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 1 - GENERAL PROVISIONS (§§ 56-7-NEW — 56-7-135) › Section 56-7-132 - [Effective Until 1/1/2025] Successor coverage health claims

(a)
As used in this section only, the following terms have the meaning as indicated:
(1)
"Original health insurer" means a health insurance entity as defined in §
56-7-109
that has verified eligibility for the date of service, or has communicated to a health care provider prior authorization or precertification for a service to be provided, to a person believed by the original health insurer to be covered under the group health care policy as of the date that eligibility was verified or prior authorization or precertification is issued, but that no longer covers the insured individual at the time the service is performed;
(2)
"Successor coverage health claim" means a claim for benefits or reimbursement under a group health care policy when the health care services performed were based upon verification of eligibility or were authorized by an original health insurer, but the original health insurer coverage has been replaced by a successor health insurer on or before the date that the services are provided to the covered person; and
(3)
"Successor health insurer" means a health insurance entity as defined by §
56-7-109
that provided group health coverage for the person at the time the original health insurer verified eligibility or approved prior authorization or precertification for the person or at the time the service was actually performed.
(b)
In the case of a successor coverage health claim, and notwithstanding the provisions of a successor health insurer group health care policy, a successor health insurer shall not:
(1)
Deny a claim because of failure to submit the claim timely; provided, that the claim was submitted within one hundred eighty (180) days of the date the claim was denied by the original health insurer; or
(2)
Deny the claim because of the covered person's failure to obtain prior authorization or precertification, if the successor insurer would have granted prior authorization or precertification for the service had it been asked to do so prior to the health care service being rendered to the covered person.
(c)
Except as may result from the application of subsection (b), nothing in this section shall require a successor health insurer to pay any claim or make reimbursement for any services not covered under the terms of its group health care policy.
(d)
This section shall not apply to TennCare or any successor program provided for in title 71, chapter 5, or CoverKids or any successor program provided for in title 71, chapter 3, part 11.
(e)
Nothing in this section shall create any obligation by an original health insurer to a successor health insurer to provide proof of eligibility inquiry by a health care provider.
Acts 2009 , ch. 462, § 5.
This section is set out more than once due to postponed, multiple, or conflicting amendments.
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 1 - GENERAL PROVISIONS (§§ 56-7-NEW — 56-7-135) › Section 56-7-133 - Provision in policy of group accident and health insurance requiring notification when person covered under group policy ceases to be covered

A policy of group accident and health insurance as defined in §
56-26-201
that is issued to an employer shall contain a provision requiring the employer to notify the insurer when any person covered under the group policy ceases to be eligible for coverage. The employer shall notify the health insurer of a covered person's loss of eligibility within the time set forth in the contract, but in no event shall the notification occur more than sixty (60) days after the employer learns of a covered person's loss of eligibility.
Acts 2009, ch. 462, § 6.
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 1 - GENERAL PROVISIONS (§§ 56-7-NEW — 56-7-135) › Section 56-7-134 - Medical records release authorization

(a)
In connection with a claim for death benefits payable under a life insurance policy or an annuity contract, the following persons are authorized to execute a medical records release authorization that may be required by the insurance company that issued the life insurance policy or annuity contract:
(1)
The personal representative of the decedent's estate, if any;
(2)
A beneficiary of the death benefits named in the policy or contract; or
(3)
A person who has filed an affidavit pursuant to §
30-4-103
in connection with the decedent's estate.
(b)
Unless prohibited by federal law, a health care provider licensed under title 33, title 63 or title 68 shall honor a medical records release authorization executed in accordance with this section.
(c)
Nothing in this section shall be construed as affecting the ability of a health care provider to charge for copies of medical records in accordance with any applicable law.
Acts 2012, ch. 886, § 9.
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 1 - GENERAL PROVISIONS (§§ 56-7-NEW — 56-7-135) › Section 56-7-135 - Rebuttable presumption

(a)
The signature of an applicant for or party to an insurance contract on an application, amendment, or other document stating the type, amount, or terms and conditions of coverage, shall create a rebuttable presumption that the statements provided by the person bind all insureds under the contract and that the person signing such document has read, understands, and accepts the contents of such document.
(b)
The payment of premium for an insurance contract, or amendment thereto, by an insured shall create a rebuttable presumption that the coverage provided has been accepted by all insureds under the contract.
Acts 2012, ch. 913, § 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 2 - GENERAL PROVISIONS - LIFE INSURANCE (§§ 56-7-201 — 56-7-207) › Section 56-7-201 - Life insurance payable to surviving spouse and children - Effect of proceeds being payable to estate

On the death of an insured, any life insurance acquired by the insured or the insured's spouse and payable to the intestate insured's estate benefits the surviving spouse and children and the proceeds shall be divided between them according to the statutes of distribution without being in any manner subject to the debts of the decedent. If the proceeds of the insurance are payable to the estate of a testate decedent or the trustee of a revocable trust of which the decedent was a settlor, the proceeds shall pass as part of the estate or trust and under the dispositive provisions of the will or trust agreement, as ordinary cash, whether or not the will or trust agreement uses any apt or express words referring to the insurance proceeds, but the proceeds shall not be subject to the debts of the decedent unless specifically charged with the debts in the will or trust agreement.
Code 1858, § 2478 (deriv. Acts 1845-1846, ch. 216, § 3); Shan., § 4231; Code 1932, § 8456; Acts 1969, ch. 233, § 1; 1972, ch. 845, § 1; 1976, ch. 668, § 1; T.C.A. (orig. ed.), § 56-1108; Acts 2007, ch. 8, § 13.
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 2 - GENERAL PROVISIONS - LIFE INSURANCE (§§ 56-7-201 — 56-7-207) › Section 56-7-202 - Insurance on married person's life, effected by spouse, not liable to debts of insured

Whenever a married person causes life insurance to be effected upon the person's spouse's life, it shall in no case be subject to the debts of the insured, but shall inure to the benefit of the surviving spouse and children, or surviving spouse or children, as the case may be; however, any life insurance proceeds payable to the testate estate shall pass under the dispositive provisions of the will, but shall not be subject to the debts of the deceased spouse unless specifically charged with the debts in the will.
Code 1858, § 2479 (deriv. Acts 1845-1846, ch. 216, § 3); Shan., § 4232; mod. Code 1932, § 8457; Acts 1969, ch. 234, § 1; T.C.A. (orig. ed.), § 56-1109.
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 2 - GENERAL PROVISIONS - LIFE INSURANCE (§§ 56-7-201 — 56-7-207) › Section 56-7-203 - Life insurance or annuity for or assigned to spouse or children or dependent relatives exempt from claims of creditors

The net amount payable under any policy of life insurance or under any annuity contract upon the life of any person made for the benefit of, or assigned to, the spouse and/or children, or dependent relatives of the persons, shall be exempt from all claims of the creditors of the person arising out of or based upon any obligation created after January 1, 1932, whether or not the right to change the named beneficiary is reserved by or permitted to that person.
Acts 1925, ch. 113, § 1; Shan. Supp., § 4232a; mod. Code 1932, § 8458; T.C.A. (orig. ed.), § 56-1110.
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 2 - GENERAL PROVISIONS - LIFE INSURANCE (§§ 56-7-201 — 56-7-207) › Section 56-7-206 - Life insurance - Proof of death for small policies

In the case of any life insurance policy with a value of fifteen thousand dollars ($15,000) or less, proof of death may be furnished by submission of a photocopy of the certificate of death, accompanied by a sworn statement by the doctor who signed the certificate or the funeral director who conducted burial services that the certificate is authentic.
Amended by 2016 Tenn. Acts, ch. 804,s 1, eff. 4/14/2016.
Acts 1976, ch. 586, § 1; T.C.A., § 56-1172; Acts 1991, ch. 137, § 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 2 - GENERAL PROVISIONS - LIFE INSURANCE (§§ 56-7-201 — 56-7-207) › Section 56-7-207 - Refusal for sickle cell trait or hemoglobin C trait prohibited

(a)
No insurance company that has been qualified and authorized to do business in this state, pursuant to chapter 2 of this title, shall refuse to issue or deliver any policy of life insurance authorized under chapter 2 of this title, solely by reason of the fact that the person to be insured possesses sickle cell trait or hemoglobin C trait.
(b)
As used in this section:
(1)
"Hemoglobin C trait" means the condition wherein the major natural hemoglobin components present in the blood of the individual are hemoglobin A (normal) and hemoglobin C as defined by standard chemical and physical analytic techniques, including electrophoresis; and the proportion of hemoglobin A is greater than the proportion of hemoglobin C or one (1) natural parent of the individual is shown to have only normal hemoglobin components (hemoglobin A, hemoglobin A2, hemoglobin F) in the normal proportions by standard chemical and physical analytic tests; and
(2)
"Sickle cell trait" means the condition wherein the major natural hemoglobin components present in the blood of the individual are hemoglobin A (normal) and hemoglobin S (sickle hemoglobin) as defined by standard chemical and physical analytic techniques, including electrophoresis; and the proportion of hemoglobin A is greater than the proportion of hemoglobin S or one (1) natural parent of the individual is shown to have only normal hemoglobin components (hemoglobin A, hemoglobin A2, hemoglobin F) in the normal proportions by standard chemical and physical analytic tests.
Acts 1988, ch. 488, § 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 3 - LIFE INSURANCE POLICIES (§§ 56-7-301 — 56-7-315) › Section 56-7-305 - Submission to commissioner for approval

Every life insurance company shall submit to the commissioner for approval the words required in §
56-7-2310
, to be printed on each policy, together with sample copy of every kind or class of policies offered for sale in this state, and every life insurance company shall print on each of its policies sold to citizens of this state the words the commissioner approves.
Acts 1905, ch. 392, § 2; Shan., § 3348a16; Code 1932, § 6187; T.C.A. (orig. ed.), § 56-1116.
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 3 - LIFE INSURANCE POLICIES (§§ 56-7-301 — 56-7-315) › Section 56-7-306 - Revocation of license for violation of section 56-7-305 or section 56-7-2310

The license of any insurance company doing business in this state may be revoked by the commissioner for violating §
56-7-305
or §
56-7-2310
.
Acts 1905, ch. 392, § 3; Shan., § 3348a17; Code 1932, § 6188; T.C.A. (orig. ed.), § 56-1117.
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 3 - LIFE INSURANCE POLICIES (§§ 56-7-301 — 56-7-315) › Section 56-7-308 - Provisions in life insurance policies issued by foreign companies - Provisions in foreign policies of domestic companies

The policies of a life insurance company not organized under the laws of this state may, if approved by the commissioner of this state, contain any provision that the law of the state, territory, district, or country under which the company is organized prescribes shall be in the policies when issued in this state, and the policies of a life insurance company organized under the laws of this state may, when issued or delivered in any other state, territory, district, or country, contain any provision required by the laws of the state, territory, district, or country in which they are issued, anything in §§
56-7-309
- 56-7-311, 56-7-2307, 56-7-2308, and 56-7-2311 to the contrary notwithstanding.
Acts 1907, ch. 457, § 5; Shan., § 3348a12; Code 1932, § 6183; T.C.A. (orig. ed.), § 56-1119.
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 3 - LIFE INSURANCE POLICIES (§§ 56-7-301 — 56-7-315) › Section 56-7-309 - Life insurance - Policies for one-year preliminary term insurance - Reserve value

(a)
This section applies only to policies of life insurance issued prior to the operative date of §
56-7-401
, the Standard Nonforfeiture Law.
(b)
Policies may be issued in this state providing for not more than one-year preliminary term insurance by the incorporation in the policy of a clause on the face of the policy distinctly specifying that the first year's insurance is term insurance.
(c)
If the premium charged for term insurance under a limited payment life or endowment preliminary term policy, providing for the payment of all premiums in less than twenty (20) years from the date of the policy, exceeds that charged for like insurance under twenty (20) pay life preliminary term policies of the same company at the same age, the reserve at the end of any year, including the first, shall not be less than the reserve on a twenty (20) pay life preliminary term policy issued in the same year and at the same age, together with an amount equivalent to the accumulation of a net level premium sufficient to provide for a pure endowment at the end of the premium payment period equal to the difference between the value at the end of the period for the twenty (20) pay life preliminary term policy and the full reserve at the time of the limited payment life or endowment policy.
Acts 1907, ch. 457, § 3; Shan., § 3348a10; Code 1932, § 6181; Acts 1945, ch. 56, § 4; C. Supp. 1950, § 6181; T.C.A. (orig. ed.), § 56-1120.
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 3 - LIFE INSURANCE POLICIES (§§ 56-7-301 — 56-7-315) › Section 56-7-310 - Policies exemptions

Sections
56-7-308
,
56-7-309
,
56-7-2307
and
56-7-2308
, do not apply to annuities, industrial policies, or to corporations or associations operating on the assessment or fraternal plan.
Acts 1907, ch. 457, § 6; Shan., § 3348a13; mod. Code 1932, § 6184; Acts 1937, ch. 270, § 1; C. Supp. 1950, § 6184; Acts 1971, ch. 296, § 2; T.C.A. (orig. ed.), § 56-1121.
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 3 - LIFE INSURANCE POLICIES (§§ 56-7-301 — 56-7-315) › Section 56-7-311 - "Company" defined

As used in §§
56-7-308
,
56-7-309
,
56-7-2307
,
56-7-2308
and
56-7-2311
, "company" includes corporations and associations.
Acts 1907, ch. 457, § 7; Shan., § 3348a14; Code 1932, § 6185; T.C.A. (orig. ed.), § 56-1122.
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 3 - LIFE INSURANCE POLICIES (§§ 56-7-301 — 56-7-315) › Section 56-7-312 - Stipulated form of insurance or cash equal to net reserve upon default

(a)
This section applies only to policies of life insurance issued prior to the operative date of §
56-7-401
, the Standard Nonforfeiture Law.
(b)
In the event of default in the payment of any premium due on any policy, there shall be secured to the owner of the policy a stipulated form of insurance as may be specified in the policy, the net value of which shall be at least equal to the reserve at the date of default on the policy and on any dividend additions thereto according to the mortality table and the rate of interest for computing the reserve as specified in the policy, less a sum of not more than two and one half percent (21/2%) of the amount insured by the policy and of any existing dividend additions thereto and less any existing indebtedness to the company on the policy at the time of default; provided, that not less than three (3) full years' premiums shall have been paid; and provided, further, that the policy shall not be continued in force by virtue of any automatic loan provision in the policy.
(c)
There shall also be secured to the owner of the policy the right to surrender the policy to the company at its home office within one (1) month from the date of default for a specified cash value at least equal to the sum that would otherwise be available for the purchase of insurance, and the payment of which cash value by the company shall not be deferred for more than six (6) months after application for the payment is made.
Acts 1907, ch. 454, § 3; Shan., § 3348a35; Code 1932, § 6210; Acts 1945, ch. 56, § 5; C. Supp. 1950, § 6210; T.C.A. (orig. ed.), § 56-1123.
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 3 - LIFE INSURANCE POLICIES (§§ 56-7-301 — 56-7-315) › Section 56-7-313 - Certain provisions as to defaulted policies, loans and reserves cannot be waived

No agreement between the company and the policyholder or applicant for insurance shall be held to waive §§
56-2-115
,
56-7-312
,
56-7-401
and
56-7-2309
.
Acts 1907, ch. 454, § 4; Shan., § 3348a36; Code 1932, § 6211; Acts 1945, ch. 56, § 9; C. Supp. 1950, § 6211; T.C.A. (orig. ed.), § 56-1124.
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 3 - LIFE INSURANCE POLICIES (§§ 56-7-301 — 56-7-315) › Section 56-7-314 - Purchase or assignment of life insurance by charitable organization - Date of insurable interest

If an organization described in either § 170(c) or § 501(c)(3) of the Internal Revenue Code of 1986 (
26 U.S.C. §§ 170(c)
and
501(c)(3)
), respectively, purchases or receives by assignment, before or after April 23, 1992, life insurance on an insured who consents in writing to the purchase or assignment, the organization is deemed to have or to have had an insurable interest in the insured person's life on the date of purchase or assignment. This section does not limit or abridge any insurable interest on April 23, 1992, at common law or by statute.
Acts 1992, ch. 755, § 1; 2004, ch. 658, § 1; 2006, ch. 593, § 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 3 - LIFE INSURANCE POLICIES (§§ 56-7-301 — 56-7-315) › Section 56-7-315 - Interest payable after receipt of claim

An insurer of a life insurance policy or annuity issued for delivery in this state, with respect to a claim for benefits by reason of the death of the insured or annuitant, shall pay interest beginning on the fifteenth day following the date of death of the insured or annuitant, with the interest compounded annually for a period not to exceed three (3) years from that date. The rate of interest payable shall not be less than the interest currently paid by the insurer with respect to proceeds left on deposit.
Acts 1993, ch. 351, § 1; 2002, ch. 681, § 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 5 - CONTINGENT AND MORTALITY CONTRACTS (§§ 56-7-501 — 56-7-503) › Section 56-7-501 - Contingent or mortality contracts - Dividing policyholders or members into classes and paying benefits to oldest member of class prohibited - Exceptions

No life insurance company, fraternal benefit society, order or association authorized to do business in this state shall hereafter be permitted to issue policies, certificates or contracts to policyholders or members providing for the establishment of its policyholders or members into divisions and classes for the purpose of providing for the payment of benefits from special funds created for that purpose to the oldest member of the division and class or to the member of the division and class whose policy has been in force the longest period of time, upon the death of a member in the division and class; provided, that any life insurance company, fraternal benefit society, order or association heretofore issuing policies, certificates, or contracts on this plan in this state may continue so to do on condition that the life insurance company, fraternal benefit society, order or association shall not hereafter establish its policyholders or members into divisions or classes, other than the divisions or classes actually containing subsisting policies or certificates on February 23, 1939. No division of any class shall contain more than twenty-six (26) policyholders. No additional policyholder or policyholders shall ever be added to any of the divisions in this state because of vacancy or vacancies created by lapsed policies, death or otherwise, and no policyholder or policyholders shall be added in this state to any of the divisions under any circumstances.
Acts 1939, ch. 31, § 1; mod. C. Supp. 1950, § 6459.1; T.C.A. (orig. ed.), § 56-1125.
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 5 - CONTINGENT AND MORTALITY CONTRACTS (§§ 56-7-501 — 56-7-503) › Section 56-7-502 - Contingent and mortality endowment contracts - Promising particular number or position in class or to division to policyholder prohibited - Penalty

(a)
No agent or organizer of any life insurance company, fraternal benefit society, order or association referred to in §
56-7-501
shall promise any particular number or position in class or division to any existing policyholder of contingent or mortality endowment contracts, as described in §
56-7-501
.
(b)
For violation of this section, agents shall be subject to revocation of license or shall pay a fine of fifty dollars ($50.00) on each individual violation, following a hearing before the commissioner; and, in the commissioner's discretion, the company that the agent represents shall be liable, following repeated violations by its agents operating in this state, to a fine not exceeding a total of two hundred fifty dollars ($250) in the commissioner's discretion following a hearing.
Acts 1939, ch. 31, § 2; mod. C. Supp. 1950, § 6459.2; impl. am. Acts 1971, ch. 137, § 2; T.C.A. (orig. ed.), § 56-1126.
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 5 - CONTINGENT AND MORTALITY CONTRACTS (§§ 56-7-501 — 56-7-503) › Section 56-7-503 - Commissioner to make orders for enforcement of contingent and mortality endowment contracts

The commissioner has authority, upon examination and investigation of any companies writing the contracts referred to in §
56-7-501
, to make orders the commissioner finds necessary from time to time to carry out the duties imposed upon the commissioner by law and by this part; but the orders shall not include authority to order the company to return premiums collected during the period and prior to the order.
Acts 1939, ch. 31, § 4; C. Supp. 1950, § 6459.3 (Williams, § 6459.4); impl. am. Acts 1971, ch. 137, § 1; T.C.A. (orig. ed.), § 56-1127.
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 6 - TENNESSEE RIGHT TO SHOP ACT (§§ 56-7-601 — 56-7-610) › Section 56-7-601 - Short title

This part shall be known and may be cited as the "Tennessee Right to Shop Act."
Acts 2019, ch. 407, § 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 6 - TENNESSEE RIGHT TO SHOP ACT (§§ 56-7-601 — 56-7-610) › Section 56-7-602 - Part definitions

As used in this part:
(1)
"Allowed amount" means the contractually agreed upon payment amount between a carrier and a healthcare entity participating in the carrier's network, excluding any member deductible, co-pay, or other obligation;
(2)
"Commissioner" means the commissioner of commerce and insurance;
(3)
"Comparable healthcare service" includes, but is not limited to:
(A)
Physical and occupational therapy services;
(B)
Radiology and imaging services;
(C)
Laboratory services; and
(D)
Infusion therapy;
(4)
"Department" means the department of commerce and insurance;
(5)
"Emergency medical service" means the service used in responding to the perceived individual need for immediate medical care in order to prevent loss of life or aggravation of physiological or psychological illness or injury;
(6)
"Health plan" means health insurance coverage as defined in §
56-7-109
;
(7)
"Healthcare entity" means:
(A)
Any healthcare facility licensed under title 33 or 68; and
(B)
Any healthcare provider licensed under title 63 or 68;
(8)
"Healthcare service":
(A)
Means a service for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease;
(B)
Includes a prescription drug or device; and
(C)
Does not include an emergency medical service;
(9)
"Insurance carrier" or "carrier" means a health insurance entity as defined in §
56-7-109
; and
(10)
"Shopping and decision support program" means the program established by a carrier pursuant to this part.
Amended by 2023 Tenn. Acts, ch. 244, s 1, eff. 7/1/2023.
Acts 2019, ch. 407, § 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 6 - TENNESSEE RIGHT TO SHOP ACT (§§ 56-7-601 — 56-7-610) › Section 56-7-605 - Order for comparable healthcare service upon request

At the request of a patient, a healthcare provider licensed under title 63 or 68 shall provide a copy of an order for a comparable healthcare service within two (2) business days of the request.
Acts 2019, ch. 407, § 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 6 - TENNESSEE RIGHT TO SHOP ACT (§§ 56-7-601 — 56-7-610) › Section 56-7-606 - Report on examples of shared savings incentive programs

The state insurance committee, created by §
8-27-201
, shall publish a report no later than January 1, 2020, on examples of shared savings incentive programs that directly incentivize current enrollees and retirees to shop for lower cost care in other states and consider implementation of such a program in this state. The state insurance committee may implement such a program as part of the next open enrollment period if it is believed to be cost effective. The state insurance committee shall share the report in writing to the government operations committees in both the senate and house of representatives.
Acts 2019, ch. 407, § 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 6 - TENNESSEE RIGHT TO SHOP ACT (§§ 56-7-601 — 56-7-610) › Section 56-7-607 - Promulgation of rules

The commissioner is authorized to promulgate rules as necessary to implement this part. The rules must be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
Acts 2019, ch. 407, § 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 6 - TENNESSEE RIGHT TO SHOP ACT (§§ 56-7-601 — 56-7-610) › Section 56-7-608 - Applicability of part

Except for §
56-7-3506
, and notwithstanding §
56-7-1005
, this part does not apply to:
(1)
Any managed care organization contracting with the state to provide insurance through the TennCare program or the CoverKids program; or
(2)
Any plan described in Section 1251 of the federal Patient Protection and Affordable Care Act (
42 U.S.C. § 18011
) and Section 2301 of the federal Health Care and Education Reconciliation Act.
Acts 2019, ch. 407, § 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 6 - TENNESSEE RIGHT TO SHOP ACT (§§ 56-7-601 — 56-7-610) › Section 56-7-609 - Annual total value of incentives

(a)
Notwithstanding this part, the total value of incentives offered to any one (1) enrollee must not exceed five hundred ninety-nine dollars ($599) in any year.
(b)
The monetary limit on incentives described in subdivision (a)(1) does not apply to §
56-7-610
.
Amended by 2023 Tenn. Acts, ch. 244, s 4, eff. 7/1/2023.
Acts 2019, ch. 407, § 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 6 - TENNESSEE RIGHT TO SHOP ACT (§§ 56-7-601 — 56-7-610) › Section 56-7-610 - Enrollee price negotiation for out of pocket services

(a)
An enrollee may choose to pay for a healthcare service out-of-pocket from an out-of-network provider. If an enrollee negotiates for a lower cost from an out-of-network provider than the average allowed amount paid by the carrier to a network provider for a comparable healthcare service, and the enrollee pays for the healthcare service out-of-pocket, then the enrollee may send documentation, which may be sent electronically, to the carrier, that provides the following:
(1)
The healthcare service the enrollee or patient received and the healthcare provider's name and contact information;
(2)
The order from the healthcare provider given to the enrollee or patient pursuant to §
56-7-605
and the final bill or statement for the healthcare service;
(3)
The average payments made by the carrier to network entities or providers for comparable healthcare services if this information is made available to the enrollee pursuant to this part;
(4)
The negotiated cost of the healthcare service that the enrollee received; and
(5)
A statement that:
(A)
The enrollee paid out-of-pocket for the healthcare services received; and
(B)
The healthcare entity is not making a claim against the carrier for payment for the healthcare service provided to the enrollee or patient.
(b)
A carrier that receives the documentation described in subsection (a) shall count the full amount that the enrollee paid out-of-pocket toward the enrollee's deductible, coinsurance, copayment, or other cost-sharing amount:
(1)
If the healthcare service is included under the enrollee's health plan; and
(2)
The enrollee negotiated for a lower cost for the healthcare service than the average allowed amount paid by the carrier to network providers for that comparable healthcare service.
(c)
The amount counted toward an enrollee's out-of-pocket deductible, coinsurance, copayment, or other cost-sharing amount must not exceed the total amount that the covered person is required to pay out-of-pocket during a contractually agreed upon period of time for healthcare services that are included under the covered person's insurance plan, and does not carry over once a new contract or agreement period for the insurance plan begins.
Amended by 2023 Tenn. Acts, ch. 244, s 3, eff. 7/1/2023.
Acts 2019, ch. 407, § 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 7 - INDUSTRIAL INSURANCE (§§ 56-7-701 — 56-7-709) › Section 56-7-701 - "Industrial life insurance" defined

"Industrial life insurance," as used in §§
56-7-702
- 56-7-704, means that form of life insurance, the policies for which include the words "industrial policy" as part of the descriptive matter; and:
(1)
Under which the premiums are payable weekly; or
(2)
Under which the premiums are payable monthly or more often, but less often than weekly, if the face amount of the insurance provided in the policy is one thousand dollars ($1,000) or less.
Acts 1945, ch. 27, § 1; C. Supp. 1950, § 6447.1; T.C.A. (orig. ed.), § 56-1128.
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 7 - INDUSTRIAL INSURANCE (§§ 56-7-701 — 56-7-709) › Section 56-7-703 - Industrial life insurance policies to which preceding section inapplicable - Provisions in addition to other requirements

The requirements of §
56-7-702
shall not be applicable as follows:
(1)
When an industrial life insurance policy is issued providing for accident and/or health benefits, in addition to natural death benefits, the requirements of §
56-7-702
shall apply only to the life insurance portion of the policy;
(2)
Any of §
56-7-702(a)
not applicable to nonparticipating or term policies shall to that extent not be incorporated into the policies. Section
56-7-702(a)
does not apply to policies issued or granted pursuant to the nonforfeiture provisions described in §
56-7-702(b)(6)-(8)
; and in the case of any company that elects to comply with §§
56-7-401
and
56-7-702(b)(6)-(8) and (10)
shall apply only to policies issued prior to the operative date of §
56-7-401
. Furthermore, in the case of term insurance policies of twenty (20) years or less that are not subject to §§
56-7-401
and
56-7-702(b)(6)-(8)
shall not be required, but the term policies shall specify the mortality table, rate of interest, and method of valuation for computing reserves;
(3)
The provisions of §
56-7-702
are in addition to, and not in lieu of, other provisions that may now or hereafter be contained in policies delivered or issued for delivery in this state, unless the provisions are wholly inconsistent with and repugnant to the provisions set out in §
56-7-702
.
Acts 1945, ch. 27, § 3; 1947, ch. 218, § 1; C. Supp. 1950, § 6447.3; Acts 1979, ch. 398, § 9; T.C.A. (orig. ed.), § 56-1130.
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 7 - INDUSTRIAL INSURANCE (§§ 56-7-701 — 56-7-709) › Section 56-7-704 - Provisions in industrial life insurance policies more favorable to policyholder permissible

Any industrial life insurance contracts may be delivered or issued for delivery in this state, which contracts contain provisions more favorable to the policyholder than those required by §§
56-7-701
- 56-7-704, and nothing in §§
56-7-701
- 56-7-704 shall be construed as prohibiting more favorable provisions.
Acts 1945, ch. 27, § 4; C. Supp. 1950, § 6447.4; T.C.A. (orig. ed.), § 56-1131.
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 7 - INDUSTRIAL INSURANCE (§§ 56-7-701 — 56-7-709) › Section 56-7-705 - Misrepresentations as to terms, benefits, or advantages of industrial life, health or accident insurance policies forbidden - "Industrial insurance" defined

No insurance company or association transacting an industrial life, health, or accident business in this state, and no officer, director, or agent thereof, shall knowingly issue, circulate, or cause to be issued or circulated, any estimate, illustration, circular, or statement of any sort misrepresenting the terms of any policy issued by it, or the benefits or advantages promised by the policy, or dividends or shares or surplus to be received on the policy, or shall use any name or title of any policy or class of policies that misrepresent the true nature of the policy; provided, that "industrial insurance", as used in this section, means insurance on which the premiums are payable in weekly installments.
Acts 1917, ch. 7, § 1; Shan., § 3369a150; Code 1932, § 6443; T.C.A. (orig. ed.), § 56-1132; Acts 1989, ch. 591, § 113.
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 7 - INDUSTRIAL INSURANCE (§§ 56-7-701 — 56-7-709) › Section 56-7-706 - Premiums or assessments for industrial or fraternal insurance not to be received after insolvency

No officer, director, or agent of an insurance company or association transacting an industrial insurance business in this state shall knowingly and willfully receive any premium or assessment on behalf of any industrial insurance company or association or fraternal organization, knowing at the time of receipt of the premium or assessment that the company or association is insolvent according to the laws of the state of the organization of the company, without giving notice to the person paying the premium or assessment.
Acts 1917, ch. 7, § 2; Shan., § 3369a151; Code 1932, § 6444; T.C.A. (orig. ed.), § 56-1133; Acts 1989, ch. 591, § 113.
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 7 - INDUSTRIAL INSURANCE (§§ 56-7-701 — 56-7-709) › Section 56-7-707 - Industrial or fraternal insurance policies or certificates not to be issued to unhealthy persons

No officer, director, agent, physician, or other person shall, with intent to defraud, knowingly issue or cause to be issued or aid in issuing an industrial policy or benefit certificate to any infirm or unhealthy person who is not in insurable condition, nor aid in reinstating in membership or policy standing any infirm or unhealthy person.
Acts 1917, ch. 7, § 2; Shan., § 3369a152; Code 1932, § 6445; T.C.A. (orig. ed.), § 56-1134; Acts 1989, ch. 591, § 113.
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 7 - INDUSTRIAL INSURANCE (§§ 56-7-701 — 56-7-709) › Section 56-7-708 - Fraudulent statements in application or claim under industrial or fraternal insurance forbidden

No person shall knowingly or willfully make or aid in making any false or fraudulent statement of any material fact or thing in any written statement or certificate for the purpose of procuring or attempting to procure the payment of any false or fraudulent claim against any industrial insurance company or fraternal or benefit association, and no person shall make any false or fraudulent statement in any application for insurance, or as to the death or disability of the policy or certificate holder for the purpose of obtaining any money or benefit from the industrial insurance company or fraternal or benefit association licensed to do business in this state.
Acts 1917, ch. 7, § 3; Shan., § 3369a153; Code 1932, § 6446; T.C.A. (orig. ed.), § 56-1135; Acts 1989, ch. 591, § 113.
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 7 - INDUSTRIAL INSURANCE (§§ 56-7-701 — 56-7-709) › Section 56-7-709 - Penalty for violation of sections 56-7-705 - 6-7-708

Any violation of §§
56-7-705
- 56-7-708 is a Class C misdemeanor.
Acts 1917, ch. 7, § 4; Shan., § 3369a154; Code 1932, § 6447; T.C.A. (orig. ed.), § 56-1136; Acts 1989, ch. 591, § 113.
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 8 - FIRE INSURANCE (§§ 56-7-801 — 56-7-804) › Section 56-7-801 - Inspection of property insured against fire - No insurance exceeding fair value of property

(a)
Within ninety (90) days after making or writing any contract of fire insurance on any building or structure in this state, the company, its designee or agent, shall cause the building or structure to be inspected.
(b)
No company, agent or insurance producer shall knowingly issue, negotiate, continue or renew, or cause or permit to be issued, negotiated, continued or renewed any fire insurance policy upon property or interests in the property within this state of an amount that, with any existing insurance on the property, exceeds the fair value of the property.
Amended by 2014 Tenn. Acts, ch. 652,s 1, eff. 4/8/2014.
Acts 1927, ch. 72, § 1; mod. Code 1932, § 6172; T.C.A. (orig. ed.), § 56-1137.
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 8 - FIRE INSURANCE (§§ 56-7-801 — 56-7-804) › Section 56-7-802 - Measure of damages for loss by fire - Insured reimbursed for excess premiums

If buildings within the state insured against loss by fire are totally destroyed by fire, the company shall not be liable beyond the actual value of the insured property at the time of the loss or damage; and if it appears that the insured has paid premiums on an amount in excess of the actual value, the insured shall be reimbursed the proportionate excess or premiums paid on the difference between the amount named in the policy and the actual value, with interest at six percent (6%) per annum from the date of issue; and the excess of premiums, and interest on the premiums, shall be allowed the insured from the time any companies carrying the insurance at the time of the loss have continuously carried the insurance on the destroyed buildings, whether under policies existing at the time of the loss or under previous policies in the same companies.
Acts 1927, ch. 72, § 2; Code 1932, § 6173; T.C.A. (orig. ed.), § 56-1138.
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 8 - FIRE INSURANCE (§§ 56-7-801 — 56-7-804) › Section 56-7-803 - Measure of damages in case of agent's failure to inspect property

If the company, its designee or agent, fails to place a reasonable value on any insured property within the ninety-day period provided in §
56-7-801
, and that is agreed to by the insured, and a loss occurs, then the value as shown by the policy or application is conclusively presumed to be reasonable, and settlement shall be made on that basis.
Amended by 2014 Tenn. Acts, ch. 652,s 2, eff. 4/8/2014.
Acts 1927, ch. 72, § 2; mod. Code 1932, § 6174; T.C.A. (orig. ed.), § 56-1139.
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 8 - FIRE INSURANCE (§§ 56-7-801 — 56-7-804) › Section 56-7-804 - Policies protecting trustees, mortgagees, assignees and like parties

When any person, as trustee, mortgagee, assignee, or otherwise, possesses or has any fire insurance policy on realty made payable to the person, or other person as that person's interest may appear, then the insurance as to the interest of the trustee, mortgagee, assignee or other person named in the policy shall not be invalidated by an act or neglect of the mortgagor owner of the property so insured, nor by any foreclosure or other proceedings or notice of sale relating to the property, nor by change in title or ownership of the property, nor by occupation of the premises for purposes more hazardous than are permitted by the policy; provided, that, in case the mortgagor or owner neglects to pay any premium due under the policy, the mortgagee, trustee, assignee, or other person shall on demand, pay the premium; and provided, further, that the mortgagee, trustee, assignee, or other person shall notify the insurance company of any change of ownership or occupancy or increase of hazard that comes to the knowledge of the mortgagee, trustee, assignee, or other person, and, unless permitted by the policy, it shall be noted on the policy, and the mortgagee, trustee, assignee, or other person shall, on demand, pay the premium for the increased hazard for the term of the use of the property, or otherwise the policy shall be null and void; and provided, further, that in the event the insurer concludes to cancel its policy under its terms, then ten (10) days' notice of the determination shall be given to the mortgagee, trustee, assignee, or other person so interested.
Acts 1925, ch. 123, § 1; Shan. Supp., § 3348a1b1; Code 1932, § 6175; T.C.A. (orig. ed.), § 56-1140.
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 56-7-902 - Compensation to creditors

(a)
(1)
As used in this section:
(A)
"Compensation" includes commissions, dividends, except where they are the distribution of earnings to stockholders of an insurance company or insurance holding company, retrospective rate credits, service fees, expense allowances or reimbursements, underwriting participations, gifts or any other form of compensation. A distribution of earnings to a stockholder of an insurance company or insurance holding company does not constitute compensation for purposes of this section, even though the stockholder receives compensation in a capacity other than that of stockholder; and
(B)
"Creditor" means the lender of money or vendor or lessor of goods, services, or property rights, or privileges, for which payment is arranged through a credit transaction, or any successor to the right, title, or interest of any lender, vendor, or lessor, or an affiliate, associate or subsidiary of any of them, or any director, officer or employee of any of them, or any other person in any way associated with them.
(2)
All other terms used in this section have the meanings generally ascribed to them in the insurance industry.
(b)
No insurer shall pay or propose to pay, directly or indirectly, to any creditor as compensation for that creditor, total compensation in excess of forty percent (40%) of premiums earned, except that if provision is made for refund of unearned commissions in the event of termination of coverage, commissions may be paid in one (1) sum at the time the single premium policy or certificate is written.
Acts 1980, ch. 867, § 2; 1981, ch. 216, § 1; 1988, ch. 557, § 1.