reglab/statecodes huggingface dataset:
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 8 - Credit Life and Accident and Health Insurance › Section 807 - Filing and approval of forms -- Loss ratio standards.

31A-22-807.
Filing and approval of forms -- Loss ratio standards.
(1) A policy, certificate of insurance, statement of insurance, or endorsement form intended for use in Utah is subject to Section 31A-21-201.
(2) In addition to the grounds for prohibiting use of a form under Subsection 31A-21-201(3), it is a ground to prohibit the use of a form that the benefits provided in the form are not reasonable in relation to the premium charge.
(3)
(a) In ascertaining whether the benefits are reasonable in relation to the premium charged, the commissioner shall consider:
(i) the mortality cost of the life insurance;
(ii) the morbidity cost of the accident and health insurance; and
(iii) the reserves set up for the payment of claims unreported or in the process of settlement.
(b) For purposes of this section, benefits are considered reasonable in relation to the premium charged if, given the costs described in this Subsection (3), the premium rate charged develops or may reasonably be expected to develop a loss ratio of:
(i) not less than 50% for credit life insurance; and
(ii) not less than 55% for credit accident and health insurance.
(4) Benefits are considered reasonable in relation to premium charged if the ratio of claims incurred to premium earned during the most recent four-year period at the rates in use produces a loss ratio that is equal to or exceeds the minimum loss ratio standard specified in Subsection (3).
(5) If the minimum loss ratio test produces a loss ratio that exceeds the minimum loss ratio standard in Subsection (4) by five percentage points or more, the insurer may file for approval and use a rate that is higher than the prima facie rate, if it can be expected that the use of the higher rate will continue to produce a loss ratio for an account to which it is applied that will satisfy the minimum loss ratio test.
(6) If the minimum loss ratio test produces a loss ratio that is lower than the minimum loss standard in Subsection (4) by five percentage points or more, the commissioner may require that the insurer:
(a) file an adjusted rate that can be expected to produce a loss ratio that will satisfy the minimum loss ratio test; or
(b) submit reasons acceptable to the commissioner why the insurer should not be required to file an adjusted rate.
Amended by Chapter 345, 2008 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 8 - Credit Life and Accident and Health Insurance › Section 808 - Premiums and refunds.

31A-22-808.
Premiums and refunds.
(1) Each policy, certificate, or statement of insurance shall provide that in the event of termination of the insurance prior to the scheduled maturity date of the indebtedness, any refund of an amount paid by the debtor for insurance shall be paid or credited promptly to the person entitled to it. The formula used in computing the refund shall be filed with and approved by the commissioner under Chapter 21, Part 2, Approval of Forms. No refund is required if it would be less than $5.
(2) If a creditor requires a debtor to make any payment for credit life or credit accident and health insurance and an individual policy, certificate, or statement of insurance is not issued, the creditor shall immediately give written notice to the debtor and credit the account.
(3) The amount charged the debtor for credit life or accident and health insurance may not exceed the premiums charged by the insurer as computed at the time the charge to the debtor is determined.
Amended by Chapter 90, 2004 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 8 - Credit Life and Accident and Health Insurance › Section 809 - Right of debtor to choose insurer.

31A-22-809.
Right of debtor to choose insurer.
When credit life insurance or credit accident and health insurance is required as security for any indebtedness, the creditor shall inform the debtor of the debtor's option to furnish the required insurance through existing policies of insurance owned or controlled by the debtor or to procure and furnish the required coverage through any insurer authorized to transact life or accident and health insurance in Utah.
Amended by Chapter 116, 2001 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 9 - Contracts of Fraternal Insurers › Section 901 - Laws applicable to contracts of fraternal insurers.

31A-22-901.
Laws applicable to contracts of fraternal insurers.
Except as otherwise provided under this part, or in Chapter 9, Insurance Fraternals, insurance contracts issued by fraternal insurers are subject to the contract provisions of the Insurance Code in the same manner as contracts issued by any other insurer.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 9 - Contracts of Fraternal Insurers › Section 902 - Fraternal contract.

31A-22-902.
Fraternal contract.
(1) A fraternal shall issue to each benefit member a policy or certificate specifying the benefits provided and containing at least the substance of all sections of the laws of the fraternal which might result in the termination of coverage or the reduction of benefits. The policy or certificate, any riders or endorsements attached to them, the laws of the fraternal, and the application and declarations made in connection with these which are signed by the applicant, constitute the agreement between the fraternal and the member, and the policy or certificate shall state this.
(2) Any changes in the laws of a fraternal which are made subsequent to the issuance of a policy or certificate bind the member and beneficiary as if they had been in force at the time of the application, so long as they do not destroy or diminish any benefits provided in the policy or certificate.
(3) Copies of any documents mentioned in Subsections (1) and (2), certified by the secretary or corresponding officer of the fraternal, are evidence of the terms and conditions of the contract.
(4) Section 31A-21-106 does not apply to fraternal contracts.
(5) If a fraternal's laws provide for expulsion or suspension of a member for any reason other than nonpayment of premium, the fraternal's insurance certificate shall contain a provision that if a member is expelled or suspended for any reason other than nonpayment of premium, the expelled member has the right to maintain the policy in force by continuing to pay the required premium.
(6) The policy or certificate shall contain a maintenance of solvency provision pursuant to Subsection 31A-9-209(2).
(7) This section applies to all contracts made by a fraternal beginning July 1, 1986. A fraternal may elect to have this section apply at an earlier date, as long as it applies simultaneously to all of its contracts and the fraternal gives the commissioner at least 30 days notice of its intention to apply this section.
Amended by Chapter 204, 1986 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 9 - Contracts of Fraternal Insurers › Section 903 - Fraud in obtaining membership.

31A-22-903.
Fraud in obtaining membership.
Subject to Sections 31A-22-403 and 31A-22-405, any certificate of membership secured by misrepresentation with reference to any application for membership, document, or other proof, for the purpose of obtaining membership in, or an insurance benefit from, the fraternal is void, if the fraternal relied on it and it is either material or fraudulent.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 9 - Contracts of Fraternal Insurers › Section 904 - Beneficiaries in fraternal contracts.

31A-22-904.
Beneficiaries in fraternal contracts.
(1) Any member may designate as beneficiary any person permitted by the laws of the fraternal. Those laws shall allow the designation of the member's estate as beneficiary.
(2) Subject to Subsection (1), Section 31A-22-413 applies.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 10 - Workers' Compensation Insurance Contracts › Section 1002 - Duration of coverage.

31A-22-1002.
Duration of coverage.
(1) Any insurer assuming a workers' compensation risk shall carry it until the policy is canceled, either:
(a) by agreement between the Division of Industrial Accidents in the Labor Commission, the insurer, and the employer; or
(b) after:
(i) notice by the insurer to the employer as provided in Section 31A-21-303; and
(ii) notice to the Division of Industrial Accidents in the Labor Commission as provided in Section 34A-2-205.
(2) Subsection (1) does not affect the requirements of Section 31A-22-1001.
Amended by Chapter 116, 2001 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 10 - Workers' Compensation Insurance Contracts › Section 1003 - Comprehensive coverage.

31A-22-1003.
Comprehensive coverage.
Every insurance policy covering the liability of an employer under Title 34A, Chapter 2, Workers' Compensation Act, shall cover all types of workers' compensation benefits required to be provided under that chapter. This section does not preclude primary and excess coverage being provided under different contracts.
Amended by Chapter 375, 1997 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 10 - Workers' Compensation Insurance Contracts › Section 1004 - Direct enforcement by employees.

31A-22-1004.
Direct enforcement by employees.
All workers' compensation insurance policies shall contain a provision that employees may enforce, in their own names, the liability of the insurer.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 10 - Workers' Compensation Insurance Contracts › Section 1005 - Payment as bar to recovery.

31A-22-1005.
Payment as bar to recovery.
Payment of compensation under a workers' compensation insurance policy, whether in whole or in part, by either the employer or the insurer, bars recovery by the employee or his dependents to the extent of the payment.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 10 - Workers' Compensation Insurance Contracts › Section 1006 - Insurer's constructive knowledge.

31A-22-1006.
Insurer's constructive knowledge.
Every workers' compensation policy or contract shall contain a provision that, as between the employee and the insurer, notice to or knowledge of the occurrence of the injury on the part of the employer is considered to be notice or knowledge to the insurer. This provision shall also state that the insurer is bound by and subject to the orders, findings, decisions, and awards rendered against the employer for the payment of compensation on account of compensable accidental injuries or occupational disease disability.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 10 - Workers' Compensation Insurance Contracts › Section 1007 - Employer's insolvency.

31A-22-1007.
Employer's insolvency.
Every workers' compensation policy or contract shall contain a provision that the insolvency of the employer and his discharge does not relieve the insurer from the payment of compensation for injuries or death sustained by an employee during the life of that policy or contract.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 10 - Workers' Compensation Insurance Contracts › Section 1008 - Employer's breach of safety rules.

31A-22-1008.
Employer's breach of safety rules.
No condition in a workers' compensation policy requiring the insured employer to comply with certain safety rules may excuse the workers' compensation insurer from paying the required benefits to an employee injured as a result of the employer's breach of a safety rule that is a condition to the workers' compensation policy. However, the insurer may bring a claim against the insured employer for breach of the policy condition.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 10 - Workers' Compensation Insurance Contracts › Section 1009 - Other applicable provisions.

31A-22-1009.
Other applicable provisions.
Workers' compensation insurance contracts are subject to any applicable requirements of Title 34A, Chapter 2, Workers' Compensation Act.
Amended by Chapter 375, 1997 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 10 - Workers' Compensation Insurance Contracts › Section 1010 - Workers' compensation deductible policies.

31A-22-1010.
Workers' compensation deductible policies.
(1) An insurer authorized to transact the business of workers' compensation in this state may issue a workers' compensation insurance policy that provides for the insured to participate in the payment of the insurance claims and losses covered by the policy in accordance with rules made by the department.
(2) Notwithstanding Subsection (1), an insurer:
(a) shall assume responsibility to pay all claims and losses under a workers' compensation insurance policy in accordance with Title 34A, Chapter 2, Workers' Compensation Act, and Chapter 3, Utah Occupational Disease Act;
(b) may not permit the insured to participate in the payment of the insurance claims and losses by any means except reimbursement of the insurer; and
(c) may not permit an employee to participate in the payment of claims or losses.
(3) For policies issued under this section, the department shall make rules consistent with this section governing:
(a) the terms of the policies; and
(b) reporting requirements for the policies.
Enacted by Chapter 277, 1998 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 10 - Workers' Compensation Insurance Contracts › Section 1012 - Workers' compensation insurance availability.

31A-22-1012.
Workers' compensation insurance availability.
(1) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the department shall make rules to monitor the following related to employers who can only obtain workers' compensation insurance pursuant to Section 31A-22-1001 because of an underwriting standard or guideline described in Subsection (2):
(a) the number of employers;
(b) the type of employers;
(c) the underwriting standard or guideline that causes the employer to obtain workers' compensation under Section 31A-22-1001; or
(d) similar information to the information described in Subsections (1)(a) through (c).
(2) An underwriting standard or guideline described in Subsection (1) includes a standard or guideline regarding:
(a) premium size;
(b) class code and risk characteristics;
(c) payroll and loss experience;
(d) another factor identified by the department; or
(e) a combination of the factors listed in Subsections (2)(a) through (d).
Enacted by Chapter 348, 2008 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 10 - Workers' Compensation Insurance Contracts › Section 1016 - Workers' compensation coverage for medical cannabis operations.

Effective 5/3/2023
31A-22-1016.
Workers' compensation coverage for medical cannabis operations.
A licensed and admitted workers' compensation insurer may issue coverage to:
(1) a cannabis production establishment as defined in Section 4-41a-102; or
(2) a medical cannabis pharmacy as defined in Section 26B-4-201.
Amended by Chapter 328, 2023 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 11 - Legal Expense Insurance › Section 1101 - Combination of lines.

31A-22-1101.
Combination of lines.
(1) Legal expense insurance may be transacted alone or together with life insurance, accident and health insurance, or casualty insurance.
(2) An insurer may not transact liability insurance and also issue legal expense insurance policies providing coverage for the expense of enforcing claims against third persons, unless the requirements of Subsection (3) are met and the commissioner is satisfied that the interests of policyholders of legal expense insurance policies are not endangered by potential conflicts of interest within the insurer.
(3) Adequate precautions shall be taken to make sure that the handling of an insured's claim for legal assistance in enforcing a claim against a third person is not affected by the insurer's actual or potential obligation as a liability insurer to pay the claim for the third person. These precautions may include:
(a) a provision in the policy that claims against third persons shall be handled exclusively by attorneys selected by the insureds themselves rather than by the insurer, that no information about the case other than the name of the defendant and the nature of the claim may be made available to the insurer, and that the insurer may not interfere with the handling of the case; or
(b) organizational separation between the legal expense and the liability insurance departments with respect to management, accounting, record keeping, and claims handling, with appropriate rules and procedures, satisfactory to the commissioner, to prevent the exchange of information between the two departments about details of cases.
Amended by Chapter 116, 2001 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 11 - Legal Expense Insurance › Section 1102 - Policy and certificate forms.

31A-22-1102.
Policy and certificate forms.
(1) Legal expense insurance may be written as individual, group, blanket, or franchise insurance. Each contractual obligation for legal expense insurance shall be evidenced by a policy. Each person insured under a group policy shall be issued a certificate of coverage.
(2) Policies and certificates of legal expense insurance are subject to Section 31A-21-201.
(3) The commissioner may not approve any form that does not meet all of the following requirements:
(a) Policies shall contain a list and description of the legal services promised or the legal matters for which expenses are to be reimbursed, and any limits on the amounts to be reimbursed.
(b) Certificates issued under group policies shall contain a full statement of the benefits provided, but may summarize the other terms of the master policy.
(c) Policies promising legal services to be provided by a limited number of attorneys who have concluded provider contracts with the insurer, whether the attorney in an individual case is to be selected by the insured or by the insurer, shall provide for alternative benefits in case the insured is unable to find a participating attorney willing to perform the promised services or the attorney selected by the insurer is disqualified or otherwise unable to perform the promised services. The alternative benefit may consist of furnishing the services of an attorney selected and paid by the insurer or paying the fee of an attorney selected by the insured. The policy shall also provide a procedure that includes impartial review for settling disagreements about the grounds for demanding an alternative benefit.
(d) No policy, except one issued by a mutual insurance company, may provide for assessments on policyholders or for reductions of benefits to maintain the insurer's solvency.
(4) The commissioner may disapprove a policy or certificate form if he finds that it:
(a) is unfair, unfairly discriminatory, misleading, or encourages misrepresentation or misunderstanding of the contract;
(b) provides coverage or benefits or contains other provisions that would endanger the solidity of the insurer; or
(c) is contrary to law.
(5) The commissioner may require the submission of relevant information he considers to be reasonably necessary in determining whether to approve or disapprove a filing.
Amended by Chapter 261, 1989 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 12 - Reinsurance › Section 1201 - Assumption agreement.

Effective 5/10/2016
31A-22-1201.
Assumption agreement.
(1) Subject to Subsection (2), a credit for reinsurance ceded under Section 31A-17-404 or 31A-17-404.1 is not allowed unless, in addition to meeting the requirements of Section 31A-17-404 or 31A-17-404.1, the reinsurance agreement provides in substance that if the ceding insurer is insolvent, the reinsurance is payable by the assuming insurer:
(a) on the basis of the liability of the ceding insurer under the contract or contracts reinsured;
(b) without diminution because of the insolvency of the ceding insurer; and
(c) directly to the ceding insurer or to its domiciliary liquidator or receiver.
(2) Subsection (1) applies except if:
(a) a contract specifically provides another payee of the insurance in the event of the insolvency of the ceding insurer; or
(b) the assuming insurer, with the consent of the one or more direct insureds, assumes the policy obligations of the ceding insurer:
(i) as direct obligations of the assuming insurer to the payees under the policies; and
(ii) in substitution for the obligations of the ceding insurer to the payees.
Amended by Chapter 138, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 12 - Reinsurance › Section 1202 - Other reinsurance contracts.

31A-22-1202.
Other reinsurance contracts.
(1) If there is no assumption agreement under Subsection 31A-22-1201(2), the reinsurer's sole obligation is to the ceding insurer.
(2) No guaranty fund, security fund, or any other person, except the estate of the ceding insurer, has a claim against a reinsurer.
(3) Subject to contractual rights of offset, if a ceding insurer is put into receivership, the reinsurer shall pay any amount due under the contract in full, without reduction because of the receivership:
(a) to the domiciliary receiver if there is one; or
(b) if there is not domiciliary receiver, to a Utah receiver.
Amended by Chapter 257, 2008 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 12 - Reinsurance › Section 1203 - Right of reinsurer to defend claim.

31A-22-1203.
Right of reinsurer to defend claim.
A reinsurance contract may provide that the receiver of a ceding insurer shall, within a specified or reasonable time after the claim is filed in court or in the receivership, give written notice to an assuming reinsurer of all or part of the claim against the ceding insurer. During the pendency of the claim, any assuming reinsurer may investigate the claim and unless forbidden to do so by the reinsurance agreement, may intervene in the proceeding in which the claim is pending and interpose any defenses it considers available which have not been raised by the ceding insurer or its receiver. The expenses incurred by the assuming reinsurer in this type of action are payable up to the amount of the expenses or the amount of the benefit produced, whichever is less, as expenses of the receivership. If two or more assuming reinsurers have potential liability because of the same claim, the expenses shall be apportioned among them in proportion to the benefit received.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 12 - Reinsurance › Section 1204 - Approval required for bulk insurance.

31A-22-1204.
Approval required for bulk insurance.
Reinsurance credit is not allowed to a domestic insurer for reinsurance ceded when such reinsurance constitutes all or substantially all of the insurance in force of the domestic insurer, unless the agreement purporting to transfer the reinsurance is in writing and:
(1) approved by the commissioner prior to execution of the agreement; or
(2) provides that the agreement is subject to the approval of the commissioner.
Enacted by Chapter 258, 1992 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 13 - Miscellaneous Provisions › Section 1300 - Aircraft public liability insurance.

Effective 5/5/2021
31A-22-1300.
Aircraft public liability insurance.
Policies containing aircraft public liability insurance coverage for an aircraft shall include minimum coverage of:
(1) $50,000 per person for bodily injury or death in any one accident;
(2) $50,000 for property damage in any one accident; and
(3) $100,000 in any one accident, whether for property damage, or bodily injury or death.
Amended by Chapter 253, 2021 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 13 - Miscellaneous Provisions › Section 1301 - Liability insurance for armored car companies and contract security companies.

31A-22-1301.
Liability insurance for armored car companies and contract security companies.
Section 58-63-302 applies to liability insurance for armored car companies and contract security companies.
Amended by Chapter 246, 2008 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 13 - Miscellaneous Provisions › Section 1302 - Insurance requirements for vehicles of unusual physical nature.

31A-22-1302.
Insurance requirements for vehicles of unusual physical nature.
Section 72-9-103 applies to the insurance requirements for vehicles of an unusual physical nature.
Amended by Chapter 270, 1998 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 13 - Miscellaneous Provisions › Section 1303 - Liability insurance for motor carriers.

31A-22-1303.
Liability insurance for motor carriers.
Motor carrier safety regulations adopted under Section 72-9-103 specify liability insurance for motor carriers.
Amended by Chapter 270, 1998 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 13 - Miscellaneous Provisions › Section 1305 - Persons authorized to issue annuities.

31A-22-1305.
Persons authorized to issue annuities.
No person may issue an annuity to another person unless the issuer is:
(1) an insurer authorized to issue annuities under Chapter 5, Domestic Stock and Mutual Insurance Corporations, Chapter 9, Insurance Fraternals, or Chapter 14, Foreign Insurers;
(2) a domestic corporation created under Title 16, Chapter 6a, Utah Revised Nonprofit Corporation Act, or other applicable law, or a foreign corporation conducted without profit, which is engaged solely in bona fide charitable, religious, missionary, educational, medical, or philanthropic activities; or
(3) a natural person who issues an annuity to his spouse, children, grandchildren, great-grandchildren, parents, grandparents, uncles, aunts, brothers, sisters, nieces, or nephews, whether those relationships are by birth, marriage, or legal adoption.
Amended by Chapter 300, 2000 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 13 - Miscellaneous Provisions › Section 1306 - Transition provision for existing policy forms.

31A-22-1306.
Transition provision for existing policy forms.
Insurance policy forms need not conform to the requirements of this chapter until July 1, 1987. However, insurance policies issued after July 1, 1986, are subject to Section 31A-21-107.
Amended by Chapter 204, 1986 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 13 - Miscellaneous Provisions › Section 1307 - Use of consumer reports by residential dwelling liability insurers.

31A-22-1307.
Use of consumer reports by residential dwelling liability insurers.
(1) An insurer who uses consumer reports in connection with the underwriting of residential dwelling liability insurance shall establish and adhere to written procedures that:
(a) identify the circumstances under which the insurer may request and the manner in which it will use consumer reports in its underwriting decisions;
(b) provide prior notice of the possible or intended use of a consumer report to an applicant for a residential liability insurance policy; and
(c) ensure compliance with the Consumer Credit Reporting Act, 15 U.S.C. Sec. 1681 et seq., including the duties that arise from taking adverse action based on information contained in a consumer report.
(2) An insurer that requests or uses a consumer report in connection with an application for a residential dwelling liability insurance policy shall maintain evidence of its compliance with the written procedures established by the insurer under Subsection (1).
(3) An insurer shall submit to the commissioner, upon request, evidence of compliance maintained in accordance with Subsection (2).
(4) As used in this section, the terms "consumer report" and "adverse action" are defined in 15 U.S.C. Sec. 1681a.
Enacted by Chapter 105, 1997 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 13 - Miscellaneous Provisions › Section 1309 - Return of unearned premium upon cancellation of errors and omissions insurance.

31A-22-1309.
Return of unearned premium upon cancellation of errors and omissions insurance.
(1) As used in this section, "unearned premium" means the amount of the premium that is collected by the insurer in excess of premium earned as of the date of the cancellation of the errors and omissions insurance policy.
(2) For an errors and omissions policy issued on or after May 14, 2013:
(a) the policyholder may cancel the errors and omissions insurance policy before its expiration or renewal date according to the procedure for cancellation set forth in the errors and omissions policy; and
(b) an insurer may not issue an errors and omissions policy that has fully earned premium upon issuance of the errors and omissions policy.
(3) If the errors and omissions insurance policy is cancelled as provided in Subsection (2), the insurer shall refund the unearned premium to the policyholder minus any charge imposed by the insurer.
Enacted by Chapter 205, 2013 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 14 - Long-Term Care Insurance Standards › Section 1401 - Application.

Effective 5/14/2019
31A-22-1401.
Application.
(1) The requirements of this part apply to individual policies and to group policies and certificates marketed in this state on or after July 1, 2001.
(2) Entities subject to this part shall comply with other applicable insurance laws and rules unless they are in conflict with this part.
(3) The laws, regulations, and rules designed and intended to apply to Medicare supplement insurance policies may not be applied to long-term care insurance.
(4) Any policy or rider advertised, marketed, or offered as long-term care or nursing home insurance shall comply with the provisions of this part.
Amended by Chapter 193, 2019 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 14 - Long-Term Care Insurance Standards › Section 1402 - Definitions.

31A-22-1402.
Definitions.
Unless the context requires otherwise, the following definitions apply in this part:
(1) "Applicant" means:
(a) in the case of an individual long-term care insurance policy, the person who seeks to contract for benefits; and
(b) in the case of a group long-term care insurance policy, the proposed certificate holder.
(2) Notwithstanding Section 31A-1-301,"certificate" means a certificate issued under a group long-term care insurance policy if the group long-term care insurance policy is delivered or issued for delivery in this state.
(3) Notwithstanding Section 31A-1-301, "policy" means a policy, contract subscriber agreement, rider, or endorsement, if the policy, contract subscriber agreement, rider, or endorsement is delivered or issued:
(a) in this state; and
(b) by:
(i) an insurer;
(ii) a fraternal benefit society;
(iii) a nonprofit health, hospital, or medical service corporation;
(iv) a prepaid health plan;
(v) a health maintenance organization; or
(vi) an entity similar to an entity described in Subsections (3)(b)(i) through (v).
Amended by Chapter 116, 2001 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 14 - Long-Term Care Insurance Standards › Section 1403 - Filing required for policies issued in another state.

31A-22-1403.
Filing required for policies issued in another state.
Group long-term care insurance coverage may not be offered to a resident of this state under a group policy issued in another state unless the policy and certificate have been filed with the commissioner.
Enacted by Chapter 243, 1991 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 14 - Long-Term Care Insurance Standards › Section 1404 - Rulemaking authority.

Effective 5/5/2021
31A-22-1404.
Rulemaking authority.
The commissioner may adopt rules that may permit or include:
(1) the increase of benefits over time;
(2) standards for full and fair disclosure of the manner, content, and required disclosures for the sale of long-term care insurance policies;
(3) terms of renewability;
(4) initial and subsequent conditions of eligibility;
(5) nonduplication of coverage provisions;
(6) coverage of dependents;
(7) termination of coverage;
(8) continuation or conversion;
(9) probationary periods;
(10) limitations, exceptions, and reductions of coverage;
(11) preexisting conditions;
(12) elimination and waiting periods;
(13) requirements for replacement;
(14) recurrent conditions;
(15) definition of terms;
(16) loss ratio requirements;
(17) post claim underwriting;
(18) waiver of premium;
(19) independent review of benefit determinations;
(20) inflation protection benefits; and
(21) premium rate filing and review.
Amended by Chapter 252, 2021 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 14 - Long-Term Care Insurance Standards › Section 1405 - Restrictions on terms of coverage.

31A-22-1405.
Restrictions on terms of coverage.
No long-term care insurance policy may:
(1) be canceled, nonrenewed, or otherwise terminated on the grounds of the age or the deterioration of the mental or physical health of the insured individual or certificate holder;
(2) contain a provision establishing a new waiting period in the event existing coverage is converted to or replaced by a new or other form within the same company, except with respect to an increase in benefits voluntarily selected by the insured individual or group policyholder; or
(3) provide coverage for skilled nursing care only or provide significantly more coverage for skilled care in a facility than coverage for lower levels of care.
Enacted by Chapter 243, 1991 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 14 - Long-Term Care Insurance Standards › Section 1406 - Preexisting conditions.

31A-22-1406.
Preexisting conditions.
(1) A long-term care insurance policy or certificate may not use a definition of a preexisting condition which is more restrictive than the following: "Preexisting condition means a condition for which medical advice or treatment was recommended by or received from a provider of health care services, within six months preceding the effective date of coverage of an insured person."
(2) A long-term care insurance policy or certificate may not exclude coverage for a loss or confinement which is the result of a preexisting condition unless such loss or confinement begins within six months following the effective date of coverage of an insured person.
(3) The commissioner may extend the preexisting condition periods provided in Subsections (1) and (2) as to specific age group categories in specific policy forms upon finding that the extension is in the best interest of the public.
(4)
(a) The definition of preexisting condition does not prohibit an insurer from using an application form designed to elicit the complete health history of an applicant and from underwriting in accordance with that insurer's established underwriting standards on the basis of the answers on that application.
(b) Unless otherwise provided in the policy or certificate, a preexisting condition, regardless of whether it is disclosed on the application, need not be covered until the waiting period described in Subsection (2) expires.
(c) A long-term care insurance policy or certificate may not exclude or use waivers or riders of any kind to exclude, limit, or reduce coverage or benefits for specifically named or described preexisting diseases or physical condition beyond the waiting period described in Subsection (2).
Amended by Chapter 297, 2011 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 14 - Long-Term Care Insurance Standards › Section 1407 - Restricted conditional terms.

31A-22-1407.
Restricted conditional terms.
(1) A long-term care insurance policy may not contain a provision that conditions eligibility:
(a) for any benefits on a prior hospitalization requirement;
(b) for benefits provided in an institutional care setting on the receipt of a higher level of institutional care; or
(c) for any benefits on a prior institutionalization requirement except for eligibility for:
(i) waiver of premium;
(ii) post confinement;
(iii) post-acute care; or
(iv) recuperative benefits.
(2) A long-term care insurance policy containing post confinement, post-acute care, or recuperative benefits shall clearly label the limitations or conditions, including any required number of days of confinement in a separate paragraph of the policy or certificate that is entitled "Limitations or Conditions on Eligibility for Benefits."
(3) A long-term care insurance policy or rider that conditions eligibility of noninstitutional benefits on the prior receipt of institutional care may not require a prior institutional stay of more than 30 days.
Amended by Chapter 116, 2001 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 14 - Long-Term Care Insurance Standards › Section 1408 - Right of return -- Notice.

31A-22-1408.
Right of return -- Notice.
Individual long-term care insurance policyholders and certificate holders other than employee and labor union certificate holders have the right to return the policy within 30 days of its delivery and to have the premium refunded if the policyholder is not satisfied for any reason after examination of the policy. Individual long-term care insurance policies shall have a notice prominently printed on the first page of the policy or attached to the policy stating in substance that the policyholder has the right to return the policy within 30 days of its delivery and to have the premium refunded if the policyholder is not satisfied for any reason after examination of the policy.
Enacted by Chapter 243, 1991 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 14 - Long-Term Care Insurance Standards › Section 1410 - Report to policyholder.

31A-22-1410.
Report to policyholder.
A monthly report shall be provided to the policyholder any time a long-term care benefit funded through a life insurance vehicle by the acceleration of the death benefit is in benefit payment status. The report shall include:
(1) any long-term care benefits paid out during the month;
(2) an explanation of any changes in the policy due to long-term care benefits being paid out such as death benefits or cash values; and
(3) the amount of long-term care benefits existing or remaining.
Enacted by Chapter 243, 1991 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 14 - Long-Term Care Insurance Standards › Section 1411 - Incontestability period.

31A-22-1411.
Incontestability period.
(1) For a policy or certificate that has been in force for less than six months, an insurer may rescind a long-term care insurance policy or certificate upon a showing of misrepresentation that is material to the acceptance for coverage.
(2) For a policy or certificate that has been in force for at least six months but less than two years, an insurer may rescind a long-term care insurance policy or certificate upon a showing of misrepresentation that:
(a) is material to the acceptance for coverage; and
(b) pertains to the condition for which benefits are sought.
Enacted by Chapter 344, 1995 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 14 - Long-Term Care Insurance Standards › Section 1412 - Nonforfeiture benefits.

31A-22-1412.
Nonforfeiture benefits.
(1)
(a) A long-term care insurance policy or certificate may not be delivered or issued for delivery in this state unless the policyholder or certificate holder has been offered the option of purchasing a policy or certificate including a nonforfeiture benefit.
(b) The offer of a nonforfeiture benefit under Subsection (1)(a) may be in the form of a rider that is attached to the policy.
(c) If the policyholder or certificate holder declines the nonforfeiture benefit offered under this Subsection (1), the insurer shall provide a contingent benefit upon lapse of the policy or certificate that is available for a specified period of time following a substantial increase in premium rates.
(d)
(i) Except as provided in Subsection (1)(d)(ii), if a group long-term care insurance policy is issued, the offer required in this Subsection (1) shall be made to the group policyholder.
(ii) If the policy is issued to a group authorized under Section 31A-22-509, the offer required under this Subsection (1) shall be made to each proposed certificate holder.
(2) The commissioner shall make rules:
(a) specifying the types of nonforfeiture benefits to be offered as part of a long-term care insurance policy or certificate;
(b) specifying the standards for nonforfeiture benefits; and
(c) regarding contingent benefits upon lapse, including a determination of:
(i) the specified period of time during which a contingent benefit upon lapse will be available as provided in Subsection (1); and
(ii) the substantial premium rate increase that triggers a contingent benefit upon lapse as provided in Subsection (1).
Amended by Chapter 116, 2001 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 14 - Long-Term Care Insurance Standards › Section 1413 - Claim information.

31A-22-1413.
Claim information.
If a claim under a long-term care insurance contract is denied, within 60 days of the date a written request by the policyholder or a representative of a policyholder is filed with the insurer, the insurer shall:
(1) provide a written explanation of the reason for the denial; and
(2) make available all information directly related to the denial.
Enacted by Chapter 116, 2001 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 14 - Long-Term Care Insurance Standards › Section 1414 - Marketing.

31A-22-1414.
Marketing.
A policy or rider shall comply with this part if it is advertised, marketed, or offered as:
(1) long-term care insurance; or
(2) nursing home insurance.
Enacted by Chapter 116, 2001 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 14 - Long-Term Care Insurance Standards › Section 1415 - Living organ donor coverage.

Effective 5/12/2020
31A-22-1415.
Living organ donor coverage.
(1) For the purposes of this section, "living organ donor" means the same as that term is defined in Section 31A-22-655.
(2) An insurer may not:
(a) deny eligibility for coverage or limit coverage of a individual under a long-term care insurance policy or contract solely due to the status of the individual as a living organ donor;
(b) preclude an individual from donating all or part of an organ as a condition of receiving or continuing to receive coverage under a long-term care insurance policy or contract; or
(c) discriminate in the offering, issuance, cancellation, amount of coverage, price, or any other condition of a long-term care insurance policy or contract for an individual based upon the status of the individual as a living organ donor without any additional actuarial risk.
(3) The commissioner shall make educational materials available to insurers and the public on the access of living organ donors to insurance.
(4) The commissioner may make rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to implement the provisions of this section.
Enacted by Chapter 128, 2020 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 15 - Liability Insurance for Motorboats › Section 1501 - Definitions.

31A-22-1501.
Definitions.
As used in this part:
(1) "Motorboat" has the same meaning as defined under Section 73-18c-102.
(2) "Motorboat business" means a motorboat sales agency, repair shop, service station, storage garage, or public marina.
(3) "Operator" has the same meaning as under Section 73-18c-102.
(4) "Owner" has the same meaning as under Section 73-18c-102.
(5) "Rental company" means any person or organization in the business of providing motorboats to the public.
(6) "Renter" means any person or organization obtaining the use of a motorboat from a rental company under the terms of a rental agreement.
Amended by Chapter 211, 2006 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 15 - Liability Insurance for Motorboats › Section 1503 - Motorboat liability policy minimum limits.

31A-22-1503.
Motorboat liability policy minimum limits.
Policies containing motorboat liability coverage may not limit the insurer's liability under that coverage below the following:
(1)
(a) $25,000 because of liability for bodily injury to or death of one person, arising out of the use of a motorboat in any one accident;
(b) subject to the limit for one person in Subsection (1)(a), in the amount of $50,000 because of liability for bodily injury to or death of two or more persons arising out of the use of a motorboat in any one accident; and
(c) in the amount of $15,000 because of liability for injury to, or destruction of, property of others arising out of the use of a motorboat in any one accident; or
(2) $65,000 in any one accident whether arising from bodily injury to or the death of others, or from destruction of, or damage to, the property of others.
Amended by Chapter 211, 2006 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 15 - Liability Insurance for Motorboats › Section 1504 - Mandatory coverage.

31A-22-1504.
Mandatory coverage.
(1) A rental company shall provide its renters with primary coverage meeting the requirements of Title 73, Chapter 18c, Financial Responsibility of Motorboat Owners and Operators Act.
(2) All coverage shall include primary defense costs and may not be waived.
Amended by Chapter 211, 2006 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 22 - Contracts in Specific Lines › Part 16 - Genetic Testing Restrictions on Insurers › Section 1602 - Genetic testing restrictions.

Effective 5/3/2023
31A-22-1602.
Genetic testing restrictions.
Except as provided under Section 31A-22-620, with respect to a matter related to genetic testing and private genetic information, an insurer shall comply with the applicable provisions of Title 13, Chapter 60, Part 2, Genetic Testing and Procedure Privacy Act, including Section 13-60-205.
Amended by Chapter 328, 2023 General Session