section 15 of this chapter and (except as otherwise expressly provided in this chapter) shall be exclusively governed by this chapter.
(b) No policy of accident and sickness insurance may be issued or delivered to any person in this state, nor may any application, rider, or endorsement be used in connection with an accident and sickness insurance policy, until a copy of the form of the policy and of the classification of risks and the premium rates, or, in the case of assessment companies, the estimated cost pertaining thereto, have been filed with and reviewed by the commissioner under section 1.5 of this chapter. This section is applicable also to assessment companies and fraternal benefit associations or societies.
(c) This chapter shall be applied in conformity with the requirements of the federal Patient Protection and Affordable Care Act (P.L. 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (P.L. 111-152), as in effect on September 23, 2010.
(d) A policy of accident and sickness insurance that is issued or delivered through a health benefit exchange established under the federal Patient Protection and Affordable Care Act (P.L. 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (P.L. 111-152), is subject to the requirements of this chapter. The commissioner may adopt rules under IC 4-22-2 to implement this subsection, including rules concerning:
(1) certification or decertification of a qualified health plan (as defined in IC 27-19-2-16); and
(2) open enrollment.
Formerly: Acts 1953, c.15, s.169.1; Acts 1975, P.L.281, SEC.1. As amended by P.L.257-1985, SEC.1; P.L.7-1987, SEC.154; P.L.173-2007, SEC.21; P.L.160-2011, SEC.17; P.L.278-2013, SEC.23.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 5. Accident and Sickness Insurance─policy Provisions › 27-8-5-2.6. Repealed

As added by P.L.93-1995, SEC.7. Amended by P.L.190-1996, SEC.2. Repealed by P.L.1-2001, SEC.51.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 5. Accident and Sickness Insurance─policy Provisions › 27-8-5-4. Effect of Other Policy Provisions or Policy Conflicting With Chapter

Sec. 4. (a) No policy provision which is not subject to section 3 of this chapter shall make a policy, or any portion thereof, less favorable in any respect to the insured or the beneficiary than the provisions thereof which are subject to this chapter.
(b) A policy delivered or issued for delivery to any person in this state in violation of this chapter shall be held valid but shall be construed as provided in this chapter. When any provision in a policy subject to this chapter is in conflict with any provision of this chapter, the rights, duties, and obligations of the insurer, the insured, and the beneficiary shall be governed by the provisions of this chapter.
Formerly: Acts 1953, c.15, s.169.4. As amended by P.L.252-1985, SEC.303.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 5. Accident and Sickness Insurance─policy Provisions › 27-8-5-5. Application; Attaching Copy to Policy; Furnishing Copy to Insured; Alterations; Effect of False Statements

Sec. 5. (a) The insured shall not be bound by any statement made in an application for a policy unless a copy of such application is attached to or endorsed on the policy when issued as a part of the policy. If any such policy delivered or issued for delivery to any person in this state shall be reinstated or renewed, and the insured or the beneficiary or assignee of such policy shall make written request to the insurer for a copy of the application, if any, for such reinstatement or renewal, the insurer shall within fifteen (15) days after the receipt of such request at its home office or any branch office of the insurer, deliver or mail to the person making such request, a copy of such application. If such copy shall not be so delivered or mailed, the insurer shall be precluded from introducing such application as evidence in any action or proceeding based upon or involving such policy or its reinstatement or renewal.
(b) No alteration of any written application for any such policy shall be made by any person other than the applicant without the applicant's written consent, except that insertions may be made by the insurer, for administrative purposes only, in such manner as to indicate clearly that such insertions are not to be ascribed to the applicant.
(c) The falsity of any statement in the application for any policy covered by this chapter may not bar the right to recovery under the policy unless such false statement materially affected either the acceptance of the risk or the hazard assumed by the insurer.
Formerly: Acts 1953, c.15, s.169.5. As amended by P.L.252-1985, SEC.304; P.L.136-2018, SEC.196.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 5. Accident and Sickness Insurance─policy Provisions › 27-8-5-6. Defenses of Insurer; Acts Not Constituting Waiver

Sec. 6. The acknowledgment by any insurer of the receipt of notice given under any policy covered by this chapter, or the furnishing of forms for filing proofs of loss, or the acceptance of such proofs, or the investigation of any claim under the policy shall not operate as a waiver of any of the rights of the insurer in defense of any claim arising under such policy.
Formerly: Acts 1953, c.15, s.169.6. As amended by P.L.252-1985, SEC.305; P.L.136-2018, SEC.197.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 5. Accident and Sickness Insurance─policy Provisions › 27-8-5-7. Acceptance of Premium for Period Beyond Termination Date; Effect; Misstatement of Age

Sec. 7. If any such policy contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective, and if such date falls within a period for which premium is accepted by the insurer or if the insurer accepts a premium after such date, the coverage provided by the policy will continue in force subject to any right of cancellation until the end of the period for which premium has been accepted. In the event the age of the insured has been misstated and if, according to the correct age of the insured, the coverage provided by the policy would not have become effective, or would have ceased prior to the acceptance of such premium or premiums, then the liability of the insurer shall be limited to the refund, upon request, of all premiums paid for the period not covered by the policy.
Formerly: Acts 1953, c.15, s.169.7.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 5. Accident and Sickness Insurance─policy Provisions › 27-8-5-8. Exemption of Accident and Sickness Coverage Incidental to Designated Other Forms of Insurance

Sec. 8. Except as otherwise expressly indicated in this section, nothing contained in sections 1 through 7 of this chapter shall apply to or affect:
(1) any policy of worker's compensation insurance or any policy of liability insurance with or without supplementary coverage in the policy;
(2) any policy or contract of reinsurance;
(3) as to sections 2 through 7 of this chapter, any blanket or group policy of insurance;
(4) life insurance, endowment, or annuity contracts, or contracts supplemental thereto which contain only such provisions relating to accident and sickness insurance as:
(A) provide additional benefits in case of death or dismemberment or loss of sight by accident; or
(B) operate to safeguard such contracts against lapse, or to give a special surrender value or special benefit or an annuity in the event that the insured or annuitant shall become totally and permanently disabled, as defined by the contract or supplemental contract;
(5) as to sections 2 through 5 of this chapter, any policies of accident and sickness insurance issued on the industrial plan with premiums payable on a weekly basis; or
(6) transportation ticket policies sold only at public transportation stations or at public transportation ticket offices by public transportation employees, as to such of the required provisions set out in section 3 of this chapter as are incongruous with the coverage and conditions of the policies.
Formerly: Acts 1953, c.15, s.169.8; Acts 1955, c.129, s.1. As amended by P.L.252-1985, SEC.306; P.L.28-1988, SEC.105.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 5. Accident and Sickness Insurance─policy Provisions › 27-8-5-9. Exemption of Certain Individual Policies

Sec. 9. An individual accident and sickness insurance policy form or any form of rider or endorsement appertaining to such a policy form, which could have been lawfully used or delivered or issued for delivery to any person in this state immediately before February 20, 1953, may be used or delivered or issued for delivery to any such person at any time prior to January 1, 1956, without being subject to the provisions of sections 2, 3, and 4 of this chapter.
Formerly: Acts 1953, c.15, s.169.9. As amended by P.L.252-1985, SEC.307.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 5. Accident and Sickness Insurance─policy Provisions › 27-8-5-10. Repealed

Formerly: Acts 1953, c.15, s.169.10; Acts 1969, c.266, s.2; Acts 1971, P.L.393, SEC.1; Acts 1974, P.L.125, SEC.1. Repealed by P.L.257-1985, SEC.6.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 5. Accident and Sickness Insurance─policy Provisions › 27-8-5-11. Franchise Plan; Accident and Sickness Insurance; Definitions, Limitations, Requirements, and Standards

Sec. 11. No policy of accident and sickness insurance on a franchise plan shall be delivered or issued for delivery to any person in this state unless it conforms to the definitions, limitations, requirements and standards in this section prescribed:
(A) Qualified Groups.
(1) Two (2) or more employees of any employer, inclusive of any governmental division, department or agency.
(2) Ten (10) or more members of any trade, occupational or professional association or of a labor union, or of any other association or group which has had an active existence for at least two (2) years and which has a constitution or by-laws and was formed in good faith for purposes other than that of obtaining insurance.
(3) Members of the family and dependents of persons eligible under (1) or (2) above may be included in the group with such eligible persons.
(B) Nature of Insurance Coverage. The insurance policies issued to members of a qualified group shall be written on identical individual policy form or forms, varying only as to amounts and kinds of coverage applied for by such persons, and such policy form or forms shall otherwise fulfill the requirements of sections 2 through 9 of this chapter. The premiums for such policies may be paid to the insurer periodically by the employer, with or without payroll deduction, or by the association for its members, or by some designated person acting on behalf of such employer or association.
(C) Rates, Benefits, Underwriting Procedures. Premium rates, benefits and underwriting procedures relating to such individual policies may differ from those relating to comparable individual policies issued singly, but as between comparable groups such rates, benefits and procedures shall be nondiscriminatory.
Formerly: Acts 1953, c.15, s.169.11. As amended by Acts 1981, P.L.248, SEC.1.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 5. Accident and Sickness Insurance─policy Provisions › 27-8-5-12. Supplementary Character of Chapter

Sec. 12. This chapter while independent in its enactment of any other statute, is nevertheless a supplement to IC 27-1 and shall be so considered and construed. Accordingly, all general provisions of IC 27-1 shall be fully and completely applicable to the sections of this chapter in the same manner as though such sections were part of IC 27-1.
Formerly: Acts 1953, c.15, s.169.12. As amended by P.L.252-1985, SEC.308.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 5. Accident and Sickness Insurance─policy Provisions › 27-8-5-13. Repeal of 1935 Act

Sec. 13. Acts 1935, c.162, s.174 is hereby expressly repealed except as to policies issued before February 20, 1953, and except as to policies which under section 9 of this chapter continue to be issued under said section 174 prior to January 1, 1956.
Formerly: Acts 1953, c.15, s.169.13. As amended by P.L.252-1985, SEC.309.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 5. Accident and Sickness Insurance─policy Provisions › 27-8-5-14. Exception of Fraternal Benefit Associations

Sec. 14. The provisions of sections 2 and 3 of this chapter shall not be applicable to fraternal benefit associations or societies.
Formerly: Acts 1953, c.15, s.169.15; Acts 1957, c.20, s.1. As amended by P.L.252-1985, SEC.310.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 5. Accident and Sickness Insurance─policy Provisions › 27-8-5-15.5. Inpatient Services for Treatment of Mental Illness or Substance Abuse

Sec. 15.5. (a) As used in this section:
"Alcohol abuse" has the meaning set forth in IC 12-7-2-10.
"Community mental health center" has the meaning set forth in IC 12-7-2-38 and IC 12-7-2-39.
"Division of mental health and addiction" refers to the division created under IC 12-21-1-1.
"Drug abuse" has the meaning set forth in IC 12-7-2-72.
"Indiana department of health" refers to the department established by IC 16-19-1-1.
"Inpatient services" means services that require the beneficiary of the services to remain overnight in the facility in which the services are offered.
"Mental illness" has the meaning set forth in IC 12-7-2-130(1).
"Psychiatric hospital" has the meaning set forth in IC 12-7-2-151.
"Substance abuse" means drug abuse or alcohol abuse.
(b) An insurance policy that provides coverage for inpatient services for the treatment of:
(1) mental illness;
(2) substance abuse; or
(3) both mental illness and substance abuse;
may not exclude coverage for inpatient services for the treatment of mental illness or substance abuse that are provided by a community mental health center or by any psychiatric hospital licensed by the Indiana department of health or the division of mental health and addiction to offer those services.
As added by P.L.258-1985, SEC.1. Amended by P.L.2-1992, SEC.784; P.L.2-1993, SEC.150; P.L.215-2001, SEC.104; P.L.56-2023, SEC.245.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 5. Accident and Sickness Insurance─policy Provisions › 27-8-5-15.6. Treatment Limitations or Financial Requirements on Coverage of Services for Mental Illness

Sec. 15.6. (a) As used in this section, "coverage of services for a mental illness" includes the services defined under the policy of accident and sickness insurance. However, the term does not include services for the treatment of substance abuse or chemical dependency.
(b) This section applies to a policy of accident and sickness insurance that:
(1) is issued on an individual basis or a group basis;
(2) is issued, entered into, or renewed after December 31, 1999; and
(3) is issued to an employer that employs more than fifty (50) full-time employees.
(c) This section does not apply to the following:
(1) A legal business entity that has obtained an exemption under section 15.7 of this chapter.
(2) Accident only, credit, dental, vision, Medicare supplement, long term care, or disability income insurance.
(3) Coverage issued as a supplement to liability insurance.
(4) Worker's compensation or similar insurance.
(5) Automobile medical payment insurance.
(6) A specified disease policy.
(7) A short term insurance plan that:
(A) may be renewed for the greater of:
(i) thirty-six (36) months; or
(ii) the maximum period permitted under federal law;
(B) has a term of not more than three hundred sixty-four (364) days; and
(C) has an annual limit of at least two million dollars ($2,000,000).
(8) A policy that provides indemnity benefits not based on any expense incurred requirement, including a plan that provides coverage for:
(A) hospital confinement, critical illness, or intensive care; or
(B) gaps for deductibles or copayments.
(9) A supplemental plan that always pays in addition to other coverage.
(10) A student health plan.
(11) An employer sponsored health benefit plan that is:
(A) provided to individuals who are eligible for Medicare; and
(B) not marketed as, or held out to be, a Medicare supplement policy.
(d) A group or individual insurance policy or agreement may not permit treatment limitations or financial requirements on the coverage of services for a mental illness if similar limitations or requirements are not imposed on the coverage of services for other medical or surgical conditions.
(e) An insurer that issues a policy of accident and sickness insurance that provides coverage of services for the treatment of substance abuse and chemical dependency when the services are required in the treatment of a mental illness shall offer to provide the coverage without treatment limitations or financial requirements if similar limitations or requirements are not imposed on the coverage of services for other medical or surgical conditions.
(f) This section does not require a group or individual insurance policy or agreement to offer mental health benefits.
(g) The benefits delivered under this section may be delivered under a managed care system.
As added by P.L.42-1997, SEC.2. Amended by P.L.81-1999, SEC.3; P.L.226-2003, SEC.1; P.L.173-2007, SEC.24; P.L.288-2019, SEC.3.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 5. Accident and Sickness Insurance─policy Provisions › 27-8-5-15.7. Exemption of Policies or Contracts From Laws Resulting in Certain Annual Premium Increases

Sec. 15.7. (a) The department shall exempt a policy or contract issued by an insurer or health maintenance organization under IC 5-10-8-9, section 15.6 of this chapter, or IC 27-13-7-14.8 by documenting to the department that compliance with the requirements of IC 5-10-8-9(c), section 15.6(d) of this chapter, or IC 27-13-7-14.8(d) have increased the annual premium or rates charged for the policy or health maintenance organization contract by more than four percent (4%) per year. An insurer or a health maintenance organization that applies for an exemption under this section shall provide documentation that is certified by an independent member of the American Academy of Actuaries of actual mental health claims incurred for a period of not less than six (6) months to substantiate the insurer's or health maintenance organization's assertion of increased claims and administrative costs by more than four percent (4%) per year.
(b) Documents submitted under this section must be available for public inspection.
As added by P.L.81-1999, SEC.4.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 5. Accident and Sickness Insurance─policy Provisions › 27-8-5-15.9. Mental Health Detention as Medically Necessary

Sec. 15.9. An insurer that issues a policy of accident and sickness insurance shall consider services provided to an individual while detained under IC 12-26-5 as medically necessary when provided in accordance with generally accepted clinical care guidelines.
As added by P.L.205-2023, SEC.24.
2023 Indiana Code › Title 27. Insurance › Article 8. Life, Accident, and Health › Chapter 5. Accident and Sickness Insurance─policy Provisions › 27-8-5-16.3. "Small Employer"; Implementation of Program for Joint Purchase of Health Insurance; Rules

Sec. 16.3. (a) As used in this section, "small employer" has the meaning set forth in IC 27-8-15-14.
(b) The commissioner and the office of the secretary of family and social services may implement a program to allow two (2) or more small employers to join together to purchase health insurance, as described in section 16(8) of this chapter.
(c) The commissioner shall adopt rules under IC 4-22-2 necessary to implement this section.
As added by P.L.16-2009, SEC.29.