reglab/statecodes huggingface dataset:
2023 Idaho Code › Title 41 - INSURANCE › Chapter 21 - DISABILITY INSURANCE POLICIES › Section 41-2141 - COORDINATION OF BENEFITS — COORDINATION WITH SOCIAL SECURITY BENEFITS.

41-2141. COORDINATION OF BENEFITS — COORDINATION WITH SOCIAL SECURITY BENEFITS. (1) Under the authority of this section and section 41-2216, Idaho Code, the director shall promulgate rules that are in accordance with the model regulations of the national association of insurance commissioners relating to coordination of benefits provisions in individual and group disability insurance policies. This section shall apply to all policies of individual disability insurance or coverage issued in this state pursuant to the provisions of chapters 21, 34, 39 and 52, title 41, Idaho Code. These rules shall establish uniformity in the permissive use of provisions governing the coordination of benefits between individual disability policies and between individual disability policies and group disability policies in order to avoid claim delays and misunderstandings that otherwise result from the use of inconsistent or incompatible provisions.
(2) Any provision contained in a policy of disability insurance providing for a reduction of benefits payable under the policy during a policy benefit period due to an increase in benefits payable under the federal social security act, as amended, shall be null and void with respect to any such increase which occurs on or after the effective date of this act.
History:
[41-2141, added 1978, ch. 10, sec. 1, p. 19; am. 1997, ch. 319, sec. 1, p. 942.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 21 - DISABILITY INSURANCE POLICIES › Section 41-2142 - LIMITATION OF BENEFITS FOR ELECTIVE ABORTIONS.

41-2142. LIMITATION OF BENEFITS FOR ELECTIVE ABORTIONS. All policies, contracts, plans or certificates of disability insurance delivered, issued for delivery or renewed in this state after the effective date of this section shall exclude coverage for elective abortions. Such exclusion may be waived by endorsement and the payment of a premium therefor. Availability of such coverage shall be at the option of the insurance carrier. For purposes of this section, an "elective abortion" means an abortion for any reason other than to preserve the life of the female upon whom the abortion is performed.
History:
[41-2142, added 1983, ch. 94, sec. 1, p. 207.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 21 - DISABILITY INSURANCE POLICIES › Section 41-2143 - SERVICES PROVIDED BY GOVERNMENTAL ENTITIES.

41-2143. SERVICES PROVIDED BY GOVERNMENTAL ENTITIES. (1) From and after July 1, 1990, no disability insurance policy shall be issued in Idaho which excludes from coverage services rendered the insured while a resident in an Idaho state institution, provided the services to the insured would be covered by the disability insurance policy if rendered to him outside an Idaho state institution.
(2) From and after July 1, 1990, no disability insurance policy shall be issued in Idaho which contains any provision denying or reducing benefits otherwise provided under the policy for the reason that the person insured is receiving health or mental health care or developmental services provided by the department of health and welfare, whether or not the department of health and welfare bases its charges for such services on the recipient’s ability to pay. Provided, nothing in this section shall prevent the issuance of a policy which excludes or reduces benefits where the charge level or amount of the charge levied by a governmental entity for such services would vary or be affected in any way by the existence of insurance coverage.
History:
[41-2143, added 1990, ch. 300, sec. 1, p. 828.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 21 - DISABILITY INSURANCE POLICIES › Section 41-2144 - MAMMOGRAPHY COVERAGE.

41-2144. MAMMOGRAPHY COVERAGE. (1) From and after July 1, 1992, all disability contracts which provide coverage for the surgical procedure known as a mastectomy which are delivered, issued for delivery, continued or renewed in this state shall provide minimum mammography examination or equivalent examination coverage. Such coverage shall include at least the following benefits:
(a) One (1) baseline mammogram for any woman who is thirty-five (35) through thirty-nine (39) years of age.
(b) A mammogram every two (2) years for any woman who is forty (40) through forty-nine (49) years of age, or more frequently if recommended by the woman’s physician.
(c) A mammogram every year for any woman who is fifty (50) years of age or older.
(d) A mammogram for any woman desiring a mammogram for medical cause.
Such coverage shall not exceed the cost of the examination.
(2) As used in this section, "mastectomy" means the removal of all or part of the breast for medically necessary reasons as determined by a licensed physician.
(3) Nothing in this section shall apply to specified accident, specified disease, hospital indemnity, medicare supplement, long-term care or other limited benefit health insurance policies.
History:
[41-2144, added 1992, ch. 132, sec. 1, p. 414; am. 1993, ch. 113, sec. 1, p. 288.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 22 - GROUP AND BLANKET DISABILITY INSURANCE › Section 41-2201 - SCOPE OF CHAPTER — SHORT TITLE.

41-2201. SCOPE OF CHAPTER — SHORT TITLE. (1) This chapter applies only to group disability insurance contracts and to blanket disability insurance contracts as herein provided for.
(2) This chapter may be cited as the "group or blanket disability insurance law".
History:
[41-2201, added 1961, ch. 330, sec. 527, p. 645.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 22 - GROUP AND BLANKET DISABILITY INSURANCE › Section 41-2203 - REQUIRED PROVISIONS IN GROUP POLICIES.

41-2203. REQUIRED PROVISIONS IN GROUP POLICIES. Each such group disability insurance policy shall contain in substance the following provisions:
(1) A provision that, in the absence of fraud, all statements made by applicants or the policyholders or by an insured person shall be deemed representations and not warranties, and that no statement made for the purpose of effecting insurance shall void such insurance or reduce benefits unless contained in a written instrument signed by the policyholder or the insured person, a copy of which has been furnished to such policyholder or to such person or his beneficiary.
(2) A provision that the insurer will furnish to the policyholder for delivery to each employee or member of the insured group, a statement in summary form of the essential features of the insurance coverage of such employee or member and to whom benefits thereunder are payable. If dependents are included in the coverage, only one (1) certificate need be issued for each family unit.
(3) A provision that to the group originally insured may be added from time to time eligible new employees or members or dependents, as the case may be, in accordance with the terms of the policy.
(4) A provision that, a policy delivered or issued for delivery in this state more than one hundred twenty (120) days after the effective date of this act under which coverage of a dependent of a member of an insured group terminates at a specified age shall, with respect to an unmarried child who is incapable of self-sustaining employment by reason of intellectual disability or physical disability and who became so incapable prior to attainment of the limiting age and who is chiefly dependent upon such member for support and maintenance, not so terminate while the policy remains in force and the dependent remains in such condition, if the member has within thirty-one (31) days of such dependent’s attainment of the limiting age submitted proof of such dependent’s incapacity as described herein. The insurer may require at reasonable intervals during the two (2) years following the child’s attainment of the limiting age subsequent proof of the child’s disability and dependency. After the two (2) year period, such subsequent proof may not be required more than once each year.
History:
[41-2203, added 1961, ch. 330, sec. 529, p. 645; am. 1972, ch. 348, sec. 3, p. 1030; am. 2010, ch. 235, sec. 33, p. 569.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 22 - GROUP AND BLANKET DISABILITY INSURANCE › Section 41-2204 - DIRECT PAYMENT OF HOSPITAL AND MEDICAL SERVICES.

41-2204. DIRECT PAYMENT OF HOSPITAL AND MEDICAL SERVICES. Any group disability policy may provide that all or any portion of any indemnities provided by any such policy on account of hospital, nursing, medical or surgical services may, at the insurer’s option, be paid directly to the hospital or person rendering such services; but the policy may not require that the service be rendered by a particular hospital or person. Payments so made shall discharge the insurer’s obligation with respect to the amount of insurance so paid.
History:
[41-2204, added 1961, ch. 330, sec. 530, p. 645.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 22 - GROUP AND BLANKET DISABILITY INSURANCE › Section 41-2205 - READJUSTMENT OF PREMIUMS — DIVIDENDS.

41-2205. READJUSTMENT OF PREMIUMS — DIVIDENDS. Any contract of group disability insurance may provide for the readjustment of the rate of premium based upon the experience thereunder. If a policy dividend is hereafter declared or a reduction in rate is hereafter made or continued for the first or any subsequent year of insurance under any policy of group disability insurance heretofore or hereafter issued to any policyholder, the excess, if any, of the aggregate dividends or rate reductions under such policy and all other group insurance policies of the policyholder over the aggregate expenditure for insurance under such policies made from funds contributed by the policyholder, or by an employer or insured persons, or by a union or association to which the insured persons belong, including expenditures made in connection with administration of such policies, shall be applied by the policyholder for the sole benefit of insured employees or members.
History:
[41-2205, added 1961, ch. 330, sec. 531, p. 645.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 22 - GROUP AND BLANKET DISABILITY INSURANCE › Section 41-2206 - “BLANKET DISABILITY INSURANCE” DEFINED.

41-2206. "BLANKET DISABILITY INSURANCE" DEFINED. "Blanket disability insurance" is hereby declared to be that form of disability insurance covering groups of persons as enumerated in one of the following subdivisions.
(1) Under a policy or contract issued to any common carrier or to any operator, owner or lessee of a means of transportation, who or which shall be deemed the policyholder, covering a group defined as all persons or all persons of a class who may become passengers on such common carrier or such means of transportation.
(2) Under a policy or contract issued to an employer, who shall be deemed the policyholder, covering the employer and all employees, dependents or guests, defined by reference to specified hazards incident to the activities or operations of the employer or any class of employees, dependents or guests similarly defined.
(3) Under a policy or contract issued to a school, or other institution of learning, camp or sponsor thereof; or to the head or principal thereof, who or which shall be deemed the policyholder, covering students or campers. Supervisors and employees may be included.
(4) Under a policy or contract issued in the name of any religious, charitable, recreational, educational, or civic organization, which shall be deemed the policyholder, covering participants in activities sponsored by the organization.
(5) Under a policy or contract issued to a sports team or sponsors thereof which shall be deemed the policyholder, covering members, officials and supervisors.
(6) Under a policy or contract issued in the name of any volunteer fire department, first aid, or other such volunteer group, or agency having jurisdiction thereof, which shall be deemed the policyholder, covering all of the members of such fire department or group.
(7) Under a policy or contract issued to cover any other risk or class of risks which, in the discretion of the director may be properly eligible for blanket disability insurance. The discretion of the director may be exercised on an individual risk basis or class of risks, or both.
History:
[41-2206, added 1961, ch. 330, sec. 532, p. 645.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 22 - GROUP AND BLANKET DISABILITY INSURANCE › Section 41-2208 - APPLICATION AND CERTIFICATES NOT REQUIRED.

41-2208. APPLICATION AND CERTIFICATES NOT REQUIRED. An individual application shall not be required from a person covered under a blanket disability policy or contract, nor shall it be necessary for the insurer to furnish each such person a certificate of the insurance.
History:
[41-2208, added 1961, ch. 330, sec. 534, p. 645.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 22 - GROUP AND BLANKET DISABILITY INSURANCE › Section 41-2209 - PAYMENT OF BENEFITS UNDER BLANKET POLICY.

41-2209. PAYMENT OF BENEFITS UNDER BLANKET POLICY. All benefits under any blanket disability policy shall be payable to the person insured, or to his designated beneficiary or beneficiaries, or to his estate; except, that if the person insured be a minor or mental incompetent, such benefits may be made payable to his parent, guardian, or other person actually supporting him; or if the entire cost of the insurance has been borne by the employer such benefits may be made payable to the employer. Provided, however, that the policy may provide that all or any portion of any indemnities provided by such policy on account of hospital, nursing, medical or surgical services may, at the insurer’s option, be paid directly to the hospital or person rendering such services; but the policy may not require that the service be rendered by a particular hospital or person. Payment so made shall discharge the insurer’s obligation with respect to the amount of insurance so paid.
History:
[41-2209, added 1961, ch. 330, sec. 535, p. 645.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 22 - GROUP AND BLANKET DISABILITY INSURANCE › Section 41-2210A - LIMITATION OF BENEFITS FOR ELECTIVE ABORTIONS.

41-2210A. LIMITATION OF BENEFITS FOR ELECTIVE ABORTIONS. All policies, contracts, plans or certificates of group or blanket disability insurance delivered, issued for delivery or renewed in this state after the effective date of this section shall exclude coverage for elective abortions. Such exclusion may be waived by endorsement and the payment of a premium therefor. Availability of such coverage shall be at the option of the insurance carrier. For purposes of this section, an "elective abortion" means an abortion for any reason other than to preserve the life of the female upon whom the abortion is performed.
History:
[41-2210A, added 1983, ch. 94, sec. 2, p. 207.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 22 - GROUP AND BLANKET DISABILITY INSURANCE › Section 41-2210D - CONVERSION PLAN — WHEN REQUIRED.

41-2210D. CONVERSION PLAN — WHEN REQUIRED. Any group carrier doing business in the state of Idaho that does not have an individual product on file with the department of insurance shall provide a conversion plan to all group insureds. The conversion plan shall provide benefits at least equal to the standard health benefit plan developed pursuant to section 41-4712, Idaho Code. The premium under the plan shall not exceed one hundred twenty-five percent (125%) of the index rate for groups.
History:
[41-2201D, added 1996, ch. 124, sec. 1, p. 438.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 22 - GROUP AND BLANKET DISABILITY INSURANCE › Section 41-2211 - SCOPE OF ACT — REPLACEMENT OF GROUP DISABILITY INSURANCE, GROUP NONPROFIT HOSPITAL AND MEDICAL SERVICE CONTRACTS AND HEALTH CARE SERVICE PLANS.

41-2211. SCOPE OF ACT — REPLACEMENT OF GROUP DISABILITY INSURANCE, GROUP NONPROFIT HOSPITAL AND MEDICAL SERVICE CONTRACTS AND HEALTH CARE SERVICE PLANS. The provisions of this act shall apply to all policies of group disability insurance issued in this state pursuant to the provisions of chapter 22, title 41, Idaho Code, and any group nonprofit hospital and medical service contract issued in this state pursuant to the provisions of chapter 34, title 41, Idaho Code, and all group health care service plans issued in this state pursuant to chapter 39, title 41, Idaho Code.
History:
[41-2211, added 1975, ch. 204, sec. 2, p. 565.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 22 - GROUP AND BLANKET DISABILITY INSURANCE › Section 41-2212 - DEFINITIONS.

41-2212. DEFINITIONS. In this act, unless the context otherwise requires:
(1) "Carrier" shall mean the insurance company, nonprofit hospital and medical service corporation, or other entity responsible for the payment of benefits or provision of services under a policy.
(2) "Dependent" shall have the meaning set forth in a policy.
(3) "Discontinuance" shall mean the termination of a policy by action taken by the policyholder, including failure to pay premium within the period provided by the policy, or by the carrier pursuant to a provision of the policy permitting termination or by mutual agreement of the policyholder and carrier.
(4) "Employee" shall mean all agents, employees, and members of unions or associations to whom benefits are provided under a policy.
(5) "Extension of Benefits" means the continuation of coverage under a particular benefit provided under a policy following discontinuance with respect to an employee or dependent who is totally disabled on the date of discontinuance.
(6) "Policy" shall mean any group insurance policy, group hospital and medical service contract or other plan, contract or policy subject to the provisions of this act.
(7) "Policyholder" shall mean the entity to which a policy is issued as specified in section 41-2213.
(8) "Premium" shall mean the consideration payable to the carrier.
(9) "Replacement Coverage" shall mean the benefits which are substituted under one carrier’s policy by similar benefits under a policy issued by another carrier.
(10) "Totally Disabled" shall have the meaning set forth in a policy and not be inconsistent with the definition of "disability insurance" in section 41-503, Idaho Code.
History:
[41-2212, added 1975, ch. 204, sec. 3, p. 565.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 22 - GROUP AND BLANKET DISABILITY INSURANCE › Section 41-2213 - POLICY STANDARDS — DISABLED INDIVIDUALS.

41-2213. POLICY STANDARDS — DISABLED INDIVIDUALS. Every policy containing the benefits described in subsections (1), (2) and (3) of this section must contain a provision which provides for a reasonable extension of benefits with respect to employees or dependents who become totally disabled after the effective date of this act and continue to be totally disabled at the date of discontinuance of the policy. Such an extension of benefits provision will be deemed a reasonable extension of benefits provision if it complies with the standards set forth in subsections (1), (2) and (3) of this section.
(1) In the case of a policy providing benefits for loss of time or a specific indemnity during hospital confinement, the extension of benefits provision will be deemed reasonable if continuance does not affect the benefit provided.
(2) In the case of a policy providing hospital, medical or surgical expense coverage, the extension of benefits provision will be deemed reasonable if it provides benefits for covered expenses incurred as the result of the disabling condition beyond the date of discontinuance for a period of not less than twelve (12) months.
(3) In the case of a policy providing loss by dismemberment, the extension of benefits provision will be deemed reasonable if it provides benefits for dismemberment loss that occurs after termination of policy that was a result of a disabling condition that occurred while the policy was in effect. Benefits for any such loss will be payable under the policy, in accordance with its limitations, exceptions and provisions as if this policy had not been so terminated.
The benefits payable during any extension of benefits may be subject to all limitations or restrictions contained in the policy. Any extension of benefits may be terminated at such time as the employee or dependent is no longer totally disabled.
History:
[41-2213, added 1975, ch. 204, sec. 4, p. 565; am. 1978, ch. 8, sec. 1, p. 14.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 22 - GROUP AND BLANKET DISABILITY INSURANCE › Section 41-2214 - POLICY STANDARDS — MATERNITY BENEFITS.

41-2214. POLICY STANDARDS — MATERNITY BENEFITS. If a policy provides any benefits for pregnancy, childbirth or miscarriage and if an employee or dependent covered for such benefit is pregnant at the time of discontinuance and is not eligible for any replacement group coverage within sixty (60) days of discontinuance, the policy must provide that benefits will be payable to the same extent as if discontinuance had not occurred for any covered benefits in connection with such pregnancy, childbirth or miscarriage, but not beyond a period of twelve (12) months following such discontinuance.
History:
[41-2214, added 1975, ch. 204, sec. 5, p. 565; am. 2001, ch. 129, sec. 1, p. 451.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 22 - GROUP AND BLANKET DISABILITY INSURANCE › Section 41-2215 - POLICY STANDARDS — REPLACEMENT CONTRACTS.

41-2215. POLICY STANDARDS — REPLACEMENT CONTRACTS. (1) Any carrier providing replacement coverage with respect to hospital, medical or surgical expense benefits within a period of sixty (60) days from the date of discontinuance of a prior policy providing such hospital, medical or surgical expense benefits shall immediately cover all employees and dependents validly covered under the previous policy at the date of discontinuance who are within the definitions of eligibility and who would otherwise be eligible for coverage under the succeeding carrier’s policy, regardless of any limitations or exclusions relating to active employment or nonconfinement.
(2) With respect to an employee or dependent who was totally disabled on the date of discontinuance of the prior carrier’s policy and required to be covered under subsection (1) of this section, the succeeding carrier shall be entitled to deduct from any benefits becoming payable under its policy the amount of benefits payable by the prior carrier pursuant to an extension of benefits provision.
(3) An employee or dependent entitled to coverage under a succeeding carrier’s policy pursuant to subsection (1) or (2) of this section shall continue to be covered by the succeeding carrier until the earlier of the following:
(a) The date coverage would terminate for an employee or dependent in accordance with the provisions of the succeeding carrier’s policy; or
(b) In the case of an employee or dependent who was totally disabled on the date of discontinuance of the prior carrier’s policy and entitled to an extension of benefits pursuant to subsection (2) of section 41-2213, the date the period of extension of benefits terminates or, if the prior carrier’s policy is not subject to this act, the date to which benefits would have been extended had the prior carrier’s policy been subject to this act.
(4) No provision in a succeeding carrier’s policy of replacement coverage which would operate to reduce or exclude benefits on the basis that the condition giving rise to benefits preexisted the effective date of the succeeding carrier’s policy shall be applied with respect to those employees and dependents validly insured under the prior carrier’s policy on the date of discontinuance, if benefits for such condition would have been payable under the prior carrier’s policy.
(5) In a situation where a determination of the prior carrier’s benefit is required by the succeeding carrier, at the succeeding carrier’s request, the prior carrier shall furnish a statement of benefits available or pertinent information, sufficient to permit verification of the benefit determination by the succeeding carrier, at no cost.
History:
[41-2215, added 1975, ch. 204, sec. 6, p. 565; am. 2003, ch. 307, sec. 1, p. 843.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 22 - GROUP AND BLANKET DISABILITY INSURANCE › Section 41-2216 - COORDINATION OF BENEFITS — COORDINATION WITH SOCIAL SECURITY BENEFITS.

41-2216. COORDINATION OF BENEFITS — COORDINATION WITH SOCIAL SECURITY BENEFITS. (1) Under the authority of this section and section 41-2141, Idaho Code, the director shall promulgate rules that are in accordance with the model regulations of the national association of insurance commissioners relating to coordination of benefits provisions in group and individual disability insurance policies. This section shall apply to all policies of group disability insurance or coverage issued in this state pursuant to the provisions of chapters 22, 34, 39 and 47, title 41, Idaho Code. These rules shall establish uniformity in the permissive use of provisions governing the coordination of benefits between group disability policies and between group disability policies and individual disability policies in order to avoid claim delays and misunderstandings that otherwise result from the use of inconsistent or incompatible provisions.
(2) Any provision contained in a policy of group or blanket disability insurance providing for a reduction of benefits payable under the policy during a policy benefit period due to an increase in benefits payable under the federal social security act, as amended, shall be null and void with respect to any such increase which occurs on or after the effective date of this act.
History:
[41-2216, added 1978, ch. 10, sec. 2, p. 20; am. 1989, ch. 143, sec. 1, p. 348; am. 1997, ch. 319, sec. 2, p. 943.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 22 - GROUP AND BLANKET DISABILITY INSURANCE › Section 41-2217 - SERVICES PROVIDED BY GOVERNMENTAL ENTITIES.

41-2217. SERVICES PROVIDED BY GOVERNMENTAL ENTITIES. (1) From and after July 1, 1990, no group or blanket disability insurance policy shall be issued in Idaho which excludes from coverage services rendered the insured while a resident in an Idaho state institution, provided the services to the insured would be covered by the policy if rendered to him outside an Idaho state institution.
(2) From and after July 1, 1990, no group or blanket disability insurance policy may contain any provision denying or reducing benefits otherwise provided under the policy for the reason that the person insured is receiving health or mental health care or developmental services provided by the department of health and welfare, whether or not the department of health and welfare bases its charges for such services on the recipient’s ability to pay. Provided, nothing in this section shall prevent the issuance of a policy which excludes or reduces benefits where the charge level or amount of the charge levied by a governmental entity for such services would vary or be affected in any way by the existence of insurance coverage.
History:
[41-2217, added 1990, ch. 300, sec. 2, p. 828.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 22 - GROUP AND BLANKET DISABILITY INSURANCE › Section 41-2218 - MAMMOGRAPHY COVERAGE.

41-2218. MAMMOGRAPHY COVERAGE. (1) From and after July 1, 1992, all group or blanket disability insurance policies which provide coverage for the surgical procedure known as a mastectomy which are delivered, issued for delivery, continued or renewed in this state shall provide minimum mammography examination or equivalent examination coverage. Such coverage shall include at least the following benefits:
(a) One (1) baseline mammogram for any woman who is thirty-five (35) through thirty-nine (39) years of age.
(b) A mammogram every two (2) years for any woman who is forty (40) through forty-nine (49) years of age, or more frequently if recommended by the woman’s physician.
(c) A mammogram every year for any woman who is fifty (50) years of age or older.
(d) A mammogram for any woman desiring a mammogram for medical cause.
Such coverage shall not exceed the cost of the examination.
(2) As used in this section, "mastectomy" means the removal of all or part of the breast for medically necessary reasons as determined by a licensed physician.
(3) Nothing in this section shall apply to specified accident, specified disease, hospital indemnity, medicare supplement, long-term care or other limited benefit health insurance policies.
History:
[41-2218, added 1992, ch. 132, sec. 2, p. 414; am. 1993, ch. 113, sec. 2, p. 289.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 23 - CREDIT LIFE AND CREDIT DISABILITY INSURANCE › Section 41-2301 - DECLARATION OF PURPOSE.

41-2301. DECLARATION OF PURPOSE. The purpose of this chapter is to promote the public welfare by regulating credit life insurance and credit disability insurance. Nothing in this chapter is intended to prohibit or discharge or discourage reasonable competition. The provisions of this chapter shall be liberally construed.
History:
[41-2301, added 1961, ch. 330, sec. 536, p. 645.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 23 - CREDIT LIFE AND CREDIT DISABILITY INSURANCE › Section 41-2302 - SHORT TITLE.

41-2302. SHORT TITLE. This chapter may be cited as "the model law for the regulation of credit life insurance and credit disability insurance".
History:
[41-2302, added 1961, ch. 330, sec. 537, p. 645.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 23 - CREDIT LIFE AND CREDIT DISABILITY INSURANCE › Section 41-2303 - SCOPE OF CHAPTER.

41-2303. SCOPE OF CHAPTER. All life insurance and all disability insurance in connection with loans or other credit transactions shall be subject to the provisions of this chapter; except, that insurance in connection with a loan or other credit transaction of more than fifteen (15) years duration shall not be subject to this chapter, nor shall insurance be subject to this chapter where the issuance of such insurance is an isolated transaction on the part of the insurer not related to an agreement or a plan for insuring debtors of the creditor.
History:
[41-2303, added 1961, ch. 330, sec. 538, p. 645; am. 1972, ch. 369, sec. 11, p. 1072; am. 1974, ch. 152, sec. 3, p. 1375; am. 1993, ch. 48, sec. 1, p. 125.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 23 - CREDIT LIFE AND CREDIT DISABILITY INSURANCE › Section 41-2304 - DEFINITIONS.

41-2304. DEFINITIONS. For the purposes 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 disability insurance" means insurance on a debtor to provide indemnity 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 of goods, services or property, including a lessor under a lease intended as a security, 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 or vendor, and an 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.
(5) "Indebtedness" means the total amount payable by a debtor to a creditor in connection with a loan or other credit transaction.
History:
[41-2304, added 1961, ch. 330, sec. 539, p. 645.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 23 - CREDIT LIFE AND CREDIT DISABILITY INSURANCE › Section 41-2305 - FORMS OF CREDIT LIFE INSURANCE AND CREDIT DISABILITY INSURANCE.

41-2305. FORMS OF CREDIT LIFE INSURANCE AND CREDIT DISABILITY INSURANCE. Credit life insurance and credit disability insurance shall be issued only in the following forms:
(1) Individual policies of life insurance issued to debtors on the term plan.
(2) Individual policies of disability insurance issued to debtors on a term plan, or disability benefit provisions in individual policies of credit life insurance.
(3) Group policies of life insurance issued to creditors providing insurance upon the lives of debtors on the term plan.
(4) Group policies of disability insurance issued to creditors on a term plan insuring debtors, or disability benefit provisions in group credit life insurance policies to provide such coverage.
History:
[41-2305, added 1961, ch. 330, sec. 540, p. 645.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 23 - CREDIT LIFE AND CREDIT DISABILITY INSURANCE › Section 41-2306 - AMOUNT OF INSURANCE.

41-2306. AMOUNT OF INSURANCE. (1) Credit life insurance:
(a) The amount of credit life insurance shall not exceed the initial indebtedness, however the indebtedness may be repayable.
(b) In cases where an indebtedness is repayable in substantially equal instalments, the amount of insurance shall at no time exceed the scheduled or actual amount of unpaid indebtedness, whichever is greater.
(c) Notwithstanding the provisions of (a) or (b) above, insurance on agricultural credit transactions not exceeding one year in duration may be written up to the amount of the loan commitment on a nondecreasing or level term plan.
(d) Except, that the amount of insurance provided under a group insurance contract shall be subject to section 41-2005(4) (debtor groups).
(2) Credit disability insurance: The total amount of indemnity payable by credit disability insurance in the event of disability, as defined in the policy, shall not exceed the aggregate of the periodic scheduled unpaid instalments of the indebtedness; and the amount of each periodic indemnity payment shall not exceed the original indebtedness divided by the number of periodic instalments.
History:
[41-2306, added 1961, ch. 330, sec. 541, p. 645.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 23 - CREDIT LIFE AND CREDIT DISABILITY INSURANCE › Section 41-2307 - TERM OF CREDIT LIFE INSURANCE AND CREDIT DISABILITY INSURANCE.

41-2307. TERM OF CREDIT LIFE INSURANCE AND CREDIT DISABILITY INSURANCE. The term of any credit life insurance or credit disability 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. Where evidence of insurability is required and such evidence is furnished more than thirty (30) days after the date when the debtor becomes obligated to the creditor, the term of the insurance may commence on the date on which the insurer 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 41-2310.
History:
[41-2307, added 1961, ch. 330, sec. 542, p. 645.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 23 - CREDIT LIFE AND CREDIT DISABILITY INSURANCE › Section 41-2310 - PREMIUMS AND REFUNDS.

41-2310. PREMIUMS AND REFUNDS. (1) Any insurer may revise its schedules of premium rates from time to time, and shall file such revised schedules with the director. No insurer shall issue any credit life insurance or credit disability insurance policy for which the premium rate exceeds that determined by the schedules of such insurer as then on file with the director.
(2) 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 director 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 director.
(3) If a creditor requires a debtor to make any payment for credit life insurance or credit disability 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.
(4) The amount charged to a debtor for any credit life or credit disability insurance shall not exceed the premiums charged by the insurer, as computed at the time the charge to the debtor is determined.
(5) Nothing in this chapter shall be construed to authorize any payments for insurance now prohibited under any statute, or rule thereunder, governing credit transactions.
History:
[41-2310, added 1961, ch. 330, sec. 545, p. 645.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 23 - CREDIT LIFE AND CREDIT DISABILITY INSURANCE › Section 41-2311 - ISSUANCE OF POLICIES.

41-2311. ISSUANCE OF POLICIES. All policies of credit life insurance and credit disability insurance shall be delivered or issued for delivery in this state only by an insurer authorized to do an insurance business therein, and shall be issued only through holders of licenses or authorizations issued by the director.
History:
[41-2311, added 1961, ch. 330, sec. 546, p. 645.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 23 - CREDIT LIFE AND CREDIT DISABILITY INSURANCE › Section 41-2312 - CLAIMS.

41-2312. CLAIMS. (1) 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.
(2) 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.
(3) 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.
History:
[41-2312, added 1961, ch. 330, sec. 547, p. 645.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 23 - CREDIT LIFE AND CREDIT DISABILITY INSURANCE › Section 41-2313 - EXISTING INSURANCE — CHOICE OF INSURER.

41-2313. EXISTING INSURANCE — CHOICE OF INSURER. When credit life insurance or credit disability insurance is required as additional security for any indebtedness, the debtor shall, upon request to the creditor, 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.
History:
[41-2313, added 1961, ch. 330, sec. 548, p. 645.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 23 - CREDIT LIFE AND CREDIT DISABILITY INSURANCE › Section 41-2314 - ENFORCEMENT.

41-2314. ENFORCEMENT. The director may, after notice and hearing, issue such rules and regulations as he deems appropriate for the supervision of this chapter. Whenever the director finds that there has been a violation of this chapter or any rules or regulations issued pursuant thereto, and after written notice thereof and hearing given to the insurer or other person authorized or licensed by the director, 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 director on the date specified unless sooner withdrawn by the director or a stay thereof has been ordered by a court of competent jurisdiction.
History:
[41-2314, added 1961, ch. 330, sec. 549, p. 645.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 23 - CREDIT LIFE AND CREDIT DISABILITY INSURANCE › Section 41-2316 - PENALTIES.

41-2316. PENALTIES. In addition to any other penalty provided by law, any person who violates an order of the director 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 Idaho 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 ($1,000). The director, in his discretion, may revoke or suspend the license or certificate of authority of the person 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 chapter 52, title 67, Idaho Code.
History:
[41-2316, added 1961, ch. 330, sec. 551, p. 645; am. 1977, ch. 142, sec. 8, p. 310; am. 2005, ch. 77, sec. 26, p. 271.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 25 - CASUALTY INSURANCE CONTRACTS › Section 41-2501 - CONTRACTS ARE SUBJECT TO GENERAL PROVISIONS.

41-2501. CONTRACTS ARE SUBJECT TO GENERAL PROVISIONS. All contracts of casualty insurance covering subjects of insurance resident, located, or to be performed in this state are subject to the applicable provisions of chapter 18 (the insurance contract), and to the other applicable provisions of this code.
History:
[41-2501, added 1961, ch. 330, sec. 553, p. 645.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 25 - CASUALTY INSURANCE CONTRACTS › Section 41-2502 - UNINSURED MOTORIST AND UNDERINSURED MOTORIST COVERAGE FOR AUTOMOBILE INSURANCE — EXCEPTIONS.

41-2502. UNINSURED MOTORIST AND UNDERINSURED MOTORIST COVERAGE FOR AUTOMOBILE INSURANCE — EXCEPTIONS. (1) Except as otherwise provided in subsection (2) of this section, no owner’s or operator’s policy of motor vehicle liability insurance that is subject to the requirements of section 49-1212(1) or (2), Idaho Code, shall be delivered or issued for delivery in this state with respect to any motor vehicle registered or principally garaged in this state unless coverage is provided therein or supplemental thereto, in limits for bodily injury or death as set forth in section 49-117, Idaho Code, as amended from time to time, under provisions approved by the director of the department of insurance, for the protection of persons insured thereunder who are legally entitled to recover damages from owners or operators of uninsured and underinsured motor vehicles because of bodily injury, sickness or disease, including death, resulting therefrom.
(2) A named insured shall have the right to reject either or both uninsured motorist coverage or underinsured motorist coverage, which rejection must be in writing or in an electronic record as authorized by the uniform electronic transactions act, chapter 50, title 28, Idaho Code, and such rejection shall be effective as to all other insureds and named insureds; and after which such rejected coverage need not be provided in or supplemental to a renewal or replacement policy issued by the same insurer or an affiliate of that insurer.
(3) Prior to the issuance of any new policy or the first renewal or replacement of any existing policy of motor vehicle liability insurance with an effective date on or after January 1, 2009, a named insured shall be provided a standard statement approved by the director of the department of insurance, explaining in summary form, both uninsured and underinsured motorist coverage, and the different forms of underinsured motorist coverage that might be available from insurers in Idaho.
(4) The provisions of this section shall not apply to policies of motor vehicle liability insurance for coverage on all-terrain vehicles, utility type vehicles, specialty off-highway vehicles or motorbikes as those terms are defined in section 67-7101, Idaho Code.
History:
[41-2502, as added by 1967, ch. 61, sec. 1, p. 124; am. 1988, ch. 265, sec. 572, p. 870; am. 2008, ch. 69, sec. 1, p. 183; am. 2009, ch. 157, sec. 1, p. 458.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 25 - CASUALTY INSURANCE CONTRACTS › Section 41-2503 - DEFINITIONS AND APPLICATION.

41-2503. DEFINITIONS AND APPLICATION. (1) For the purposes of uninsured motorist coverage, the term "uninsured motor vehicle" shall, subject to the terms and conditions of such coverage, be deemed to include an insured motor vehicle where the liability insurer thereof is unable to make payment with respect to the legal liability of its insured within the limits specified therein because of insolvency.
(2) For purposes of underinsured motorist coverage, subject to the further definitions, terms and conditions of such coverage, the term "underinsured motor vehicle" means a motor vehicle that is a self-insured motor vehicle, or a motor vehicle that is covered by a policy of motor vehicle liability insurance or an indemnity bond, with limits for bodily injury or death at least equal to those limits set forth in section 49-117, Idaho Code.
(3) Except as provided in subsections (1) and (2) of this section, the terms and conditions of any policy of motor vehicle liability insurance providing uninsured motorist coverage or underinsured motorist coverage are not altered or amended.
History:
[41-2503, as added by 1967, ch. 61, sec. 2, p. 124; am. 2008, ch. 69, sec. 2, p. 184.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 25 - CASUALTY INSURANCE CONTRACTS › Section 41-2504 - APPLICATION OF UNINSURED MOTORIST COVERAGE.

41-2504. APPLICATION OF UNINSURED MOTORIST COVERAGE. An insurer’s insolvency protection shall be applicable only to accidents occurring during a policy period in which its insured’s uninsured motorist coverage is in effect where the liability insurer of the tortfeasor becomes insolvent within one (1) year after such an accident. Nothing herein contained shall be construed to prevent any insurer from affording insolvency protection under terms and conditions more favorable to its insureds than is provided hereunder.
History:
[I.C., sec. 41-2504, as added by 1967, ch. 61, sec. 3, p. 124.]
2023 Idaho Code › Title 41 - INSURANCE › Chapter 25 - CASUALTY INSURANCE CONTRACTS › Section 41-2505 - SUBROGATION RIGHTS OF INSURER.

41-2505. SUBROGATION RIGHTS OF INSURER. In the event of payment to an insured under the coverage required by this section and subject to the terms and conditions of such coverage, the insurer making such payment shall, to the extent thereof, be entitled to the proceeds of any settlement or judgment resulting from the exercise of any rights of recovery of such insured against any person or organization legally responsible for the bodily injury for which such payment is made, including the proceeds recoverable from the assets of the insolvent insurer. Whenever an insurer shall make payment under the coverage required by this section and which payment is occasioned by an insolvency, such insurer’s right of recovery or reimbursement shall not include any rights against the insured of said insolvent insurer, but such paying insurer shall have the right to proceed directly against the insolvent insurer or its receiver, and in pursuance of such right such paying insurer shall possess any rights which the insured of the insolvent company might otherwise have had, if the insured of the insolvent insurer had personally made the payment.
History:
[I.C., sec. 41-2505, as added by 1967, ch. 61, sec. 4, p. 124.]