reglab/statecodes huggingface dataset:
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 9 - CREDIT LIFE AND HEALTH INSURANCE (§§ 56-7-901 — 56-7-914) › Section 56-7-903 - Applicability of credit life insurance provisions

All life insurance policies and certificates issued in connection with loans or credit transactions for a duration of fifteen (15) years or less shall be subject to §
56-7-902
- 56-7-912, except in connection with a loan or other credit transaction where the period of coverage on the debtor determined at date of issuance of the coverage is of more than ten (10) years' duration. Insurance shall not be subject to §
56-7-902
- 56-7-912 where the issuance of the insurance is an isolated transaction on the part of the insurer not related to an agreement or a plan for insuring debtors of the creditor.
Acts 1985, ch. 107, § 3; 1988, ch. 709, § 2.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 9 - CREDIT LIFE AND HEALTH INSURANCE (§§ 56-7-901 — 56-7-914) › Section 56-7-905 - Credit life insurance policies - Prohibitions - Prerequisites - Filings - Reports

(a)
Credit life insurance policies that provide benefits differing in kind or character from the following shall not be permitted:
(1)
Individual policies of credit life insurance issued to debtors on the term plan;
(2)
Group policies of credit life insurance issued to creditors providing insurance upon the lives of debtors on the term plan; and
(3)
Other arrangements providing credit life insurance as may be approved by the commissioner.
(b)
No insurer shall issue a policy or certificate of credit life insurance covering a resident of this state unless:
(1)
The insurer is authorized to do business in this state; and
(2)
The policy or certificate is issued through holders of licenses or authorizations issued by the commissioner.
(c)
All policies, certificates of insurance, notices of proposed insurance, applications for insurance, endorsements and riders delivered or issued for delivery in this state and the schedules of premium rates pertaining to the policies, certificates of insurance, notices of proposed insurance, applications for insurance, endorsements and riders, shall be filed with the commissioner.
(d)
Insurers doing credit life insurance business in this state shall annually file with the commissioner a report of its credit life insurance experience on forms prescribed by the commissioner.
Acts 1985, ch. 107, § 3.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 9 - CREDIT LIFE AND HEALTH INSURANCE (§§ 56-7-901 — 56-7-914) › Section 56-7-907 - Initial amount - Commencement and term of insurance - Discharge of indebtedness

(a)
The initial amount of credit life insurance issued in connection with a specific loan or other credit transaction shall not exceed the total amount repayable under the contract of indebtedness, which amount repayable may include the amount of the loan commitment by the creditor.
(b)
(1)
The term of any credit life insurance shall, subject to acceptance by the insurer, if required, and unless otherwise permitted pursuant to §
56-7-906(c)
, commence on the date when the debtor becomes obligated to the creditor. Where a group policy provides coverage with respect to existing obligations, the credit life insurance on a debtor with respect to the indebtedness, unless otherwise expressly authorized by the commissioner, shall commence on the effective date of the policy. The term of an individual policy of credit life insurance shall not extend more than fifteen (15) days beyond the scheduled maturity date of the indebtedness unless extended at no cost to the debtor. If insurance on the life of a debtor is provided under a group policy, the term of the insurance shall not be continued for a period greater than the duration of the indebtedness.
(2)
Evidence of insurability in the form of answers to questions regarding the debtor's health may be required:
(A)
If a debtor requests coverage more than thirty (30) days after the extension of credit for which coverage is sought; or
(B)
If the amount of life insurance applied for is twenty-five thousand dollars ($25,000) or more.
(3)
Where evidence of insurability is required and the evidence is furnished more than thirty (30) days after the date when the debtor becomes obligated to the creditor, the term of the insurance may commence on the date on which the insurance company determines the evidence to be satisfactory, and in such event there shall be an appropriate refund or adjustment of any charge to the debtor for the insurance.
(c)
If the indebtedness is discharged due to prepayment, the credit life insurance in force shall be terminated. If the indebtedness is discharged due to renewal or refinancing prior to the scheduled maturity date, the insurance in force shall be terminated before any new insurance may be issued in connection with the renewed or refinanced indebtedness. In all cases of termination prior to scheduled maturity, a refund shall be paid or credited as provided in §
56-7-909
.
Acts 1985, ch. 107, § 3.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 9 - CREDIT LIFE AND HEALTH INSURANCE (§§ 56-7-901 — 56-7-914) › Section 56-7-909 - Termination of insurance - Refunds and charges

(a)
Each individual policy of credit life insurance on which the premium is paid by the debtor and each group certificate for which an identifiable charge is made to the debtor shall provide that, in the event of termination of the insurance prior to the scheduled maturity date of the indebtedness, any refund or premium or identifiable charge due shall be paid or credited promptly to the debtor. If a debtor has paid a premium or an identifiable charge for credit life insurance to the creditor and the insurance is declined by the insurer or otherwise does not become effective, the insurer or creditor shall immediately give written notice to the debtor and shall promptly arrange for refund or credit to the debtor of any premium or identifiable charge paid by the debtor for the insurance plus interest and fees charged on the premium or identifiable charge.
(b)
(1)
The refund of premiums or identifiable charges, in the case of level term credit life insurance and of reducing term credit life insurance on which premiums are payable other than by a single premium, shall be equal to the pro rata unearned gross premium, and in the case of reducing term credit life insurance paid by a single premium shall be equal to the amount computed by the sum of digits formula commonly known as the "Rule of 78"; however, refunds calculated at less than one dollar ($1.00) need not be made. If fifteen (15) days or less of a loan month has been earned, no charge may be made, but if over fifteen (15) days, a full month may be charged.
(2)
The formulae to be used in computing the amounts of the return premiums shall be filed with and approved by the commissioner.
(c)
An insurer shall promptly refund to an individual policyholder, and refund or credit to a group policyholder, any refund of premium due on termination of insurance prior to the scheduled maturity date of the indebtedness, and a group policyholder or creditor shall promptly refund or credit to the debtor any refund due. If an amount at least equal to the amount of any premium refund is still owed to the creditor on the indebtedness as covered, then the creditor may elect to apply the amount of the refund to the indebtedness. It shall be the obligation of the insured to notify the insurer of any early payoff of the indebtedness that is covered by insurance. Insurers shall establish procedures by which the refunds or credits are made. Each individual policy or group certificate of credit life insurance issued after January 1, 2006, shall provide a notice in the policy or certificate that it is the obligation of the insured to notify the insurer of any early payoff of the indebtedness that is covered by the insurance and that the insured may be entitled to a refund.
Acts 1985, ch. 107, § 3; 2005, ch. 399, § 1.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 9 - CREDIT LIFE AND HEALTH INSURANCE (§§ 56-7-901 — 56-7-914) › Section 56-7-910 - Claims - Verification of premiums and payments

(a)
An insurer issuing credit life insurance shall be responsible for the settlement, adjustment and payment of all claims and shall establish and maintain adequate claim files, which may be reviewed and examined by the commissioner. All claims shall be promptly reported to the insurer, or its designated claim representative, and all claims shall be settled as soon as possible and in accordance with the terms of the insurance contract. "Promptly reported" means that adequate proofs of loss are in the possession of the insurer at the time its funds are disbursed in payment of claims. All claims shall be paid either by draft drawn upon the insurer or by check of the insurer to the order of the claimant to whom payment of the claim is due pursuant to the policy provisions, or upon direction of the claimant to the one specified.
(b)
No plan or arrangement shall be used whereby any person, firm or corporation other than the insurer or its designated claim representative is authorized to settle or adjust claims. The creditor shall not be designated as claim representative for the insurer in settling or adjusting claims; provided, that a group policyholder that employs one (1) or more persons for claims and insurance administration who are not directly involved in making loans may, by arrangement with the group insurer, draw drafts or checks in payment of claims due to the group policyholder subject to audit and review by the insurer. However, nothing in this section shall be construed to relieve the insurer of the responsibility for the proper settlement, adjustment and payment of all claims in accordance with the terms of the insurance contract and this regulation.
(c)
It is the responsibility of the insurer to make a good faith examination of each lender's account at least annually, verifying the accuracy of premiums or other identifiable credit life insurance charges, premium refunds, and claims payments which have been reported to the insurer.
Acts 1985, ch. 107, § 3.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 9 - CREDIT LIFE AND HEALTH INSURANCE (§§ 56-7-901 — 56-7-914) › Section 56-7-912 - Powers and duties of commissioner

(a)
Within sixty (60) days of the filing of any item described in §
56-7-905(c)
, the commissioner shall approve the item unless it contains provisions that are contrary to this title.
(b)
The commissioner may adopt rules interpreting or making specific application of §§
56-7-903
- 56-7-912, but has no power to vary or deviate from §§
56-7-903
- 56-7-911 and this section, nor to extend the commissioner's power or jurisdiction to matters not provided for in §§
56-7-903
- 56-7-912.
(c)
Notwithstanding subsection (b) or any other provision to the contrary, the commissioner may exempt credit life insurance for which no identifiable charge is made to the debtor from the application of §§
56-7-903
- 56-7-911 and this section, if the commissioner finds that the application of §§
56-7-903
- 56-7-911 and this section to the insurance is not necessary for the protection of insured debtors.
Acts 1985, ch. 107, § 3.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 9 - CREDIT LIFE AND HEALTH INSURANCE (§§ 56-7-901 — 56-7-914) › Section 56-7-913 - Advisory committee on credit life insurance rates

(a)
There is established the advisory committee on credit life insurance rates to be composed of six (6) persons, at least two (2) of whom shall be directly associated with the credit life insurance business. The governor shall appoint the members for staggered six-year terms. The members shall receive no compensation but shall be reimbursed for all travel in accordance with the travel regulations promulgated by the department of finance and administration.
(b)
It is the duty of the advisory committee to hold hearings and to recommend the rates for credit life insurance, which levels would be deemed reasonable in relation to the benefits provided. The recommendations must include rates for single life and joint life decreasing term credit life insurance, and single life and joint life level term credit life insurance. The recommendations shall be by majority vote of the membership of the advisory committee. The department shall provide any personnel, services, information or other assistance requested by the committee as it needs to decide its recommendations.
(c)
The recommendations on rates shall be filed with the commissioner. The commissioner shall approve rates for credit life insurance after consideration of the recommendations. The decision of the commissioner is appealable to chancery court, where the review shall be de novo upon the record accompanied by the presumption of correctness of the finding, unless the preponderance of the evidence is otherwise.
Acts 1985, ch. 107, § 8.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 9 - CREDIT LIFE AND HEALTH INSURANCE (§§ 56-7-901 — 56-7-914) › Section 56-7-914 - Annual declaration concerning compensation to creditors

(a)
As part of its required annual statement, each company licensed to sell credit insurance in this state and each company authorized as a credit reinsurer in this state shall submit a declaration under oath executed by the company president stating whether the company or a subsidiary has:
(1)
Paid any compensation to creditors in violation of §
56-7-902
; or
(2)
Entered into any reinsurance transaction with a reinsurer who, with the knowledge of the declaring company, has paid compensation to creditors in violation of §
56-7-902
.
(b)
In the event a company submits a false declaration as described in subsection (a), the company shall be subject to the sanctions set forth in §
56-8-109
.
Acts 1988, ch. 834, § 1.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 10 - HEALTH AND ACCIDENT INSURANCE (§§ 56-7-NEW — 56-7-1019) › Section 56-7-NEW - [Newly enacted section not yet numbered] [Effective 1/1/2026]

(a)
As used in this section:
(1)
"Electronic insurance card" means a digital or electronic representation of a covered individual's insurance information issued by a health insurance entity, including the policy holder's name, policy number, coverage dates and other relative policy information;
(2)
"Health insurance entity" means an entity subject to the insurance laws of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide health insurance coverage, including, but not limited to, an insurance company, a health maintenance organization, and a nonprofit hospital and medical service corporation; and
(3)
"Healthcare provider" means a physician, hospital, or other person licensed, accredited, or certified to perform specified healthcare services pursuant to title 63, chapter 6 or 9, or title 68.
(b)
A healthcare provider shall accept an electronic insurance card as valid evidence of an individual's health insurance plan, policy, or contract.
Added by 2024 Tenn. Acts, ch. 789,s 1, eff. 1/1/2026.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 10 - HEALTH AND ACCIDENT INSURANCE (§§ 56-7-NEW — 56-7-1019) › Section 56-7-1004 - Managed health insurer prohibited from contacting patient of physician's practice to change referral for services to another provider - Exceptions - Civil penalty - Applicability

(a)
A managed health insurance issuer, as defined by §
56-32-128(a)
, that has contracted with a physician's practice to be a part of that health insurance plan's network of providers shall not directly contact or employ an agent to directly contact a patient of the physician's practice in an effort to change a referral for services to another provider, unless the following occurs:
(1)
The ordering physician, the nurse practitioner under the physician's supervision, the physician assistant under the physician's supervision, or a representative of one (1) of the providers is given the opportunity to indicate a particular preference as to the provider of a requested service. In the event a managed health insurance issuer or its agent contacts the patient to suggest alternative providers, the patient shall be notified that the ordering provider indicated a particular preference;
(2)
The ordering physician, the nurse practitioner under the physician's supervision, the physician assistant under the physician's supervision, or a representative of one (1) of the providers is notified if the patient elects a provider other than that requested by the ordering provider if the ordering provider indicated a particular preference; and
(3)
The patient is provided orally or electronically with a disclosure that the patient has a right to discuss the change of referral with the patient's ordering physician, the nurse practitioner under the physician's supervision, the physician assistant under the physician's supervision, or a representative of one (1) of the providers, before the appointment is changed.
(b)
Nothing in this section is intended to prohibit an insurer or the insurer's agent from contacting its enrollees in a health plan to inform the patient that a provider is not included in the patient's network and that there may be out-of-network costs incurred by using that provider.
(c)
The commissioner may assess a civil penalty for a violation of this section pursuant to §
56-2-305
.
(d)
This section shall not apply to:
(1)
TennCare or any successor program provided for in title 71, chapter 5;
(2)
CoverKids or any successor program provided for in the CoverKids Act of 2006, compiled in title 71, chapter 3, part 11;
(3)
Cover Tennessee or any successor program provided for in the Cover Tennessee Act of 2006, compiled in part 30 of this chapter [repealed];
(4)
Access Tennessee or any successor program provided for in the Access Tennessee Act of 2006, compiled in part 29 of this chapter; or
(5)
A program for home-based and community-based services to eligible individuals served through a health care financing administration (HCFA) approved waiver.
Added by 2015 Tenn. Acts, ch. 518,s 1, eff. 7/1/2015.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 10 - HEALTH AND ACCIDENT INSURANCE (§§ 56-7-NEW — 56-7-1019) › Section 56-7-1005 - State mandated health benefits - Applicability

Notwithstanding any other law to the contrary, a state mandated health benefit, as defined in §
3-2-111
, that takes effect after March 24, 2016, shall apply not only to private health insurance issuers, as defined in §
3-2-111
, but also any state or local insurance program, under title 8, chapter 27, and any managed care organization contracting with the state to provide insurance through the TennCare program.
Added by 2016 Tenn. Acts, ch. 683,s 1, eff. 7/1/2015.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 10 - HEALTH AND ACCIDENT INSURANCE (§§ 56-7-NEW — 56-7-1019) › Section 56-7-1006 - Prohibition against denial of reimbursement to or discrimination against physician based on maintenance of certification or licensure

(a)
As used in this section:
(1)
"Continuing medical education" means board of medical examiners or board of osteopathic examination required continued postgraduate medical education intended to provide medical professionals with knowledge of new developments in the professional's field;
(2)
"Maintenance of certification" means any process requiring periodic recertification examinations or other activities to maintain specialty medical board certification;
(3)
"Maintenance of licensure" means the proprietary framework for physician license renewal established through the Federation of State Medical Boards or its successor organization, which includes additional periodic testing or requirements other than continuing medical education; and
(4)
"Specialty medical board certification" means certification by a board that specializes in one (1) particular area of medicine and typically requires additional examinations other than the requirements of the board of medical examiners or board of osteopathic examination to practice medicine.
(b)
A health insurance entity, as defined in §
56-7-109
, shall not deny reimbursement to or prevent a physician licensed pursuant to title 63, chapter 6 or 9 from participating in any of the insurance entity's provider networks based solely on a physician's decision not to participate in any form of maintenance of licensure or maintenance of certification, including basing a physician's network participation on any form of maintenance of licensure tied to maintenance of certification.
(c)
A health insurance entity, as defined in §
56-7-109
, shall not discriminate with respect to reimbursement levels based solely on a physician's decision not to participate in any form of maintenance of licensure or maintenance of certification, including basing a physician's reimbursement level on any form of maintenance of licensure tied to maintenance of certification.
Acts 2018, ch. 694, § 2.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 10 - HEALTH AND ACCIDENT INSURANCE (§§ 56-7-NEW — 56-7-1019) › Section 56-7-1008 - Uniform claim forms authorized

(a)
The commissioner has the discretion to prescribe by regulation, after due consultation with providers of health care or treatment, accident and sickness insurers, hospital, medical and dental service corporations and other prepayment organizations representative of those organizations, claim forms for reporting by health care providers. The prescribed forms shall include, but need not be limited to, information regarding the medical diagnosis, treatment and prognosis of the patient, together with the details of charges incident to the providing of the care, treatment or services, sufficient for the purpose of meeting the proof requirements of an accident and sickness insurance or hospital, medical or dental service contract.
(b)
The adoption of any uniform claim forms by the commissioner pursuant to this section shall not preclude an insurer, hospital, medical or dental service corporation or other prepayment organization from obtaining any necessary additional information regarding a claim from the claimant, provider of health care or treatment, or certifier of coverage.
(c)
Any regulation so adopted shall specify an effective date, which shall not be less than twelve (12) months after the date of adoption or promulgation, after which no accident and sickness insurer, hospital, medical or dental service corporation or other prepayment plan may require providers of health care or treatment to complete forms differing from those prescribed by the commissioner pursuant to this section.
Acts 1980, ch. 506, § 1.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 10 - HEALTH AND ACCIDENT INSURANCE (§§ 56-7-NEW — 56-7-1019) › Section 56-7-1009 - Health care provider credentialing applications from the Council on Affordable Quality Healthcare (CAQH)

(a)
A health insurance entity, as defined in §
56-7-109
, that credentials or recredentials the providers in its networks shall accept, in addition to its own credentialing and recredentialing applications, the credentialing and recredentialing applications from the Council on Affordable Quality Healthcare (CAQH). If the health insurance entity is a participating organization of CAQH, then the health insurance entity shall accept the application from either CAQH by electronic means or from the provider by electronic means or by a paper copy. If the health insurance entity is not a participating organization of CAQH, then the health insurance entity shall accept the application only from the provider by electronic means or by a paper copy. In either case, the provider shall complete and submit the attestation clause of the health insurance entity before an application is considered complete, if the health insurance entity requires it.
(b)
Nothing in this section may be construed to require a health insurance entity to be a participating organization or pay a fee to CAQH.
2005, ch. 167, § 1.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 10 - HEALTH AND ACCIDENT INSURANCE (§§ 56-7-NEW — 56-7-1019) › Section 56-7-1010 - Jurisdiction over insurers

(a)
Notwithstanding any other law, and except as provided in this title, any person or other entity that provides coverage in this state for medical, surgical, chiropractic, physical therapy, speech pathology, audiology, professional mental health, dental, hospital, or optometric expenses, whether the coverage is by direct payment, reimbursement, or otherwise, shall be presumed to be subject to the jurisdiction of the department unless the person or other entity shows that while providing the services it is subject to the jurisdiction of another agency of this or another state or the federal government.
(b)
A person or entity may show that it is subject to the jurisdiction of another agency of the state or federal government by providing to the commissioner the appropriate certificate, license or contract issued by the other governmental agency that permits or qualifies it to provide those services for which it is licensed or certified.
(c)
Any person or entity that is unable to show that it is subject to the jurisdiction of another agency of this or another state or the federal government shall submit to an examination by the commissioner to determine the organization and solvency of the person or the entity, and to determine whether or not the person or entity is in compliance with the applicable provisions of this code.
(d)
Any person or entity unable to show that it is subject to the jurisdiction of another agency of this state or another state or the federal government shall be subject to all appropriate provisions of this code regarding the conduct of its business.
(e)
Any production agency or administrator, licensed by the department, that advertises, sells, transacts or administers coverage in this state, as described in subsection (a), which is provided by any person or entity described in subsection (c), shall, if that coverage is not fully insured or otherwise fully covered by an admitted life or health insurer, nonprofit hospital service plan corporation, or nonprofit medical service plan corporation, advise any purchaser, prospective purchaser, and covered person of the lack of insurance or other coverage. Any administrator that advertises or administers coverage in this state that is described in subsection (a), that is provided by any person or entity described in subsection (c), shall advise any production agency of the elements of the coverage including the amount of stop-loss insurance in effect.
Acts 1983, ch. 314, § 1.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 10 - HEALTH AND ACCIDENT INSURANCE (§§ 56-7-NEW — 56-7-1019) › Section 56-7-1011 - Remote patient monitoring services

(a)
As used in this section, "remote patient monitoring services" means using digital technologies to collect medical and other forms of health data from a patient and then electronically transmitting that information securely to healthcare providers in a different location for interpretation and recommendation.
(b)
A health insurance entity may consider any remote patient monitoring service a covered medical service if the same service is covered by medicare. The appropriate parties may negotiate the rate for these services in the manner in which is deemed appropriate by the parties.
(c)
Reimbursement of expenses for covered remote patient monitoring services must be established through negotiations conducted by the health insurance entity with the healthcare services provider, healthcare system, or practice group in the same manner as the health insurance entity establishes reimbursement of expenses for covered healthcare services that are delivered by in-person means.
(d)
Remote patient monitoring services are subject to utilization review under the Health Care Service Utilization Review Act, compiled in chapter 6, part 7 of this title.
(e)
This section does not apply to a health incentive program operated by a health insurance entity that utilized an electronic device for physiological monitoring.
Acts 2020 (2nd Ex. Sess.), ch. 4, § 7.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 10 - HEALTH AND ACCIDENT INSURANCE (§§ 56-7-NEW — 56-7-1019) › Section 56-7-1014 - Protocols and procedures for reimbursing physicians employed by federally qualified health centers - Expedited credentialing process

(a)
Health insurance entities, as defined in §
56-7-109
, that contract with the state and perform services for the TennCare program or any successor program pursuant to title 71 shall establish reasonable protocols and procedures for reimbursing physicians employed by federally qualified health centers, so long as the protocols and procedures do not violate National Committee for Quality Assurance (NCQA) standards. At a minimum, the protocols and procedures shall:
(1)
Subject to approval of a physician credentialing application, permit physician reimbursement for rendered services from the date the physician's completed credentialing application is received for consideration by the health insurance entity; provided, however, that a contractual relationship exists between the provider or the group or facility for whom the physician works; and
(2)
Require that any reimbursement paid the physician shall be retroactively recouped or rescinded in the event the physician's credentialing application is denied.
(b)
As an alternative to subsection (a), health insurance entities, as defined in §
56-7-109
, that contract with the state and perform services for the TennCare program or any successor program pursuant to title 71 may establish an expedited credentialing process for reimbursing physicians employed by federally qualified health centers, so long as the process does not violate NCQA standards.
(c)
As used in this section, "federally qualified health center" means entities defined in §§ 1861(aa) and 1905 of the federal Social Security Act (
42 U.S.C. § 1395x
and
42 U.S.C. § 1396d
, respectively).
(d)
Nothing in this section shall require reimbursement of physician-rendered services that are not benefits or services covered by the health insurance entity.
Acts 2006, ch. 966, § 1.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 10 - HEALTH AND ACCIDENT INSURANCE (§§ 56-7-NEW — 56-7-1019) › Section 56-7-1017 - Prohibition against a dental insurance plan from requiring a participating dentist to provide services to covered individuals at a fee set by the plan

(a)
As used in this section:
(1)
"Covered services" means dental care for which a reimbursement is available under the enrollee's plan contract, or for which a reimbursement would be available but for the application of contractual limitations such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums, frequency limitations, alternative benefits payments, or any other limitation; and
(2)
"Participating provider" means a dentist licensed to practice dentistry in this state, who provides dental services to an enrollee at a fee set by or at a fee subject to the approval of an insurer, dental services plan, third party administrator or any other party that contracts to provide dental services.
(b)
No contract offered by any insurer, dental service plan, third party administrator or other party that covers any dental services, and no contract or participating provider agreement with a dentist may require, directly or indirectly, that a dentist who is a participating provider, provide services to an enrollee at a fee set by, or at a fee subject to the approval of the dental service plan, insurer, third party administrator or other party that covers any dental plan services unless the dental services are covered services.
(c)
No contract offered by any insurer, dental service plan, third party administrator or other party with a participating provider that covers any covered services may provide nominal or de minimis coverage for covered services under the contract for the sole purpose of avoiding the requirements of this section.
(d)
Nothing in this section shall apply to the TennCare program and any medical assistance provided pursuant to title 71, chapter 5, or to the state children's health insurance program established under title XXI of the Social Security Act, subchapter XXI, chapter 7 of title 42 (
42 U.S.C. § 1397aa
et seq.).
(e)
A violation of this section may subject the insurer, dental service plan, third-party administrator, or other party that covers any dental services to the sanctions described in §
56-2-305
.
Amended by 2024 Tenn. Acts, ch. 589,s 2, eff. 7/1/2024.
Acts 2011 , ch. 240, § 1.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 10 - HEALTH AND ACCIDENT INSURANCE (§§ 56-7-NEW — 56-7-1019) › Section 56-7-1018 - Coverage for complex rehabilitation technology in health benefit plan

(a)
As used in this section:
(1)
"Complex rehabilitation technology" has the same meaning as defined in §
71-5-159
;
(2)
"Health benefit plan" means health insurance coverage as defined in §
56-7-109
; and
(3)
"Health insurer" means a health insurance entity as defined in §
56-7-109
.
(b)
A health insurer that offers a health benefit plan that provides coverage of complex rehabilitation technology:
(1)
Shall not consider the location where the complex rehabilitation technology will be used when making a determination of medical necessity; and
(2)
Shall offer covered persons a prior authorization process that reviews billable codes and provides coverage determinations for complex rehabilitation technology.
(c)
If a health insurer notifies a person who is covered under a policy or contract for a health benefit plan that includes complex rehabilitation technology benefits and coverage that complex rehabilitation technology equipment that was approved in a prior authorization will be fully funded under the health benefit plan, then, as long as the person remains covered under the policy or contract at the time the complex rehabilitation technology is delivered to the person, the health insurer:
(1)
Shall pay one hundred percent (100%) of the amount approved in the prior authorization, subject to applicable copayment, coinsurance, or deductible requirements as provided in the policy; and
(2)
Shall not seek payment or reimbursement from the covered person, a complex rehabilitation technology vendor, or another party involved with the sale or delivery of the complex rehabilitation technology.
(d)
This section does not require a health insurer to offer coverage for complex rehabilitation technology in a health benefit plan.
Added by 2022 Tenn. Acts, ch. 973, s 1, eff. 7/1/2022.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 10 - HEALTH AND ACCIDENT INSURANCE (§§ 56-7-NEW — 56-7-1019) › Section 56-7-1019 - Complex rehabilitation technology (CRT)

(a)
Notwithstanding §
56-7-1018
, a health insurance entity that offers health insurance coverage of complex rehabilitation technology (CRT) or manual wheelchairs shall not require a prior authorization for repairs of such technology or equipment unless:
(1)
The repairs are covered under a manufacturer's warranty;
(2)
The cost of the repairs exceeds the cost to replace the CRT or manual wheelchair; or
(3)
The CRT or manual wheelchair in need of repair is subject to replacement because the age of the CRT or manual wheelchair exceeds, or is within one (1) year of the expiration of, the recommended lifespan of the CRT or manual wheelchair.
(b)
As used in this section:
(1)
"Complex rehabilitation technology" has the same meaning as defined in §
71-5-159
;
(2)
"Health insurance coverage" has the same meaning as defined in §
56-7-109
; and
(3)
"Health insurance entity" has the same meaning as defined in §
56-7-109
.
Acts 2023, ch. 447, § 1.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 11 - GENERAL PROVISIONS - AUTO INSURANCE (§§ 56-7-1101 — 56-7-1120) › Section 56-7-1101 - Priority and applicability of coverages

(a)
(1)
In all cases arising out of the use of a motor vehicle on which the owner of the motor vehicle has any insurance coverages, the owner's policy is primary if the vehicle is being operated with the permission of the owner and within the scope of the permission granted.
(2)
Any other coverages that may be available to the permittee are not applicable unless and until the limits of all coverages provided by the owner's policy first are exhausted.
(b)
Any provision of subdivision (a)(1) or (a)(2) to the contrary notwithstanding, where the only insurance coverage provided by the owner of the vehicle is under a garage policy, then any coverage that may be available to the permittee shall be primary and the coverage under the owner's garage policy shall not be applicable unless and until the limits of all coverage available to the permittee shall be first exhausted; provided, that when any non-owned vehicle is in the possession, custody or control of a person who is in the business of storing, parking, servicing or repairing vehicles, then any insurance available to the owner shall not be applicable unless and until all insurance that is available under a garage policy of the person in possession has been exhausted.
(c)
When a claim arises out of the operation of a motor vehicle that is leased under a written lease agreement, and pursuant to which agreement the lessee provides coverage for the vehicle, then any other coverage that may be available for the vehicle through the lessor is not applicable unless and until the limits of all coverage provided by the lessee for the vehicle first are exhausted.
(d)
Subsections (a) and (c) are effective as to all policies written after May 7, 1973, and to all renewals of existing policies made after May 7, 1973. Subsection (b) is effective as to all policies written after April 5, 1974, and to all renewals of existing policies made after April 5, 1974.
Acts 1973, ch. 209, §§ 1-3; 1974, ch. 779, §§ 1, 2; 1976, ch. 652, §§ 1, 2; T.C.A., § 56-1164.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 11 - GENERAL PROVISIONS - AUTO INSURANCE (§§ 56-7-1101 — 56-7-1120) › Section 56-7-1102 - Automobile liability insurance - Noncancellable and guaranteed renewable policies

(a)
Any insurer licensed to write automobile liability insurance in this state may issue a noncancellable and guaranteed renewable automobile liability insurance policy, which shall not be cancelled by the insurer and may be renewed at the option of the insured for so long as:
(1)
The insurer remains licensed to write automobile liability insurance in this state;
(2)
The insured and all other operators of the insured motor vehicle maintain valid operator's licenses;
(3)
All premiums, premium balances and renewal premiums are paid when due; and
(4)
The insured motor vehicle is used for any purpose for which the insurer has a valid rate approved by the commissioner.
(b)
If membership in any organization is a prerequisite for the issuance of all policies by an insurer, then the insurer may require active membership and continuation of active membership for the issuance of the policy or renewal of the policy issued by the insurer.
(c)
Any insurer who issues an automobile liability insurance policy with noncancellable or guaranteed renewable restrictions, using rates or rating plans filed with and approved by the commissioner, may not be bound by the restrictions if any rates or rating plans that have been filed for the specific use of the policies are subsequently rejected by the commissioner.
Acts 1972, ch. 723, § 1; T.C.A., § 56-1161.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 11 - GENERAL PROVISIONS - AUTO INSURANCE (§§ 56-7-1101 — 56-7-1120) › Section 56-7-1103 - Motor vehicle liability - Applicability of sections

Sections
56-7-1103
- 56-7-1105 are applicable only in causes of action arising out of the ownership or operation of a motor vehicle when service of process cannot be obtained on the owner or operator of the motor vehicle by either personal service of process or by service on the secretary of state where there is a nonresident involved.
Acts 1976, ch. 612, § 1; T.C.A., § 56-1173.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 11 - GENERAL PROVISIONS - AUTO INSURANCE (§§ 56-7-1101 — 56-7-1120) › Section 56-7-1104 - Requiring whereabouts of insured

(a)
Upon a sheriff's return of "not to be found" within the particular county, or upon the secretary of state being unable to complete process upon the defendant or defendants, the plaintiff may serve demand notice upon the liability insurance carrier to reveal the location and whereabouts of the defendant automobile owner or operator.
(b)
If the carrier is not a domestic company, the demand notice shall be through the commissioner. The demand notice shall be by certified mail with a return receipt requested and shall include a certified copy of the sheriff's return.
(c)
The liability insurance carrier shall, upon notice, reveal to the plaintiff or the plaintiff's attorney any information it possesses as to the location of the defendant automobile operator or owner.
Acts 1976, ch. 612, § 2; T.C.A., § 56-1174.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 11 - GENERAL PROVISIONS - AUTO INSURANCE (§§ 56-7-1101 — 56-7-1120) › Section 56-7-1105 - Liability for failure to comply

Willful violation of §§
56-7-1103
,
56-7-1104
and this section by the liability insurance carrier shall render the carrier liable in damages to the plaintiff.
Acts 1976, ch. 612, § 3; T.C.A., § 56-1175.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 11 - GENERAL PROVISIONS - AUTO INSURANCE (§§ 56-7-1101 — 56-7-1120) › Section 56-7-1106 - Collision insurance purchased as a condition to financing automobile purchase

When a creditor or lender requires a borrower to purchase collision insurance as a condition to obtaining a loan to purchase an automobile, and sells collision, but not liability, insurance to the borrower, then the creditor or lender shall provide written notice to the borrower that no liability insurance is being sold. This written notice shall be signed by the borrower and explained to the borrower as a part of or together with the loan papers executed by the borrower.
Acts 1981, ch. 409, § 1.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 11 - GENERAL PROVISIONS - AUTO INSURANCE (§§ 56-7-1101 — 56-7-1120) › Section 56-7-1108 - Personal automobile insurance of municipal, county, and state employees

Whenever a full-time employee of municipal, county, or state government is involved in a traffic accident while acting as the agent of the governmental employer and while operating a motor vehicle owned by the governmental employer, the accident shall in no way be considered by the employee's personal automobile insurance carrier in fixing insurance premiums, nor shall it cause any increase in the employee's personal automobile insurance premiums.
Acts 1983, ch. 195, § 1.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 11 - GENERAL PROVISIONS - AUTO INSURANCE (§§ 56-7-1101 — 56-7-1120) › Section 56-7-1109 - Effect of accidents on premiums

(a)
Whenever a person who is employed as a driver is involved in a traffic accident in the course of employment and while operating a motor vehicle owned by or leased to the person's employer, the accident shall in no way be considered by the person's personal automobile insurance carrier in fixing insurance premiums, nor shall it cause any increase in the person's personal automobile insurance premiums, if the accident did not involve negligence on the part of the person. Likewise, an accident involving the person while using the person's personal vehicle and not involving negligence by the person shall not be considered relative to insurance or premiums for the person's employer.
(b)
Whenever a person is involved in a traffic accident while operating a motor vehicle, if the accident did not involve negligence on the part of the person, it shall in no way be considered by the person's personal automobile insurance carrier in fixing premiums, nor shall it cause any increase in the person's personal automobile insurance premiums. Likewise, an accident involving the person, while operating another person's insured vehicle under the other person's authority and not involving negligence on the part of the driver, shall not cause an increase in the personal automobile insurance premiums for the owner of the vehicle; provided, that the owner did not violate any contractual duties or obligations by authorizing the driver to operate the vehicle.
Acts 1988, ch. 759, § 1; 1989, ch. 378, § 1.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 7 - POLICIES AND POLICYHOLDERS 33|373 (§§ 56-7-NEW — 56-7-3722) › Part 11 - GENERAL PROVISIONS - AUTO INSURANCE (§§ 56-7-1101 — 56-7-1120) › Section 56-7-1110 - Insurance coverage or collision damages waivers for rental cars

Any rental car company, offering for sale insurance coverage or collision damage waivers, shall state clearly on the front page of the rental contract that the purchaser of the insurance coverage or collision damage waiver offered may be covered for such claims on the purchaser's personal motor vehicle insurance policy, and that if such insurance coverage exists under the renter's personal insurance policy, and the coverage is confirmed, the renter may require the rental car company to submit any claims to the renter's personal insurance carrier as the renter's agent. The rental car company shall not make any written or oral representations that it will not present claims or negotiate with the renter's insurance carrier. As used in this section, "confirmation of coverage" includes telephone confirmation from an insurance company representative.
Acts 1988, ch. 838, § 1.