reglab/statecodes huggingface dataset:
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 1 - General Rules › Section 101 - Scope of Chapters 21 and 22.

Effective 5/5/2021
31A-21-101.
Scope of Chapters 21 and 22.
(1) Except as provided in Subsections (2) through (6), this chapter and Chapter 22, Contracts in Specific Lines, apply to all insurance policies, applications, and certificates:
(a) delivered or issued for delivery in this state;
(b) on property ordinarily located in this state;
(c) on persons residing in this state when the policy is issued; or
(d) on business operations in this state.
(2) This chapter and Chapter 22, Contracts in Specific Lines, do not apply to:
(a) an exemption provided in Section 31A-1-103;
(b) an insurance policy procured under Sections 31A-15-103 and 31A-15-104;
(c) an insurance policy on business operations in this state:
(i) if:
(A) the contract is negotiated primarily outside this state; and
(B) the operations in this state are incidental or subordinate to operations outside this state; and
(ii) except that insurance required by a Utah statute shall conform to the statutory requirements; or
(d) other exemptions provided in this title.
(3)
(a) Sections 31A-21-102, 31A-21-103, 31A-21-104, Subsections 31A-21-107(1) and (3), and Sections 31A-21-306, 31A-21-308, 31A-21-312, and 31A-21-314 apply to ocean marine and inland marine insurance.
(b) Section 31A-21-201 applies to inland marine insurance that is written according to manual rules or rating plans.
(c) Inland marine insurance that includes accident and health insurance is subject to Chapter 22, Contracts in Specific Lines.
(4) A group insurance policy or a blanket insurance policy is subject to this chapter and Chapter 22, Contracts in Specific Lines, except:
(a) a group insurance policy outside the scope of this title under Subsection 31A-1-103(3)(h);
(b) a blanket insurance policy outside the scope of this title under Subsection 31A-1-103(3)(h); and
(c) other exemptions provided under Subsection (5).
(5) The commissioner may by rule exempt any class of insurance contract or class of insurer from any or all of the provisions of this chapter and Chapter 22, Contracts in Specific Lines, if the interests of the Utah insureds, creditors, or the public would not be harmed by the exemption.
(6) Workers' compensation insurance is subject to this chapter and Chapter 22, Contracts in Specific Lines.
(7) Unless clearly inapplicable, any provision of this chapter or Chapter 22, Contracts in Specific Lines, applicable to either a policy or a contract is applicable to both.
Amended by Chapter 252, 2021 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 1 - General Rules › Section 102 - Oral contracts of insurance and binders.

31A-21-102.
Oral contracts of insurance and binders.
(1) "Binder" means a writing which describes the subject and amount of insurance and temporarily binds insurance coverage pending the issuance of an insurance policy. "Binder" does not include conditional receipts by life insurance companies under which issuance of the policy or coverage under the policy is contingent upon the acceptability of the risk to the insurer.
(2) Binding oral contracts of insurance may only be made as to casualty insurance, liability insurance, property insurance, vehicle liability insurance, workers' compensation insurance, and as to combinations of these coverages. The insurer shall issue a policy or binder as soon as reasonably possible after negotiation of any oral contract under this subsection.
(3) No binder is valid beyond the issuance of the policy as to which the binder was given, or beyond 150 days from the binder's effective date, whichever occurs first.
(4) If a policy has not been issued as to a binder, the binder may be extended or renewed beyond 150 days, but only upon the commissioner's written approval, or under rules adopted by the commissioner.
(5) A binder may be cancelled by the insurer prior to its expiration date only in the same manner as and subject to the same restrictions that apply to insurance policies under Section 31A-21-303.
Amended by Chapter 261, 1989 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 1 - General Rules › Section 103 - Capacity to contract.

31A-21-103.
Capacity to contract.
Any person 16 years of age or older who is otherwise competent to contract under Utah law, and who is not subject to any legal disability, may contract for insurance. If there is a conservator appointed under Title 75, Utah Uniform Probate Code, the conservator, rather than the person whose property is subject to the conservatorship, may contract for insurance to protect the property under conservatorship. In the case of a conservatorship over the person or property of a person under 16 years of age, the conservator may invest funds of the estate in life or accident and health insurance or annuity contracts, but only with the approval of the court having jurisdiction over the conservatorship.
Amended by Chapter 116, 2001 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 1 - General Rules › Section 106 - Incorporation by reference.

Effective 5/9/2017
31A-21-106.
Incorporation by reference.
(1)
(a) Except as provided in Subsection (1)(b), an insurance policy may not contain any agreement or incorporate any provision not fully set forth in the policy or in an application or other document attached to and made a part of the policy at the time of its delivery, unless the policy, application, or agreement accurately reflects the terms of the incorporated agreement, provision, or attached document.
(b)
(i) A policy may by reference incorporate rate schedules and classifications of risks and short-rate tables filed with the commissioner.
(ii) By rule or order, the commissioner may authorize incorporation by reference of provisions for:
(A) administrative arrangements;
(B) premium schedules; and
(C) payment procedures for complex contracts.
(c)
(i) A policy of title insurance insuring the mortgage or deed of trust of an institutional lender may, if requested by an institutional lender, incorporate by reference generally applicable policy terms that are contained in a specifically identified policy that has been filed with the commissioner.
(ii) As used in Subsection (1)(c)(i), "institutional lender" means a person that regularly engages in the business of making loans secured by real estate.
(d) A policy may incorporate by reference the following by citing in the policy:
(i) a federal law or regulation;
(ii) a state law or rule; or
(iii) a public directive of a federal or state agency.
(2) A purported modification of a contract during the term of the policy may not affect the obligations of a party to the contract:
(a) unless the modification is:
(i) in writing; and
(ii) agreed to by the party against whose interest the modification operates; and
(b) except:
(i) as provided in:
(A) Subsection (3) or (4);
(B) Subsection 31A-22-618.6(8); or
(C) Subsection 31A-22-618.7(4); or
(ii) as otherwise mandated by law.
(3) Subsection (2) does not prevent a change in coverage under group contracts resulting from:
(a) provisions of an employer eligibility rule;
(b) the terms of a collective bargaining agreement; or
(c) provisions in federal Employee Retirement Income Security Act plan documents.
(4) Subsection (2) does not prevent a premium increase at any renewal date that is applicable uniformly to all comparable persons.
Amended by Chapter 292, 2017 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 1 - General Rules › Section 107 - Contract rights under noncomplying policies.

31A-21-107.
Contract rights under noncomplying policies.
(1) Except as otherwise specifically provided by this title, a policy is enforceable against the insurer according to its terms, even if it exceeds the authority of the insurer.
(2) Any insurance policy, rider, or endorsement issued after July 1, 1986, and which is otherwise valid, which contains any condition or provision not in compliance with the requirements of this title, is not rendered invalid by this title. However, those conditions and provisions shall be construed and applied as if the policy, rider, or endorsement was in full compliance with this title.
(3) Upon written request of the policyholder or an insured whose rights under the policy are continuing and not transitory, an insurer shall reform and reissue or amend by a clearly stated rider its written policy to comply with the requirements of the law existing at the date of issuance of the policy. Subject to this section and Section 31A-21-102, a person seeking to reform a written insurance agreement by complaint or petition to a judicial authority shall show by clear and convincing evidence the existence of facts establishing the reformation.
Amended by Chapter 204, 1986 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 1 - General Rules › Section 110 - Prohibition against certain use of Social Security number -- Exceptions -- Applicability of section.

31A-21-110.
Prohibition against certain use of Social Security number -- Exceptions -- Applicability of section.
(1) As used in this section "publicly display or publicly post" means to intentionally communicate or otherwise make available to the general public.
(2) An insurer not subject to Section 31A-22-634 may not do any of the following:
(a) publicly display or publicly post in any manner an individual's Social Security number; or
(b) print an individual's Social Security number on any card required for the individual to access products or services provided or covered by the insurer.
(3) This section does not prevent:
(a) the collection, use, or release of a Social Security number as required by state or federal law;
(b) the use of a Social Security number for internal verification or administrative purposes; or
(c) the release of a Social Security number:
(i) for claims administration purposes; or
(ii) as part of the verification, eligibility, or payment process.
(4)
(a) An insurer shall comply with this section by July 1, 2005.
(b) An insurer may obtain an extension for compliance with this section in accordance with this Subsection (4)(b).
(i) The request for extension shall:
(A) be in writing to the department prior to July 1, 2005; and
(B) provide an explanation as to why the insurer cannot comply.
(ii) The commissioner shall grant a request for extension:
(A) for a period of time not to exceed March 1, 2006; and
(B) if the commissioner finds that the explanation provided under Subsection (4)(b)(i) is a reasonable explanation.
Enacted by Chapter 2, 2004 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 1 - General Rules › Section 111 - Insurers to follow terms of policy.

31A-21-111.
Insurers to follow terms of policy.
Unless otherwise provided by this title, an insurer shall follow the terms of an insurance policy issued or assumed by the insurer.
Enacted by Chapter 197, 2006 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 1 - General Rules › Section 112 - Language other than English.

31A-21-112.
Language other than English.
(1) An insurer may conduct a transaction in a language other than English through an employee or agent acting as interpreter or through an interpreter provided by the customer.
(2) An insurer may provide a customer an insurance policy, endorsement, rider, or explanatory or advertising material in a language other than English. If there is a dispute or complaint regarding the insurance policy, endorsement, rider, or explanatory or advertising material, the English language version of the insurance coverage shall control the resolution of the dispute or complaint.
(3) A non-English language policy delivered or issued for delivery in this state is considered to be in compliance with this title if the insurer certifies that the policy is translated from an English language policy that complies with this title.
(4) If an insurance policy, endorsement, or rider is provided in a language other than English, it shall be accompanied by:
(a) the corresponding English language version; and
(b) a disclaimer in both English and the other language that states that the foreign language version is provided only as an accommodation or courtesy to the customer and the English language version shall control the resolution of any dispute or complaint.
Enacted by Chapter 443, 2013 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 2 - Approval of Forms › Section 202 - Explicit approval required.

31A-21-202.
Explicit approval required.
(1) The following clauses are disapproved unless the commissioner gives them explicit approval:
(a) clauses requiring more expeditious notice of loss or proof of loss than is required by Section 31A-21-312 or rules adopted under that section; and
(b) a schedule of reinstatement fees under Section 31A-22-608, if made a part of the policy. This type of schedule need not be included in the policy but may be given approval as a separate document specifically made applicable to particular classes of policies and incorporated in the policy by reference.
(2) If an insurer fails to obtain explicit approval from the commissioner for the clauses specified in Subsection (1), the clauses are void.
Amended by Chapter 204, 1986 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 2 - Approval of Forms › Section 203 - Authorized clauses for insurance forms.

31A-21-203.
Authorized clauses for insurance forms.
(1) The commissioner may not adopt mandatory uniform clauses. However, the commissioner may adopt authorized clauses by rule upon a finding that:
(a) price or coverage competition is ineffective because diversity in language or content makes comparison difficult;
(b) provision of language, content, or form of specific clauses is necessary to provide certainty of meaning to those clauses;
(c) regulation of policy forms would be more effective or litigation would be substantially reduced if there were increased standardization of certain clauses; or
(d) reasonable minimum standards of insurance protection are needed for policies to serve a useful purpose.
(2) Any rule creating an authorized clause may prescribe that to be treated as an authorized clause there shall be verbatim or substantial adherence to prescribed language, that certain standards or criteria shall be met, or that certain drafting principles shall be followed. The rules may also permit liberalization of prescribed language. A rule may prescribe verbatim adherence only after the commissioner has made a finding that substantial adherence to the prescribed language is not sufficient and that liberalization of prescribed language will frustrate the purposes of the prescription. If an insurer uses authorized clauses as part of filed forms, the commissioner may only disapprove those clauses under Section 31A-21-201 upon a finding that improper combination of clauses makes them violate the criteria of Section 31A-21-201.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 3 - Specific Clauses in Contracts › Section 301 - Clauses required to be in a prominent position.

Effective 5/12/2020
31A-21-301.
Clauses required to be in a prominent position.
(1) The following portions of insurance policies shall appear conspicuously in the policy:
(a) as required by Subsections 31A-21-201(3)(a)(iii) and (iv):
(i) the exact name of the insurer;
(ii) the state of domicile of the insurer; and
(iii) for life insurance and annuity policies only, the address of the administrative office of the insurer;
(b) information that two or more insurers under Subsection (1)(a) undertake only several liability, as required by Section 31A-21-306;
(c) if a policy is assessable, a statement of that;
(d) a statement that benefits are variable, as required by Section 31A-22-411; however, the methods of calculation need not be in a prominent position;
(e) the right to return a life or accident and health insurance policy under Sections 31A-22-423 and 31A-22-606; and
(f) the beginning and ending dates of insurance protection.
(2) Each clause listed in Subsection (1) shall be displayed conspicuously and separately from any other clause.
Amended by Chapter 32, 2020 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 3 - Specific Clauses in Contracts › Section 302 - Premiums.

31A-21-302.
Premiums.
(1) Subject to Section 31A-21-310 and Subsection 31A-21-106(1), the policy shall clearly state the amount of the total premium or shall explain in detail how it is calculated. Any fee, charge, or other consideration that is not part of the premium shall be disclosed and explained in writing to the insured. The disclosure and explanation shall be clearly stated either on the policy, or on the insurer's billing to the insured. The premium need not be contained in a certificate issued under a group policy. This Subsection (1) does not preclude premium adjustments or changes upon the renewal or endorsement of an existing policy. However, the renewal or endorsement notice shall contain or be accompanied by a statement of the renewal or endorsement premium or credit.
(2) Except as provided in Chapter 23a, Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries, no person may charge or receive any consideration for the insurance policy which is not stated in Subsection (1).
(3) No person may knowingly collect any excessive amount as a premium or any amount for insurance which is not in the course of processing. Any amount unknowingly collected shall be returned immediately on learning of the mistake. Prepayment of premiums pursuant to the policy is not an excessive collection. Insurance is in the course of processing if an application has been made for it which is being considered by the insurer, even though it has not yet been accepted or rejected.
Amended by Chapter 298, 2003 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 3 - Specific Clauses in Contracts › Section 304 - Special cancellation provisions.

31A-21-304.
Special cancellation provisions.
Whether or not Section 31A-21-303 is also applicable:
(1) Section 31A-21-305 applies to cancellation on request of a premium finance company;
(2) Section 70C-6-304 applies to cancellation upon request of a creditor; and
(3) Sections 41-12a-404 and 41-12a-405 apply to the cancellation or other termination of insurance coverage or of a surety bond after the insurer or surety has provided a certificate of insurance or suretyship to the Department of Public Safety.
Amended by Chapter 91, 1987 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 3 - Specific Clauses in Contracts › Section 306 - Policies or surety bonds jointly issued.

31A-21-306.
Policies or surety bonds jointly issued.
Two or more insurers may together issue a policy or surety bond. Their liability shall be joint and several with respect to the policy or bond. The policy or bond shall state the proportion or amount of premium to be paid to each insurer and, as between the issuing insurers, the type and the proportion or amount of liability each insurer assumes. Service of process on any of the insurers is service on all of them.
Amended by Chapter 204, 1986 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 3 - Specific Clauses in Contracts › Section 307 - Other insurance.

31A-21-307.
Other insurance.
(1) When two or more policies promise to indemnify an insured against the same loss without intending cumulative coverage, no "other insurance" provisions of the policies may reduce the aggregate protection of the insured below the lesser of the actual insured loss suffered by the insured and the maximum indemnification promised by any policy without regard to any "other insurance" provision.
(2) Subject to Subsection (1), the policies may by their terms define the extent to which each insurance is primary and each is excess, but if the "other insurance" terms of the policies are inconsistent, there is joint and several liability to the insured on any coverage which overlaps and which has inconsistent terms. Subsequent settlement among the insurers does not alter any rights of the insured. The commissioner may adopt rules consistent with this section concerning "other insurance."
(3) This section does not apply to accident and health insurance policies. Refer to Section 31A-22-619 for the coordination of accident and health benefits.
Amended by Chapter 116, 2001 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 3 - Specific Clauses in Contracts › Section 308 - Limitations on loss to be borne by insurer.

31A-21-308.
Limitations on loss to be borne by insurer.
(1) An insurance policy indemnifying an insured against loss may by clear language limit the part of the loss to be paid by the insurer to a specified or determinable maximum amount, to loss in excess of a specified or determinable amount, to a specified proportion of the loss which may vary with the amount of the loss, or to any combination of these methods. If the policy covers various risks, different limitations may be provided separately for each risk, if the policy clearly states that.
(2) A policy indemnifying an insured against loss of or damage to property may limit the part of the loss to be paid by the insurer to a percentage of the total loss that corresponds to the ratio of the insured sum to a specified percentage of the value of the insured property.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 3 - Specific Clauses in Contracts › Section 309 - Nonwaiver clause.

31A-21-309.
Nonwaiver clause.
An insurer may insert a provision in any insurance policy that no change in the policy is valid unless approved by an executive officer of the insurer, or unless the approval is endorsed on the policy or attached to it, or both, and that no agent has authority to change the policy or waive any of its provisions. This does not preclude a person claiming a right under the policy from relying on waiver or estoppel in an appropriate case.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 3 - Specific Clauses in Contracts › Section 310 - Dividends on policies.

31A-21-310.
Dividends on policies.
(1) Section 31A-22-418 applies to life insurance and annuities.
(2) Any insurer may distribute a portion of surplus attributable to policies other than life insurance or annuities, in amounts and with classifications the board of directors determines to be fair and reasonable. This distribution may not be contingent on the renewal of any policy or of premium payments unless the policy stated that limitation when it was written. A schedule explaining the basis for the distribution shall be filed with the commissioner prior to the distribution. The schedule shall be kept confidential by the commissioner unless he finds that the interests of insureds and the public require that it be made public.
(3) Any insurer may distribute surplus to any class of policyholder, even if their policies do not provide for it. A schedule explaining the basis for the distribution shall be filed with the commissioner under Subsection (2) at least 30 days prior to the distribution. The commissioner shall disallow any distribution which is materially unfair to other policyholders or which would place the insurer in a financially hazardous condition.
(4) It is permissible to provide an indivisible dividend to classes of policyholders having more than one type of policy, including a combination of life or annuities with other types of insurance.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 3 - Specific Clauses in Contracts › Section 312 - Notice and proof of loss.

31A-21-312.
Notice and proof of loss.
(1) Every insurance policy shall provide that:
(a) when notice of loss is required separately from proof of loss, notice given by or on behalf of the insured to any authorized agent of the insurer within this state, with particulars sufficient to identify the policy, is notice to the insurer; and
(b) failure to give any notice or file any proof of loss required by the policy within the time specified in the policy does not invalidate a claim made by the insured, if the insured shows that it was not reasonably possible to give the notice or file the proof of loss within the prescribed time and that notice was given or proof of loss filed as soon as reasonably possible.
(2) Failure to give notice or file proof of loss as required by Subsection (1)(b) does not bar recovery under the policy if the insurer fails to show it was prejudiced by the failure. This subsection may not be construed to extend the statute of limitations applicable under Section 31A-21-313.
(3) The insurer shall, on request, promptly furnish an insured any forms or instructions needed to make a proof of loss.
(4) As an alternative to giving notice directly under Subsection (1)(a), it is a sufficient service of notice or of proof of loss if a first class postage prepaid envelope addressed to the insurer and containing the proper notice or proof of loss is deposited in any United States post office within the time prescribed.
(5) The commissioner shall adopt rules dealing with notice of loss and proof of loss time limitations under insurance policies. Under Section 31A-21-202, the commissioner's express approval shall be received before any contract clause requiring notice of loss or proof of loss in a manner inconsistent with the rule may be used in an insurance contract.
(6) The acknowledgment by the insurer of the receipt of notice, the furnishing of forms for filing proofs of loss, the acceptance of those proofs, or the investigation of any claim are not alone sufficient to waive any of the rights of the insurer in defense of any claim arising under the insurance policy.
Amended by Chapter 297, 2011 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 3 - Specific Clauses in Contracts › Section 313 - Limitation of actions.

Effective 5/3/2023
31A-21-313.
Limitation of actions.
(1)
(a) A person shall commence an action on a written policy or contract of first party insurance within three years after the inception of the loss except as provided in:
(i) Subsection 31A-22-305(11); and
(ii) Subsection 31A-22-307(7).
(b) The inception of the loss on a fidelity bond is the date the insurer first denies all or part of a claim made under the fidelity bond.
(2) Except as provided in Subsection (1) or elsewhere in this title, an action on a written policy or contract for insurance is subject to the law applicable to limitation of actions in Title 78B, Chapter 2, Statutes of Limitations.
(3) An insurance policy may not:
(a) limit the time for beginning an action on the policy to a time less than that authorized by statute;
(b) prescribe in what court an action may be brought on the policy; or
(c) provide that no action may be brought, subject to permissible arbitration provisions in contracts.
(4)
(a) Unless by verified complaint it is alleged that prejudice to the complainant will arise from a delay in bringing suit against an insurer, which prejudice is other than the delay itself, an action may not be brought against an insurer on an insurance policy to compel payment under the insurance policy until the earlier of:
(i) 60 days after proof of loss has been furnished as required under the policy;
(ii) waiver by the insurer of proof of loss; or
(iii)
(A) the insurer's denial of full payment; or
(B) for an accident and health insurance policy, the insurer's denial of payment.
(b) Under an accident and health insurance policy, an insurer may not require the completion of an appeals process that exceeds the provisions in 29 C.F.R. Sec. 2560.503-1 to bring suit under this Subsection (4).
(5) The period of limitation is tolled during the period in which the parties conduct an appraisal or arbitration procedure prescribed by the insurance policy, by law, or as agreed to by the parties.
Amended by Chapter 185, 2023 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 3 - Specific Clauses in Contracts › Section 314 - Prohibited provisions.

Effective 5/8/2018
31A-21-314.
Prohibited provisions.
(1) As used in this section:
(a) "Reserving discretionary authority" means a policy provision that:
(i) has the effect of conferring discretion on an insurer, or other claim administrator, to:
(A) determine eligibility for benefits; or
(B) interpret the terms or provisions of the policy, contract, certificate, or agreement; and
(ii) could lead to a deferential standard of review by a reviewing court.
(b) "Reserving discretionary authority" does not include a policy provision that:
(i) informs an insured that, as part of the insurer's routine operations, the insurer applies the terms of the contract for:
(A) making a decision, including making a determination regarding eligibility, or receipt of benefits or claims; or
(B) explaining the insurer's policies and procedures; and
(ii) does not give rise to a deferential standard of review by a reviewing court.
(2) An insurance policy subject to this chapter may not contain a provision:
(a) requiring the insurance policy to be construed according to the laws of another jurisdiction except as necessary to meet the requirements of compulsory insurance laws of other jurisdictions;
(b) depriving Utah courts of jurisdiction over an action against the insurer, except as provided in permissible arbitration provisions;
(c) limiting the right of action against the insurer to less than three years from the date the cause of action accrues; or
(d) for life insurance or accident and health insurance, reserving discretionary authority.
(3) For purposes of Subsection (2)(c), the cause of action accrues on a fidelity bond on the date the insurer first denies all or part of a claim made under the fidelity bond.
Amended by Chapter 351, 2018 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 3 - Specific Clauses in Contracts › Section 315 - Refund of canceled health insurance premiums and Medicare supplement insurance premiums.

31A-21-315.
Refund of canceled health insurance premiums and Medicare supplement insurance premiums.
(1) As used in this section, "unearned amount of the collected premium" means the amount of the collected premium applicable to the unexpired portion of the time period to which the policy or certificate relates.
(2) If a health insurance policy or a Medicare supplement policy is cancelled for a reason other than a material misrepresentation, the insurer shall refund the unearned amount of the collected premium.
(3) If an insurer cancels a health insurance policy or a Medicare supplement policy because of a material misrepresentation on the application, the insurer shall refund all premiums collected minus claims that have been paid.
Amended by Chapter 156, 2009 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 4 - Mass Marketed Life or Accident and Health Insurance › Section 401 - Scope and construction of part.

31A-21-401.
Scope and construction of part.
This part applies to all mass marketed life or accident and health insurance, notwithstanding Subsection 31A-1-103(3). This part may not be construed to limit the application of other provisions of this title to insurers effecting mass marketed life or accident and health insurance policies on persons in this state.
Amended by Chapter 116, 2001 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 4 - Mass Marketed Life or Accident and Health Insurance › Section 402 - Definitions.

Effective 5/5/2021
31A-21-402.
Definitions.
As used in this part:
(1)
(a) "Direct response solicitation" means any offer an insurer makes to persons in this state, either directly or through a third party, to effect life or accident and health insurance coverage which enables the individual to apply or enroll for the insurance on the basis of the offer.
(b) "Direct response solicitation" does not include:
(i) solicitations for insurance through an employee benefit plan exempt from state regulation under preemptive federal law; or
(ii) solicitations through an individual's creditor with respect to credit life or credit accident and health insurance.
(2) "Mass marketed life or accident and health insurance" means the insurance under any individual, franchise, group, or blanket insurance policy offering life or accident and health insurance:
(a) that is offered by means of direct response solicitation through:
(i) a sponsoring organization; or
(ii) the mails or other mass communications media; and
(b) under which the person insured pays all or substantially all of the cost of the person's insurance.
Amended by Chapter 252, 2021 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 4 - Mass Marketed Life or Accident and Health Insurance › Section 403 - Orders terminating effectiveness of policies.

31A-21-403.
Orders terminating effectiveness of policies.
Upon the commissioner's order, no mass marketed life or accident and health insurance issued by an insurer may continue to be effected on persons in this state. The commissioner may issue an order under this section only if the commissioner finds, after a hearing, that the total charges for the insurance to the persons insured are unreasonable in relation to the benefits provided. The commissioner's findings under this section shall be in writing. Orders under this section may direct the insurer to cease effecting the insurance until the total charges for the insurance are found by the commissioner to be reasonable in relation to the benefits provided.
Amended by Chapter 297, 2011 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 4 - Mass Marketed Life or Accident and Health Insurance › Section 404 - Out-of-state insurers.

Effective 5/5/2021
31A-21-404.
Out-of-state insurers.
Notwithstanding Subsection 31A-1-103(3)(h), an insurer extending mass marketed life or accident and health insurance under a group insurance policy issued outside of this state to residents of this state or a blanket insurance policy issued outside of this state to residents of this state shall, with respect to the mass marketed life or accident and health insurance policy:
(1) comply with:
(a) Sections 31A-23a-402, 31A-23a-402.5, and 31A-23a-403; and
(b)Chapter 26, Part 3, Claim Practices; and
(2) upon the commissioner's request, deliver to the commissioner a copy of:
(a) any mass marketed life or accident and health insurance policy;
(b) a certificate issued under a mass marketed life or accident and health insurance policy;
(c) an application for a mass marketed life or accident and health insurance policy;
(d) an enrollment form for a mass marketed life or accident and health insurance policy; and
(e) advertising material used in this state in connection with a mass marketed life or accident and health insurance policy.
Amended by Chapter 252, 2021 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 5 - Domestic Violence or Child Abuse - Insurance Practices › Section 501 - Definitions.

Effective 5/4/2022
31A-21-501.
Definitions.
For purposes of this part:
(1) "Applicant" means:
(a) in the case of an individual life or accident and health policy, the person who seeks to contract for insurance benefits; or
(b) in the case of a group life or accident and health policy, the proposed certificate holder.
(2) "Cohabitant" means an emancipated individual pursuant to Section 15-2-1 or an individual who is 16 years old or older who:
(a) is or was a spouse of the other party;
(b) is or was living as if a spouse of the other party;
(c) is related by blood or marriage to the other party;
(d) has one or more children in common with the other party; or
(e) resides or has resided in the same residence as the other party.
(3) "Child abuse" means the commission or attempt to commit against a child a criminal offense described in:
(a)Title 76, Chapter 5, Part 1, Assault and Related Offenses;
(b)Title 76, Chapter 5, Part 4, Sexual Offenses;
(c) Section 76-9-702, Lewdness;
(d) Section 76-9-702.1, Sexual battery; or
(e) Section 76-9-702.5, Lewdness involving a child.
(4) "Domestic violence" means any criminal offense involving violence or physical harm or threat of violence or physical harm, or any attempt, conspiracy, or solicitation to commit a criminal offense involving violence or physical harm, when committed by one cohabitant against another and includes commission or attempt to commit, any of the following offenses by one cohabitant against another:
(a) aggravated assault, as described in Section 76-5-103;
(b) assault, as described in Section 76-5-102;
(c) criminal homicide, as described in Section 76-5-201;
(d) harassment, as described in Section 76-5-106;
(e) electronic communication harassment, as described in Section 76-9-201;
(f) kidnapping, child kidnapping, or aggravated kidnapping, as described in Sections 76-5-301, 76-5-301.1, and 76-5-302;
(g) mayhem, as described in Section 76-5-105;
(h) sexual offenses, as described in Title 76, Chapter 5, Part 4, Sexual Offenses, and Sections 76-5b-201 and 76-5b-201.1;
(i) stalking, as described in Section 76-5-106.5;
(j) unlawful detention or unlawful detention of a minor, as described in Section 76-5-304;
(k) violation of a protective order or ex parte protective order, as described in Section 76-5-108;
(l) any offense against property described in Title 76, Chapter 6, Part 1, Property Destruction, Part 2, Burglary and Criminal Trespass, or Part 3, Robbery;
(m) possession of a deadly weapon with intent to assault, as described in Section 76-10-507; or
(n) discharge of a firearm from a vehicle, near a highway, or in the direction of any person, building, or vehicle, as described in Section 76-10-508.
(5) "Subject of domestic abuse" means an individual who is, has been, may currently be, or may have been subject to domestic violence or child abuse.
Amended by Chapter 185, 2022 General Session
Amended by Chapter 430, 2022 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 5 - Domestic Violence or Child Abuse - Insurance Practices › Section 503 - Discrimination based on domestic violence or child abuse prohibited.

31A-21-503.
Discrimination based on domestic violence or child abuse prohibited.
(1) Except as provided in Subsection (2), an insurer of life or accident and health insurance may not consider whether an insured or applicant is the subject of domestic abuse as a factor to:
(a) refuse to insure the applicant;
(b) refuse to continue to insure the insured;
(c) refuse to renew or reissue a policy to insure the insured or applicant;
(d) limit the amount, extent, or kind of coverage available to the insured or applicant;
(e) charge a different rate for coverage to the insured or applicant;
(f) exclude or limit benefits or coverage under an insurance policy or contract for losses incurred;
(g) deny a claim; or
(h) terminate coverage or fail to provide conversion privileges in violation of Section 31A-22-612 under a group accident and health policy for the insured because the coverage was issued in the name of the perpetrator of the domestic violence or abuse.
(2)
(a) Notwithstanding Subsection (1), an insurer may underwrite on the basis of the physical or mental condition of an insured or applicant if the underwriting is on the basis of a determination that there is a correlation between the medical or mental condition and a material increase in insurance risk.
(b) For purposes of Subsection (2)(a), the fact that an insured or applicant is a subject of domestic abuse is not a mental or physical condition.
(c) The determination required by Subsection (2)(a) shall be made in conformance with sound actuarial principles.
(d) Within 30 days after receiving an oral or written request from an insured or applicant, an insurer shall disclose in writing:
(i) the basis of an action permitted under Subsection (2)(a); and
(ii) if the policy has been issued or modified, the extent the action taken will impact the amount, extent, or kind of coverage or benefits available to the insured.
Amended by Chapter 319, 2013 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 5 - Domestic Violence or Child Abuse - Insurance Practices › Section 504 - Investigation -- Use of information used -- Disclosure.

31A-21-504.
Investigation -- Use of information used -- Disclosure.
(1) An insurer may not ask an insured or applicant or use any other means to determine whether the insured or applicant is the subject of domestic abuse.
(2) If an insured or applicant voluntarily discloses to the insurer or to the insured's or applicant's treating physician that the insured or applicant or a member of the insured's or applicant's household is the subject of domestic abuse, an insurer may not use the information of domestic violence or child abuse in violation of this part.
(3)
(a) An insurer may not disclose or transfer information to a third party relating to whether a specifically identifiable insured or applicant is the subject of domestic abuse unless the information:
(i) is required to be disclosed by the commissioner;
(ii) is required to be disclosed by a court of competent jurisdiction;
(iii) is necessary for the direct provision of health care services;
(iv) is permitted to be disclosed to an authorized agency under Chapter 31, Insurance Fraud Act;
(v) is required to be disclosed by abuse reporting laws; or
(vi) is authorized to be disclosed by the written consent of the individual who is the subject of domestic abuse, if that person is at least 18 years old.
(b) Subsection (3)(a) may not prevent an insured or applicant from obtaining the insured's or applicant's own medical or insurance records.
(c) Disclosure of information permitted under Subsection (3)(a) is subject to any state or federal law related to the confidentiality of medical information.
(d) For purposes of Subsection (3)(a), "third party" does not include an insurer's employees, agents, or contractors who are engaged in the insurer's necessary business operation.
(4) This section may not be construed to prohibit an insurer from:
(a) asking an applicant or insured about a medical condition, even if the condition is related to domestic violence or child abuse;
(b) using information obtained under Subsection (4)(a) for the purpose of actions or practices permitted under this part.
Enacted by Chapter 132, 1997 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 5 - Domestic Violence or Child Abuse - Insurance Practices › Section 505 - Limit on liability.

31A-21-505.
Limit on liability.
An insurer that issues a life or accident and health insurance policy to an individual who is the subject of domestic abuse is not liable civilly or criminally for the death of or any injuries to the insured as a result of domestic violence or child abuse beyond the obligations of the insurer under:
(1) the insurance policy; or
(2) this title.
Amended by Chapter 116, 2001 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 21 - Insurance Contracts in General › Part 5 - Domestic Violence or Child Abuse - Insurance Practices › Section 506 - Enforcement -- Private rights.

31A-21-506.
Enforcement -- Private rights.
(1) An insurer that violates this part is subject to any penalty permitted under this title.
(2) This part does not:
(a) create a private right of action for a violation of this part; or
(b) limit or impair the right of an individual to sue and recover damages from the insurer in a civil action for a cause of action that is not based on a violation of this part.
Enacted by Chapter 132, 1997 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 1 - Contracts of Suretyship › Section 101 - Scope of part.

31A-22-101.
Scope of part.
This Part 1, Contracts of Suretyship, applies to those suretyship obligations that are subject to Chapter 21, Insurance Contracts in General, and this chapter under Section 31A-21-101.
Amended by Chapter 90, 2004 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 1 - Contracts of Suretyship › Section 102 - Bonds need not be under seal.

31A-22-102.
Bonds need not be under seal.
Under this code, no suretyship obligation is required to be under seal.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 1 - Contracts of Suretyship › Section 103 - Validity of surety bonds.

31A-22-103.
Validity of surety bonds.
(1) An undertaking to stand as surety which is issued by an insurer authorized to do a surety business in this state is complete compliance with any qualification requirement in Utah law respecting surety bonds. This undertaking is acceptable to any state official or court-appointed fiduciary authorized to receive or empowered to require the undertaking. A copy of a surety's certificate of authority, certified by the commissioner, is prima facie evidence that a surety was authorized to do business in this state on the date of the certificate.
(2) No instrument executed by an insurer authorized to do a surety business is ineffective because of the insurer's failure to attach a copy of its certificate of authority to do business in this state. However, a public official or court-appointed fiduciary may, by prior written request, require that a copy of the insurer's certificate of authority, certified by the commissioner, be delivered. The insurer's failure to deliver a certified copy of the surety's certificate of authority within 10 days of receipt of the request is adequate grounds for refusing to accept the suretyship instrument. Failure to request a copy of the certificate of authority prior to accepting the surety instrument is a waiver of the right to request the certificate.
(3) After executing an obligation of suretyship, no insurer may deny its corporate power to execute that type of instrument or to incur that type of liability in any proceeding against the insurer upon that instrument.
Amended by Chapter 204, 1986 General Session