reglab/statecodes huggingface dataset:
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3412 - Notice of Claim; Provision Required.

500.3412 Notice of claim; provision required.
Sec. 3412.
(1) Except as otherwise provided in subsection (2), an insurer shall include in a disability insurance policy, other than a health insurance policy, a provision as follows:
NOTICE OF CLAIM: Written notice of claim must be given to the insurer within 20 days after the occurrence or commencement of a loss covered by the policy, or as soon after the loss as is reasonably possible. Notice given by or on behalf of the insured or the beneficiary to the insurer at ..................... (insert the location of the office the insurer designates for this purpose), or to any authorized agent of the insurer, with information sufficient to identify the insured, is considered notice to the insurer.
(2) For a policy that provides a loss-of-time benefit payable for at least 2 years, an insurer may at its option insert the following between the first and second sentences of the provision required under subsection (1):
Subject to the qualifications set forth below, if the insured suffers loss of time on account of disability for which indemnity is payable for at least 2 years, the insured will, at least once in every 6 months after having given notice of claim, give to the insurer notice of continuance of the disability, unless the insured is legally incapacitated. The period of 6 months following any filing of proof by the insured or any payment by the insurer on account of the claim or any denial of liability in whole or in part by the insurer is excluded in applying this provision. Delay in giving the notice required under this provision does not impair the insured's right to any indemnity that would otherwise have accrued during the 6 months preceding the date on which the notice is actually given.
History:
1956, Act 218, Eff. Jan. 1, 1957 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3413 - Claim Forms; Provision Required.

500.3413 Claim forms; provision required.
Sec. 3413.
An insurer shall include in a disability insurance policy, other than a health insurance policy, a provision as follows:
CLAIM FORMS: The insurer, upon receipt of a notice of claim, will furnish to the claimant the forms that are usually furnished for filing proofs of loss. If the forms are not furnished within 15 days after the giving of the notice, the claimant is considered to have complied with the requirements of this policy as to proof of loss upon submitting, within the time fixed in the policy for filing proofs of loss, written proof covering the occurrence, the character, and the extent of the loss for which claim is made.
History:
1956, Act 218, Eff. Jan. 1, 1957 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3414 - Proofs of Loss; Provision Required.

500.3414 Proofs of loss; provision required.
Sec. 3414.
An insurer shall include in a disability insurance policy, other than a health insurance policy, a provision as follows:
PROOFS OF LOSS: Written proof of loss must be furnished to the insurer at its designated office. Proof of loss for a claim for loss for which this policy provides any periodic payment that is contingent upon continuing loss must be furnished within 90 days after the termination of the period for which the insurer is liable. Proof of loss for a claim for any other loss must be furnished within 90 days after the date of the loss. Failure to furnish the proof within the time required under this provision does not invalidate or reduce the claim if it was not reasonably possible to give proof within the time required if the proof is furnished as soon as reasonably possible and, unless the claimant is legally incapacitated, not later than 1 year after the time proof is otherwise required.
History:
1956, Act 218, Eff. Jan. 1, 1957 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3416 - Time of Payment of Claims; Provision Required.

500.3416 Time of payment of claims; provision required.
Sec. 3416.
An insurer shall include in a disability insurance policy, other than a health insurance policy, a provision as follows:
TIME OF PAYMENT OF CLAIMS: Indemnities payable under this policy for a loss other than loss for which this policy provides a periodic payment will be paid immediately upon receipt of due written proof of the loss. Subject to due written proof of loss, all accrued indemnities for loss for which this policy provides periodic payment will be paid ....................... (insert period for payment that must not be less frequently than monthly) and any balance remaining unpaid on the termination of liability will be paid immediately upon receipt of due written proof.
History:
1956, Act 218, Eff. Jan. 1, 1957 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3418 - Payment of Claims; Provision Required.

500.3418 Payment of claims; provision required.
Sec. 3418.
(1) Except as otherwise provided in subsection (2), an insurer shall include in a disability insurance policy, other than a health insurance policy, a provision as follows:
PAYMENT OF CLAIMS: Indemnity for loss of life will be payable in accordance with the beneficiary designation and the provisions respecting the payment, which may be prescribed in this policy, and effective at the time of payment. If a designation or provision is not in effect, the indemnity is payable to the estate of the insured. Other accrued indemnities unpaid at the insured's death may, at the option of the insurer, be paid either to the beneficiary or to the estate. All other indemnities are payable to the insured.
(2) One or more of the following provisions may be included with the provision required under subsection (1) at the option of the insurer:
(a) If indemnity under this policy is payable to the estate of the insured, or to an insured or beneficiary who is a minor or otherwise not competent to give a valid release, the insurer may pay the indemnity, up to an amount that does not exceed $........ (insert an amount that does not exceed $1,000.00), to any relative by blood or connection by marriage of the insured or beneficiary who is determined by the insurer to be equitably entitled to the indemnity. Payment made by the insurer in good faith pursuant to this provision fully discharges the insurer to the extent of the payment.
(b) Subject to any written direction of the insured in the application or otherwise, all or a portion of any indemnities provided by this policy on account of health care services may, at the insurer's option and unless the insured requests otherwise in writing not later than the time of filing proofs of the loss, be paid directly to the hospital or person rendering the health care services.
History:
1956, Act 218, Eff. Jan. 1, 1957 ;-- Am. 1984, Act 280, Imd. Eff. Dec. 20, 1984 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3420 - Physical Examinations and Autopsy; Provision Required.

500.3420 Physical examinations and autopsy; provision required.
Sec. 3420.
An insurer shall include in a disability insurance policy, other than a health insurance policy, a provision as follows:
PHYSICAL EXAMINATIONS AND AUTOPSY: The insurer at its own expense has the right and must be given the opportunity to examine the insured at reasonable times and as frequently as reasonably required during the pendency of a claim under this policy and to make an autopsy in case of death if not forbidden by law.
History:
1956, Act 218, Eff. Jan. 1, 1957 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3422 - Legal Actions; Provision Required.

500.3422 Legal actions; provision required.
Sec. 3422.
An insurer shall include in a disability insurance policy, other than a health insurance policy, a provision as follows:
LEGAL ACTIONS: An insured must not bring an action at law or in equity to recover on this policy before the expiration of 60 days after written proof of loss has been furnished in accordance with the requirements of this policy. An insured must not bring an action at law or in equity after the expiration of 3 years after the time written proof of loss is required to be furnished.
History:
1956, Act 218, Eff. Jan. 1, 1957 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3424 - Change of Beneficiary; Provision Required.

500.3424 Change of beneficiary; provision required.
Sec. 3424.
(1) Except as otherwise provided in subsection (2), an insurer shall include in a disability insurance policy, other than a health insurance policy, a provision as follows:
CHANGE OF BENEFICIARY: Unless the insured makes an irrevocable designation of beneficiary, the insured has the right to change the beneficiary under this policy. Consent of a beneficiary is not required to surrender this policy, for the assignment of the policy, to change a beneficiary, or to make any other changes in the policy.
(2) The first clause of the provision required under subsection (1), relating to the irrevocable designation of beneficiary, may be omitted at the insurer's option.
History:
1956, Act 218, Eff. Jan. 1, 1957 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3425 - Health Insurance Policy; Coverage for Intermediate and Outpatient Care for Substance Use Disorder Required; Charges, Terms, and Conditions; Reduction of Coverage; Deductibles and Copayment Provisions; Definitions.

500.3425 Health insurance policy; coverage for intermediate and outpatient care for substance use disorder required; charges, terms, and conditions; reduction of coverage; deductibles and copayment provisions; definitions.
Sec. 3425.
(1) Except as otherwise provided in this subsection, an insurer that delivers, issues for delivery, or renews in this state a health insurance policy shall provide coverage for intermediate and outpatient care for substance use disorder. This section does not apply to limited classification policies.
(2) Charges, terms, and conditions for the coverage required to be provided under subsection (1) must not be less favorable than the maximum prescribed for any other comparable service.
(3) The insurer shall not reduce the coverage required to be provided under subsection (1) by terms or conditions that apply to other items of coverage in a health insurance policy, group or individual. This subsection does not prohibit an insurer from providing in a health insurance policy deductibles and copayment provisions for coverage for intermediate and outpatient care for substance use disorder.
(4) As used in this section:
(a) "Intermediate care" means the use, in a full 24-hour residential therapy setting, or in a partial, less than 24-hour, residential therapy setting, of any or all of the following therapeutic techniques, as identified in a treatment plan for individuals physiologically or psychologically dependent on or abusing alcohol or drugs:
(i) Chemotherapy.
(ii) Counseling.
(iii) Detoxification services.
(iv) Other ancillary services, such as medical testing, diagnostic evaluation, and referral to other services identified in the treatment plan.
(b) "Limited classification policy" means an accident only policy, a limited accident policy, a travel accident policy, or a specified disease policy.
(c) "Outpatient care" means the use, on both a scheduled and a nonscheduled basis, of any or all of the following therapeutic techniques, as identified in a treatment plan for individuals physiologically or psychologically dependent on or abusing alcohol or drugs:
(i) Chemotherapy.
(ii) Counseling.
(iii) Detoxification services.
(iv) Other ancillary services, such as medical testing, diagnostic evaluation, and referral to other services identified in the treatment plan.
(d) "Substance use disorder" means that term as defined in section 100d of the mental health code, 1974 PA 258, MCL 330.1100d.
History:
Add. 1980, Act 429, Eff. Jan. 1, 1982 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3428 - Provider Network.

500.3428 Provider network.
Sec. 3428.
An insurer that delivers, issues for delivery, or renews in this state a health insurance policy shall establish and maintain a provider network that, at a minimum, satisfies any network adequacy requirements imposed by the director under federal law.
History:
Add. 2013, Act 5, Imd. Eff. Mar. 18, 2013 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3430 - Optional Policy Provisions; Insurance Commissioner's Approval.

500.3430 Optional policy provisions; insurance commissioner's approval.
Sec. 3430.
Except as provided in subsection (2) of section 3406 (inapplicable or inconsistent provisions), no such policy delivered or issued for delivery to any person in this state shall contain provisions respecting the matters set forth in sections 3432 through 3454 unless such provisions are in the words in which the same appear in such sections: Provided, however, That the insurer may, at its option, use in lieu of any such provision a corresponding provision of different wording approved by the commissioner which is not less favorable in any respect to the insured or the beneficiary. Any such provision contained in the policy shall be preceded individually by the appropriate caption appearing in the pertinent section or, at the option of the insurer, by such appropriate individual or group captions or subcaptions as the commissioner may approve.
History:
1956, Act 218, Eff. Jan. 1, 1957
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3432 - Change of Occupation; Optional Provision.

500.3432 Change of occupation; optional provision.
Sec. 3432.
An insurer may include in a disability insurance policy, other than a health insurance policy, a provision as follows:
CHANGE OF OCCUPATION: If the insured is injured or contracts an illness after changing his or her occupation to 1 classified by the insurer as more hazardous than the occupation stated in this policy or while doing for compensation anything pertaining to an occupation classified as more hazardous, the insurer will pay only the portion of the indemnities provided in this policy that the premium paid would have purchased at the rates and within the limits fixed by the insurer for the more hazardous occupation. If the insured changes his or her occupation to 1 classified by the insurer as less hazardous than that stated in this policy, the insurer, upon receipt of proof of the change of occupation, will reduce the premium rate accordingly, and will return the excess pro rata unearned premium from the date of change of occupation or from the policy anniversary date immediately preceding receipt of the proof, whichever is the more recent. In applying this provision, the classification of occupational risk and the premium rates must be those that were last filed by the insurer before the occurrence of the loss for which the insurer is liable or before the date of proof of change in the occupation with the state official that supervises insurance in the state where the insured resided at the time this policy was issued. However, if that filing was not required in that state, the classification of occupational risk and the premium rates must be those last made effective by the insurer in that state before the occurrence of the loss or before the date of proof of change in the occupation.
History:
1956, Act 218, Eff. Jan. 1, 1957 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3434 - Misstatement of Age; Optional Provision.

500.3434 Misstatement of age; optional provision.
Sec. 3434.
There may be a provision as follows:
MISSTATEMENT OF AGE: If the age of the insured has been misstated, all amounts payable under this policy shall be such as the premium paid would have purchased at the correct age.
History:
1956, Act 218, Eff. Jan. 1, 1957
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3436 - Other Insurance With Same Insurer; Optional Provision.

500.3436 Other insurance with same insurer; optional provision.
Sec. 3436.
There may be a provision as follows:
OTHER INSURANCE IN THIS INSURER: If an accident or sickness or accident and sickness policy or policies previously issued by the insurer to the insured be in force concurrently herewith, making the aggregate indemnity for ...................... (insert type of coverage or coverages) in excess of $..................... (insert maximum limit of indemnity or indemnities), the excess insurance shall be void and all premiums paid for such excess shall be returned to the insured or to his estate.
Or, in lieu thereof:
Insurance effective at any one time on the insured under a like policy or policies in this insurer is limited to the one such policy elected by the insured, his beneficiary or his estate, as the case may be, and the insurer will return all premiums paid for all other such policies.
History:
1956, Act 218, Eff. Jan. 1, 1957
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3439 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

500.3439 Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Compiler's Notes:
The repealed section pertained to provisions concerning insurance with other insurers.
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3444 - Relation of Earnings to Insurance; Optional Provision.

500.3444 Relation of earnings to insurance; optional provision.
Sec. 3444.
There may be a provision as follows:
RELATION OF EARNINGS TO INSURANCE: If the total monthly amount of loss of time benefits promised for the same loss under all valid loss of time coverage upon the insured, whether payable on a weekly or monthly basis, shall exceed the monthly earnings of the insured at the time disability commenced or his average monthly earnings for the period of 2 years immediately preceding a disability for which claim is made, whichever is the greater, the insurer will be liable only for such proportionate amount of such benefits under this policy as the amount of such monthly earnings or such average monthly earnings of the insured bears to the total amount of monthly benefits for the same loss under all such coverage upon the insured at the time such disability commences and for the return of such part of the premiums paid during such 2 years as shall exceed the pro rata amount of the premiums for the benefits actually paid hereunder; but this shall not operate to reduce the total monthly amount of benefits payable under all such coverage upon the insured below the sum of $200.00 or the sum of the monthly benefits specified in such coverages, whichever is the lesser, nor shall it operate to reduce benefits other than those payable for loss of time. (The foregoing policy provision may be inserted only in a policy which the insured has the right to continue in force subject to its terms by the timely payment of premiums (1) until at least age 50, or (2) in the case of a policy issued after age 44, for at least 5 years from its date of issue. The insurer may, at its option, include in this provision a definition of "valid loss of time coverage", approved as to form by the commissioner, which definition shall be limited in subject matter to coverage provided by governmental agencies or by organizations subject to regulation by insurance law or by insurance authorities of this or any other state of the United States or any province of Canada, or to any other coverage the inclusion of which may be approved by the commissioner or any combination of such coverages. In the absence of such definition such term shall not include any coverage provided for such insured pursuant to any compulsory benefit statute (including any workmen's compensation or employer's liability statute), or benefits provided by union welfare plans or by employer or employee benefit organizations.)
History:
1956, Act 218, Eff. Jan. 1, 1957
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3446 - Unpaid Premium; Optional Provision.

500.3446 Unpaid premium; optional provision.
Sec. 3446.
There may be a provision as follows:
UNPAID PREMIUM: Upon the payment of a claim under this policy, any premium then due and unpaid or covered by any note or written order may be deducted therefrom.
History:
1956, Act 218, Eff. Jan. 1, 1957
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3448 - Cancellation; Optional Provision.

500.3448 Cancellation; optional provision.
Sec. 3448.
There may be a provision as follows:
CANCELLATION: The insurer may cancel this policy at any time by written notice delivered to the insured, or mailed to the insured, stating when, not less than 5 days thereafter, the cancellation shall be effective; and after the policy has been continued beyond its original term the insured may cancel this policy at any time by written notice delivered or mailed to the insurer, effective upon receipt or on a later date as may be specified in the notice. In the event of cancellation, the insurer may retain the pro rata premium for the expired time or $25.00, whichever is greater. Cancellation is without prejudice to any claim originating prior to the effective date of cancellation.
History:
1956, Act 218, Eff. Jan. 1, 1957 ;-- Am. 1987, Act 168, Imd. Eff. Nov. 9, 1987 ;-- Am. 1990, Act 170, Imd. Eff. July 2, 1990
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3450 - Conformity With State Statutes; Optional Provision.

500.3450 Conformity with state statutes; optional provision.
Sec. 3450.
There may be a provision as follows:
CONFORMITY WITH STATE STATUTES: Any provision of this policy which, on its effective date, is in conflict with the statutes of the state in which the insured resides on such date is hereby amended to conform to the minimum requirements of such statutes.
History:
1956, Act 218, Eff. Jan. 1, 1957
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3452 - Illegal Occupation or Criminal Activity; Optional Provision; Definitions.

500.3452 Illegal occupation or criminal activity; optional provision; definitions.
Sec. 3452.
(1) An insurer may include in a disability insurance policy a provision as follows:
ILLEGAL OCCUPATION OR CRIMINAL ACTIVITY: The insurer is not liable for any loss to which a contributing cause was the insured's commission of or attempt to commit a felony or to which a contributing cause was the insured's being engaged in an illegal occupation or other willful criminal activity.
(2) As used in this section:
(a) "Willful criminal activity" includes, but is not limited to, any of the following:
(i) Operating a vehicle while intoxicated in violation of section 625 of the Michigan vehicle code, 1949 PA 300, MCL 257.625, or similar law in a jurisdiction outside of this state.
(ii) Operating a methamphetamine laboratory. As used in this subdivision, "methamphetamine laboratory" means that term as defined in section 1 of 2006 PA 255, MCL 333.26371.
(b) "Willful criminal activity" does not include a civil infraction or other activity that does not rise to the level of a misdemeanor or felony.
History:
1956, Act 218, Eff. Jan. 1, 1957 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3454 - Repealed. 1980, Act 429, Eff. Mar. 31, 1981.

500.3454 Repealed. 1980, Act 429, Eff. Mar. 31, 1981.
Compiler's Notes:
The repealed section pertained to intoxicants and narcotics.
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3460 - Order of Certain Policy Provisions.

500.3460 Order of certain policy provisions.
Sec. 3460.
The provisions which are the subject of sections 3406 through 3454, or any corresponding provisions which are used in lieu thereof in accordance with such sections, shall be printed in the consecutive order of the provisions in such sections or, at the option of the insurer, any such provision may appear as a unit in any part of the policy, with other provisions to which it may be logically related, provided the resulting policy shall not be in whole or in part unintelligible, uncertain, ambiguous, abstruse, or likely to mislead a person to whom the policy is offered, delivered or issued.
History:
1956, Act 218, Eff. Jan. 1, 1957
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3462 - Third Party Ownership of Policy.

500.3462 Third party ownership of policy.
Sec. 3462.
The word "insured", as used in this chapter, shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under such a policy to any indemnities, benefits and rights provided therein.
History:
1956, Act 218, Eff. Jan. 1, 1957
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3464 - Foreign or Alien Insurers; Provision Required by Other State Law; Domestic Insurers; Provision Required by Other State or Country.

500.3464 Foreign or alien insurers; provision required by other state law; domestic insurers; provision required by other state or country.
Sec. 3464.
(1) Any policy of a foreign or alien insurer, when delivered or issued for delivery to any person in this state, may contain any provision which is not less favorable to the insured or the beneficiary than the provisions of this chapter and which is prescribed or required by the law of the state under which the insurer is organized.
(2) Any policy of a domestic insurer may, when issued for delivery in any other state or country, contain any provision permitted or required by the laws of such other state or country.
History:
1956, Act 218, Eff. Jan. 1, 1957
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3466 - Filing Procedure; Insurance Commissioner, Regulatory Powers.

500.3466 Filing procedure; insurance commissioner, regulatory powers.
Sec. 3466.
The commissioner may make such reasonable rules and regulations concerning the procedure for the filing or submission of policies subject to this chapter as are necessary, proper or advisable to the administration of this chapter. This provision shall not abridge any other authority granted the commissioner by law.
History:
1956, Act 218, Eff. Jan. 1, 1957
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3468 - Provisions Violating Code; Construction of Noncomplying Policies and Provisions.

500.3468 Provisions violating code; construction of noncomplying policies and provisions.
Sec. 3468.
(1) No policy provision which is not subject to sections 3406 through 3454 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.
(2) A policy delivered or issued for delivery to any person in this state in violation of this insurance code shall be held valid but shall be construed as provided in this code. 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.
History:
1956, Act 218, Eff. Jan. 1, 1957
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3470 - Age of Insured; Provision Regulations.

500.3470 Age of insured; provision regulations.
Sec. 3470.
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.
History:
1956, Act 218, Eff. Jan. 1, 1957
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3472 - Open Enrollment Period; Prohibitions; Establishment of Reasonable Periods for Health Insurance Policies; Minimum Standards for Frequency and Duration of Open Enrollment Periods; Denial of Coverage.

500.3472 Open enrollment period; prohibitions; establishment of reasonable periods for health insurance policies; minimum standards for frequency and duration of open enrollment periods; denial of coverage.
Sec. 3472.
(1) During an applicable open enrollment period, an insurer that offers, delivers, issues for delivery, or renews in this state a health insurance policy shall not deny or condition the issuance or effectiveness of the policy and shall not discriminate in the pricing of the policy on the basis of health status, claims experience, receipt of health care, or medical condition.
(2) Subject to prior approval of the director, an insurer shall establish reasonable open enrollment periods for all health insurance policies offered, delivered, issued for delivery, or renewed in this state.
(3) The director shall establish minimum standards for the frequency and duration of open enrollment periods established under subsection (2). The director shall uniformly apply the minimum standards for the frequency and duration of open enrollment periods established under this subsection to all insurers.
(4) Subject to approval by the director, an insurer may deny health insurance coverage in the group or individual market if the insurer does not have the network capacity or financial reserves necessary to offer additional coverage. An insurer described in this subsection shall act uniformly with regard to all employers or individuals in the group or individual market. An insurer described in this subsection shall act without regard to the claims experience of an individual or employer and its employees and the employee's dependents and without regard to any health-status-related factor relating to the individual or employer and its employees and the employee's dependents.
(5) Subject to approval by the director, an insurer that denies health insurance coverage to an employer or individual under subsection (4) shall not offer coverage in the group or individual market, as applicable, before the later of the one hundred eighty-first day after the date the insurer denies the coverage or the date the insurer demonstrates to the director that the insurer has sufficient network capacity or financial reserves, as applicable, to underwrite additional coverage.
(6) Subject to approval by the director, subsection (4) does not limit the insurer's ability to renew coverage already in force or relieve the insurer of the responsibility to renew the coverage.
(7) The director may provide for the application of subsection (4) on a service-area-specific basis for health maintenance organizations.
History:
Add. 2013, Act 5, Imd. Eff. Mar. 18, 2013 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3474 - Risk Classification; Rates; Filing Requirements.

500.3474 Risk classification; rates; filing requirements.
Sec. 3474.
No policy of insurance against loss or expense from the sickness, or from the bodily injury or death from accident of the insured, nor any application, rider or endorsement to be used in connection therewith, shall be delivered or issued for delivery to any person in this state, until the classification of risks and any premium rates pertaining thereto have been filed with the department of insurance.
History:
1956, Act 218, Eff. Jan. 1, 1957
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3474a - Premium Rate After January 1, 2014; Basis; Factors.

500.3474a Premium rate after January 1, 2014; basis; factors.
Sec. 3474a.
The premium rate charged by an insurer, health maintenance organization, or nonprofit health care corporation for health insurance coverage offered through a policy or certificate delivered, issued for delivery, or renewed in this state on or after January 1, 2014 in the individual or small group market shall vary based on the following factors only:
(a) Whether the policy or certificate covers an individual or family.
(b) The rating area.
(c) Age, except that the premium rate shall not vary by more than 3 to 1 for adults for all plans other than child-only plans.
(d) Tobacco use, except that the premium rate shall not vary by more than 1.5 to 1.
History:
Add. 2013, Act 5, Imd. Eff. Mar. 18, 2013
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3475 - Reimbursement for Services by Licensed Psychologist, Podiatrist, or Chiropractor; Section Inapplicable to Policy Involving Prudent Purchaser Agreement.

500.3475 Reimbursement for services by licensed psychologist, podiatrist, or chiropractor; section inapplicable to policy involving prudent purchaser agreement.
Sec. 3475.
(1) Notwithstanding any provision of a disability insurance policy, if the disability insurance policy provides for reimbursement for any service that is legally performed by a person fully licensed as a psychologist under part 182 of the public health code, 1978 PA 368, MCL 333.18201 to 333.18237; by a podiatrist licensed under part 180 of the public health code, 1978 PA 368, MCL 333.18001 to 333.18058; or by a chiropractor licensed under part 164 of the public health code, 1978 PA 368, MCL 333.16401 to 333.16431, the insurer shall not deny reimbursement under the insurance policy if the service is rendered by a person fully licensed as a psychologist under part 182 of the public health code, 1978 PA 368, MCL 333.18201 to 333.18237; by a podiatrist licensed under part 180 of the public health code, 1978 PA 368, MCL 333.18001 to 333.18058; or by a chiropractor licensed under part 164 of the public health code, 1978 PA 368, MCL 333.16401 to 333.16431, within the statutory provisions provided in his or her individual practice act.
(2) This section does not require coverage for a psychologist in an insurance policy. This section does not require coverage or reimbursement for any of the following:
(a) A practice of chiropractic service unless the service was included in the definition of practice of chiropractic under section 16401 of the public health code, 1978 PA 368, MCL 333.16401, as of January 1, 2009.
(b) A service provided by a physical therapist or physical therapist assistant unless the service was provided by a licensed physical therapist or physical therapist assistant under the supervision of a licensed physical therapist pursuant to a prescription from a health care professional who holds a license issued under part 166, 170, 175, or 180 of the public health code, 1978 PA 368, MCL 333.16601 to 333.16648, 333.17001 to 333.17084, 333.17501 to 333.17556, and 333.18001 to 333.18058, or the equivalent license issued by another state.
(3) This section does not apply to a policy written under section 3405 that involves a prudent purchaser agreement.
History:
Add. 1963, Act 56, Eff. Sept. 6, 1963 ;-- Am. 1966, Act 92, Imd. Eff. June 15, 1966 ;-- Am. 1968, Act 182, Eff. Nov. 15, 1968 ;-- Am. 1984, Act 280, Imd. Eff. Dec. 20, 1984 ;-- Am. 2009, Act 227, Imd. Eff. Jan. 5, 2010 ;-- Am. 2014, Act 263, Imd. Eff. July 1, 2014 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3476 - Telemedicine Services; Provisions; Definitions.

500.3476 Telemedicine services; provisions; definitions.
Sec. 3476.
(1) An insurer that delivers, issues for delivery, or renews in this state a health insurance policy shall not require face-to-face contact between a health care professional and a patient for services appropriately provided through telemedicine, as determined by the insurer. Telemedicine services must be provided by a health care professional who is licensed, registered, or otherwise authorized to engage in his or her health care profession in the state where the patient is located. Telemedicine services are subject to all terms and conditions of the health insurance policy agreed upon between the policy holder and the insurer, including, but not limited to, required copayments, coinsurances, deductibles, and approved amounts.
(2) As used in this section:
(a) After December 31, 2017, "insurer" includes a nonprofit dental care corporation operating under 1963 PA 125, MCL 550.351 to 550.373.
(b) "Telemedicine" means the use of an electronic media to link patients with health care professionals in different locations. To be considered telemedicine under this section, the health care professional must be able to examine the patient via a health insurance portability and accountability act of 1996, Public Law 104-191 compliant, secure interactive audio or video, or both, telecommunications system, or through the use of store and forward online messaging.
History:
Add. 2012, Act 215, Imd. Eff. June 28, 2012 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 ;-- Am. 2017, Act 223, Imd. Eff. Dec. 20, 2017 ;-- Am. 2020, Act 97, Imd. Eff. June 24, 2020
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3477 - Use of Financial Incentive or Payment to Act as Inducement to Deny, Reduce, Limit, or Delay Services; Prohibition; Exception.

500.3477 Use of financial incentive or payment to act as inducement to deny, reduce, limit, or delay services; prohibition; exception.
Sec. 3477.
(1) An insurer shall not use any financial incentive or make any payment to a health professional that acts directly or indirectly as an inducement to deny, reduce, limit, or delay specific medically necessary and appropriate services.
(2) Subsection (1) does not prohibit payment arrangements that are not tied to specific medical decisions or prohibit the use of risk sharing as otherwise authorized in this chapter.
History:
Add. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3480 - Repealed. 1963, Act 127, Eff. Sept. 6, 1963.

500.3480 Repealed. 1963, Act 127, Eff. Sept. 6, 1963.
Compiler's Notes:
The section imposed penalties for violation of disability insurance provisions.
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580) › Section 500.3503 - Applicability of Provisions to Health Maintenance Organization.

500.3503 Applicability of provisions to health maintenance organization.
Sec. 3503.
(1) Unless specifically excluded, or otherwise specifically provided for in this chapter, all of the provisions of this act that apply to a domestic insurer authorized to issue a health insurance policy apply to a health maintenance organization.
(2) Sections 408, 410, 411, and 901, and chapters 77 and 79 do not apply to a health maintenance organization.
History:
Add. 2000, Act 252, Imd. Eff. June 29, 2000 ;-- Am. 2006, Act 366, Imd. Eff. Sept. 18, 2006 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
Popular Name:
HMO
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580) › Section 500.3505 - Health Maintenance Contract; Use of Descriptive Words; Restrictions.

500.3505 Health maintenance contract; use of descriptive words; restrictions.
Sec. 3505.
(1) A health maintenance organization shall not issue a health maintenance contract before it receives a certificate of authority under this act.
(2) A person shall not use the term health maintenance organization to describe or refer to a person, and a person shall not use any other descriptive words that may mislead, deceive, or imply that it is a health maintenance organization, unless the person described or referred to has a certificate of authority as a health maintenance organization under this act.
(3) Except as otherwise provided in this subsection, a health maintenance organization shall not use in its name, contracts, or literature the words "insurance", "casualty", "surety", or "mutual" or any other words descriptive of an insurance, casualty, or surety business or deceptively similar to the name or description of an insurance or surety corporation doing business in this state. A health maintenance organization may use a name or description that is similar to its affiliate.
History:
Add. 2000, Act 252, Imd. Eff. June 29, 2000 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
Popular Name:
HMO
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580) › Section 500.3507 - Authorizing and Regulating Health Maintenance Organization; Establishment of System by Director.

500.3507 Authorizing and regulating health maintenance organization; establishment of system by director.
Sec. 3507.
The director shall establish a system of authorizing and regulating health maintenance organizations in this state to protect and promote the public health through the assurance that the organizations provide all of the following:
(a) An acceptable quality of health care by qualified personnel.
(b) Health care facilities, equipment, and personnel that may reasonably be required to economically provide health services.
(c) Operational arrangements that integrate the delivery of various services.
(d) Financially sound prepayment plans for meeting health care costs.
History:
Add. 2000, Act 252, Imd. Eff. June 29, 2000 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
Popular Name:
HMO