reglab/statecodes huggingface dataset:
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 55 - TENNESSEE VEHICLE PROTECTION PRODUCT ACT (§§ 56-55-101 — 56-55-115) › Section 56-55-109 - Restrictions on use of deceptive language - False or misleading statements - Fraud

(a)
Unless licensed as an insurance company, a vehicle protection product warrantor shall not use in its name, contracts, or literature the words "insurance," "casualty," "surety," "mutual," or any other word that is descriptive of the insurance, casualty, or surety business or that is deceptively similar to the name or description of any insurance or surety corporation or any other vehicle protection product warrantor. A warrantor may use the term "guaranty" or a similar word in the warrantor's name.
(b)
A vehicle protection product warrantor shall not make, permit, or cause any false or misleading statements, either oral or written, in connection with the sale, offer to sell, or advertisement of a vehicle protection product.
(c)
A vehicle protection product warrantor shall not permit or cause the omission of any material statement in connection with the sale, offer to sell, or advertisement of a vehicle protection product, that, under the circumstances, should have been made, in order to make the statements that were made not misleading.
(d)
A vehicle protection product warrantor shall not make, permit, or cause any false or misleading statements, either oral or written, about the performance required or payments that may be available under the vehicle protection product warranty.
(e)
A vehicle protection product warrantor shall not make, permit, or cause any statement or practice that has the effect of creating or maintaining a fraud.
(f)
A vehicle protection product seller or warrantor may not require, as a condition of sale or financing, that a retail purchaser of a motor vehicle purchase a vehicle protection product that is not installed on the motor vehicle at the time of sale.
Acts 2005, ch. 244, § 10.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 55 - TENNESSEE VEHICLE PROTECTION PRODUCT ACT (§§ 56-55-101 — 56-55-115) › Section 56-55-110 - Accounts, books, and records

(a)
All vehicle protection product warrantors shall keep accurate accounts, books, and records concerning transactions regulated under this chapter.
(b)
A vehicle protection product warrantor's accounts, books, and records shall include:
(1)
Copies of all vehicle protection product warranties;
(2)
The name and address of each warranty holder; and
(3)
The dates, amounts, and descriptions of all receipts, claims, and expenditures.
(c)
A vehicle protection product warrantor shall retain all required accounts, books, and records pertaining to each warranty holder for at least two (2) years after the specified period of coverage has expired. A warrantor discontinuing business in this state shall maintain the records until it furnishes the commissioner satisfactory proof that it has discharged all obligations to warranty holders in this state.
(d)
Vehicle protection product warrantors shall make all accounts, books, and records concerning transactions regulated under this chapter available to the commissioner for the purpose of examination.
Acts 2005, ch. 244, § 11.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 55 - TENNESSEE VEHICLE PROTECTION PRODUCT ACT (§§ 56-55-101 — 56-55-115) › Section 56-55-111 - Examination of accounts, books, and records for compliance - Costs and fees of examination - Enforcement - Violations - Hearings - Penalties

(a)
(1)
The commissioner may conduct examinations of warrantors, administrators, or other persons to enforce this chapter, and to protect warranty holders in this state. Upon request of the commissioner, a warrantor shall make available to the commissioner all accounts, books, and records concerning vehicle protection products sold by the warrantor that are necessary to enable the commissioner to reasonably determine compliance or noncompliance with this chapter.
(2)
Any person or entity examined shall pay any and all appropriate and reasonable costs incurred by the commissioner during the examination, including, but not limited to, the compensation of experts, actuaries, examiners, or other persons that may be contracted for by the commissioner or the commissioner's designated appointee for the purpose of assisting in the examination. The compensation shall be fixed at a reasonable amount, commensurate with usual compensation for like services, and shall be contracted for in accordance with applicable state contracting procedures, if applicable.
(b)
The commissioner may take action that is necessary or appropriate to enforce this chapter and the commissioner's rules and orders, and to protect warranty holders in this state. If a person or entity violates this chapter and the commissioner reasonably believes the violation threatens to cause irreparable loss or injury to the property or business of any person or company located in this state, the commissioner may:
(1)
Issue an order directed to the warrantor to cease and desist from engaging in further acts, practices, or transactions that are causing the conduct;
(2)
Issue an order prohibiting the warrantor from selling, or offering for sale, vehicle protection products in violation of this chapter;
(3)
Issue an order imposing a civil penalty on the warrantor; or
(4)
Issue any combination of subdivisions (b)(1)-(3), as applicable.
(c)
At any hearing under this chapter, the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, shall apply.
(d)
The commissioner may bring an action in any court of competent jurisdiction, for an injunction or other appropriate relief, to enjoin threatened or existing violations of this chapter, or of the commissioner's orders or rules. An action filed under this section may also seek restitution on behalf of persons aggrieved by a violation of this chapter, or orders or rules of the commissioner.
(e)
A person or entity that is found to have violated this chapter or orders or rules of the commissioner may be ordered to pay to the commissioner a civil penalty in an amount determined by the commissioner, not to exceed five thousand dollars ($5,000) per violation.
Acts 2005, ch. 244, § 12.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 55 - TENNESSEE VEHICLE PROTECTION PRODUCT ACT (§§ 56-55-101 — 56-55-115) › Section 56-55-112 - Commissioner or secretary of state as attorney for service of process

(a)
Any warrantor doing business in this state in accordance with this chapter shall be deemed to have appointed the commissioner its true and lawful attorney upon whom may be served all lawful process in any action or proceeding against it.
(b)
Any warrantor doing business in this state unauthorized by this chapter shall be deemed to have appointed the secretary of state to be its true and lawful attorney upon whom may be served all lawful process in any action or proceeding against it.
Acts 2005, ch. 244, § 13.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 55 - TENNESSEE VEHICLE PROTECTION PRODUCT ACT (§§ 56-55-101 — 56-55-115) › Section 56-55-113 - Rules and regulations

The commissioner may adopt administrative rules consistent with this chapter that are necessary to implement this chapter. The rules shall include disclosures for the benefit of the warranty holder, record keeping requirements, registration fees, penalties, and procedures for public complaints. The rules shall also include the conditions under which surplus lines insurers may be rejected for the purpose of underwriting vehicle protection product warranty agreements.
Acts 2005, ch. 244, § 14.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 55 - TENNESSEE VEHICLE PROTECTION PRODUCT ACT (§§ 56-55-101 — 56-55-115) › Section 56-55-114 - Application - Effective date

This chapter applies to all vehicle protection products sold or offered for sale on or after July 1, 2006. The failure of any person to comply with this chapter prior to July 1, 2006, shall not be admissible in any court proceeding, administrative proceeding, arbitration, or alternative dispute resolution proceeding and may not otherwise be used to prove that the action of any person or the affected vehicle protection product was unlawful or otherwise improper.
Acts 2005, ch. 244, § 15.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 55 - TENNESSEE VEHICLE PROTECTION PRODUCT ACT (§§ 56-55-101 — 56-55-115) › Section 56-55-115 - Sale of warranties only authorized as part of vehicle protection product

Nothing in this chapter shall authorize the sale of warranties, as defined in §
56-55-102
, except as part of a vehicle protection product.
Acts 2005, ch. 244, § 16.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 56 - PROFESSIONAL EMPLOYER ORGANIZATION BENEFIT AND WELFARE PLAN (§§ 56-56-101 — 56-56-102) › Section 56-56-101 - "Professional employer organization benefit and welfare plan" defined

As used in this chapter, "professional employer organization benefit and welfare plan" means a plan offered to the covered employees of a professional employer organization registered pursuant to the Tennessee Professional Employer Organization Act, compiled in title 62, chapter 43, and as amended.
Acts 2012, ch. 1081, § 2.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 56 - PROFESSIONAL EMPLOYER ORGANIZATION BENEFIT AND WELFARE PLAN (§§ 56-56-101 — 56-56-102) › Section 56-56-102 - Self-insured plans

A professional employer organization may sponsor and maintain employee benefit and welfare plans in accordance with §
62-43-108(c)
, for the benefit of covered employees. The self-insured plans developed under this section are not subject to the premium taxes imposed by this title. The department may promulgate rules regulating self-insured plans under this section.
Acts 2012, ch. 1081, § 2.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 57 - VOLUNTEER RX (§§ 56-57-101 — 56-57-106) › Section 56-57-101 - Chapter definitions

As used in this chapter, unless the context otherwise requires:
(1)
"Commissioner" means the commissioner of commerce and insurance;
(2)
"Department" means the department of commerce and insurance;
(3)
"Member" means any person who enrolls at no cost, or who pays fees, dues, charges or other consideration for the right to enroll to receive the purported benefits of a prescription drug discount plan;
(4)
"Operator" means any person that engages as principal in the business of offering, selling, marketing, advertising or otherwise distributing a prescription drug discount plan within this state. Operator does not include discount cards offered by a nonprofit association to its members as an incidental benefit to membership in the association; provided, that membership in the association entitles members to apply for insurance or other health benefits that are available only to members of the association;
(5)
"Person" means an individual, corporation, partnership, association, joint venture, joint stock company, trust, unincorporated organization, limited liability company, any similar entity, or any combination of these entities;
(6)
"Prescription drug" has the same meaning as the term is defined in §
63-10-204
; and
(7)
"Prescription drug discount plan" means any card or other purchasing mechanism or device, that is not insurance, that purports to offer discounts or access to discounts to any person for the retail purchase of prescription drugs from licensed pharmacies. A prescription drug discount plan does not include any drug discount card or drug benefit plan provided by a self-insured employer's group health benefits plan, or any prescription drug discount plan offered by an insurer licensed under this title in conjunction with health insurance.
Acts 2005, ch. 474, § 2.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 57 - VOLUNTEER RX (§§ 56-57-101 — 56-57-106) › Section 56-57-102 - Authority for a prescription drug discount plan known as "Volunteer Rx"

(a)
The department of health is authorized to develop and implement a prescription drug discount plan, which shall be known as "Volunteer Rx," or, if the department of health deems appropriate, may contract for, pursuant to state purchasing laws, a prescription drug discount plan. The purpose of this section is to assist in providing, when possible, cost savings on medications for uninsured Tennesseans, or for insured Tennesseans whose insurance does not provide for prescription drug coverage on or after January 1, 2005.
(b)
Notwithstanding subsection (a), the department of health may, if funding is made available through the general appropriations act, provide benefits through the prescription drug discount plan. The benefits would be limited by the funds specifically appropriated for that purpose. The department of health shall also have the authority to develop and implement prescription drug discount plans targeted for specific defined populations. The plans may also incorporate benefits; provided, that funds are specifically allocated for the benefits in the general appropriations act.
(c)
In developing the plans authorized by this section, the department of health may consider the use of different means to lower the overall cost to participants, including, but not limited to, the payment or waiver of any membership fees, as well as the use of cost-sharing arrangements and deductibles.
(d)
Nothing in the creation of a prescription drug discount program, pursuant to this section, shall be construed as creating any entitlement by any individuals or entities to any services or medications.
Acts 2005, ch. 474, § 2.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 57 - VOLUNTEER RX (§§ 56-57-101 — 56-57-106) › Section 56-57-103 - Regulation and compliance

A prescription drug discount plan issued pursuant to §
56-57-102
is subject to regulation by the department and compliance with laws applicable to pharmacy discount cards, including, but not limited to, chapter 17 of this title.
Repealed and reenacted by 2021 Tenn. Acts, ch. 372, s 2, eff. 7/1/2021.
Acts 2005, ch. 474, § 2.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 57 - VOLUNTEER RX (§§ 56-57-101 — 56-57-106) › Section 56-57-104 - [Repealed]

Repealed and reenacted by 2021 Tenn. Acts, ch. 372, s 1, eff. 7/1/2021.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 57 - VOLUNTEER RX (§§ 56-57-101 — 56-57-106) › Section 56-57-105 - [Repealed]

Repealed and reenacted by 2021 Tenn. Acts, ch. 372, s 1, eff. 7/1/2021.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 57 - VOLUNTEER RX (§§ 56-57-101 — 56-57-106) › Section 56-57-106 - [Repealed]

Repealed and reenacted by 2021 Tenn. Acts, ch. 372, s 1, eff. 7/1/2021.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 58 - INTERSTATE INSURANCE PRODUCT REGULATION COMPACT ACT OF 2007 (§§ 56-58-101 — 56-58-102) › Section 56-58-101 - Short title

This chapter shall be known and may be cited as the "Interstate Insurance Product Regulation Compact Act of 2007."
Acts 2007, ch. 148, § 2.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 59 - GUARANTEED ASSET PROTECTION WAIVER ACT OF 2008 (§§ 56-59-101 — 56-59-109) › Section 56-59-101 - Short title - Purpose - Applicability

(a)
This chapter shall be known and may be cited as the "Guaranteed Asset Protection Waiver Act of 2008."
(b)
The purpose of this chapter is to provide a framework within which guaranteed asset protection (GAP) waivers are defined and may be offered within the state. GAP waivers governed under this chapter are not insurance and are exempt from the insurance laws of this state. Persons marketing, soliciting, negotiating, selling or offering to sell GAP waivers to borrowers that comply with this chapter are exempt from this state's insurance licensing requirements. This chapter does not apply to an insurance policy offered by an insurer under the insurance laws of this state or a debt cancellation or debt suspension contract being offered in compliance in 12 CFR Part 37 or 12 CFR Part 721 or other state or federal law, including §
45-2-601
.
Acts 2008 , ch. 1055, § 2.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 59 - GUARANTEED ASSET PROTECTION WAIVER ACT OF 2008 (§§ 56-59-101 — 56-59-109) › Section 56-59-102 - Chapter definitions

The following definitions are for purposes of this chapter and are not intended to provide actual terms required in GAP waivers:
(1)
"Administrator" means a person, other than an insurer or creditor, that performs administrative or operational functions pursuant to the GAP waiver program;
(2)
"Borrower" means a debtor, retail buyer or lessee under a finance agreement;
(3)
"Commissioner" means the commissioner of commerce and insurance;
(4)
"Creditor" means:
(A)
The lender in a loan or credit transaction;
(B)
The lessor in a lease transaction;
(C)
Any motor vehicle dealer as defined in §
55-17-102
;
(D)
The seller in commercial retail installment transactions; or
(E)
The assignees of any of subdivisions (4)(A)-(D) to whom the credit obligation is payable;
(5)
"Finance agreement" means a loan, lease or retail installment sales contract for the purchase of a motor vehicle;
(6)
"Free look period" means the period of time from the effective date of the GAP waiver until the date the borrower may cancel the contract without penalty, fees or costs to the borrower. This period of time shall not be shorter than thirty (30) days;
(7)
"Guaranteed asset protection waiver" or "GAP waiver" means a contractual agreement wherein a creditor agrees for a separate charge to cancel or waive all or part of amounts due on a borrower's finance agreement in the event of a total physical damage loss or unrecovered theft of a motor vehicle, which agreement must be part of, or a separate addendum to, the finance agreement;
(8)
"Insurer" means an insurance company licensed, registered, or otherwise authorized to do business under the laws of this state, including surplus lines insurers;
(9)
"Motor vehicle" means self propelled or towed vehicles designed for personal or commercial use, including, but not limited to, automobiles, trucks, motorcycles, recreational vehicles, all terrain vehicles, campers, boats, personal watercraft, and motorcycle, boat, camper and personal watercraft trailers;
(10)
"Person" includes an individual, company, association, organization, partnership, business trust, corporation, and every form of legal entity;
(11)
"Related finance company" means a finance company that has common ownership of fifty percent (50%) or more with the retail seller;
(12)
"Retail buyer" means a person who buys motor vehicles not principally for the purpose of resale; and
(13)
"Retail seller" means a person that is regularly engaged in the selling of motor vehicles to a retail buyer and that holds any necessary license or licenses to sell to a retail buyer.
Amended by 2014 Tenn. Acts, ch. 971,s 1, eff. 7/1/2014.
Acts 2008, ch. 1055, § 3.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 59 - GUARANTEED ASSET PROTECTION WAIVER ACT OF 2008 (§§ 56-59-101 — 56-59-109) › Section 56-59-103 - GAP waiver - Insurance policy

(a)
GAP waivers may be offered, sold, or provided to borrowers in this state in compliance with this chapter.
(b)
GAP waivers may, at the option of the creditor, be sold for a single payment or may be offered with a monthly or periodic payment option.
(c)
Notwithstanding any other law, any cost to the borrower for a GAP waiver entered into in compliance with the Truth in Lending Act (
15 U.S.C. § 1601
et seq.), and its implementing regulations, must be separately stated and is not to be considered a finance charge or interest.
(d)
(1)
A retail seller shall insure its GAP waiver obligations under a contractual liability or other insurance policy issued by an insurer; provided, that:
(A)
A retail seller that does not assign the financing agreement of which the GAP waiver is a part to anyone other than the retail seller's related finance company is not required to insure its GAP waiver obligation; and
(B)
Retail sellers that are lessors of motor vehicles are not required to insure obligations related to GAP waivers on leased vehicles.
(2)
A creditor not otherwise required to insure its GAP waiver obligation pursuant to subdivision (d)(1) may insure its GAP waiver obligation under a contractual liability policy or other such policy issued by an insurer. Any such insurance policy may be directly obtained by a creditor, retail seller, or may be procured by an administrator to cover a creditor or retail seller's obligations.
(e)
The GAP waiver remains a part of the finance agreement upon the assignment, sale or transfer of such finance agreement by the creditor.
(f)
Neither the extension of credit, the term of credit, nor the term of the related motor vehicle sale or lease may be conditioned upon the purchase of a GAP waiver.
(g)
Any creditor that offers a GAP waiver must report the sale of, and forward funds received on all such waivers to the designated party, if any, as prescribed in any applicable administrative services agreement, contractual liability policy, other insurance policy or other specified program documents.
(h)
Funds received or held by a creditor or administrator and belonging to an insurer, creditor or administrator, pursuant to the terms of a written agreement must be held by such creditor or administrator in a fiduciary capacity.
Amended by 2014 Tenn. Acts, ch. 971,s 2, eff. 7/1/2014.
Acts 2008, ch. 1055, § 4.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 59 - GUARANTEED ASSET PROTECTION WAIVER ACT OF 2008 (§§ 56-59-101 — 56-59-109) › Section 56-59-104 - Coverage under contractual liability or other insurance policy - Cancellation

(a)
Contractual liability or other insurance policies insuring GAP waivers must state the obligations of the insurer to reimburse or pay to the creditor any sums the creditor is legally obligated to waive under the GAP waivers issued by the creditor and purchased or held by the borrower.
(b)
Coverage under a contractual liability or other insurance policy insuring a GAP waiver must also cover any subsequent assignee upon the assignment, sale or transfer of the finance agreements.
(c)
Coverage under a contractual liability or other insurance policy insuring a GAP waiver must also remain in effect unless canceled or terminated in compliance with applicable insurance laws of this state.
(d)
The cancellation or termination of a contractual liability or other insurance policy must not reduce the insurer's responsibility for GAP waivers issued by the creditor prior to the date of cancellation or termination and for which premium has been received by the insurer.
Acts 2008, ch. 1055, § 5.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 59 - GUARANTEED ASSET PROTECTION WAIVER ACT OF 2008 (§§ 56-59-101 — 56-59-109) › Section 56-59-105 - Disclosure of guaranteed asset protection waiver

GAP waivers must disclose, as applicable, in writing and in clear, understandable language that is easy to read, the following:
(1)
The name and address of the initial creditor and the borrower at the time of sale, and the identity of any administrator if different from the creditor;
(2)
The purchase price and the terms of the GAP waiver, including, without limitation, the requirements for protection, conditions, or exclusions associated with the GAP waiver;
(3)
That the borrower may cancel the GAP waiver within a free look period, as specified in the waiver, and will be entitled to a full refund of the purchase price; provided, that no claim for benefits has been made or no benefits have been paid, or in the event a claim has been made or benefits have been paid, the borrower may receive a full or partial refund if the waiver so provides;
(4)
The procedure the borrower must follow, if any, to obtain GAP waiver benefits under the terms and conditions of the waiver, including a telephone number and address where the borrower may apply for waiver benefits;
(5)
Whether or not the GAP waiver is cancelable after the free look period and the conditions under which it may be cancelled or terminated including the procedures for requesting any refund due;
(6)
That in order to receive any refund due in the event of a borrower's cancellation of the GAP waiver agreement or early termination of the finance agreement after the free look period of the GAP waiver, the borrower, in accordance with terms of the waiver, must provide a written request to cancel to the creditor, administrator or such other party, within ninety (90) days after the borrower's decision to cancel the waiver or the occurrence of the event terminating the finance agreement;
(7)
The methodology for calculating any refund of the unearned purchase price of the GAP waiver due, in the event of cancellation of the GAP waiver or early termination of the finance agreement;
(8)
That neither the extension of credit, the terms of the credit, nor the terms of the related motor vehicle sale or lease, may be conditioned upon the purchase of the GAP waiver; and
(9)
That the cost of the GAP waiver is not regulated and that the consumer has the responsibility to determine whether the cost of the GAP waiver is reasonable in relation to the protection afforded by the GAP waiver.
Acts 2008, ch. 1055, § 6.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 59 - GUARANTEED ASSET PROTECTION WAIVER ACT OF 2008 (§§ 56-59-101 — 56-59-109) › Section 56-59-106 - Cancellation or termination of GAP waiver or finance agreement - Free look period

(a)
GAP waiver agreements may be cancelable or noncancelable after the free look period. GAP waivers must provide that if a borrower cancels a waiver within the free look period, the borrower will be entitled to a full refund of the purchase price; provided, that no claims have been made or no benefits have been paid, or in the event benefits have been paid or claims made, the borrower may receive a full or partial refund if the waiver so provides.
(b)
In the event of a borrower's cancellation of the GAP waiver or early termination of the finance agreement, after the agreement has been in effect beyond the free look period, the borrower may be entitled to a refund of any unearned portion of the purchase price of the waiver unless the waiver provides otherwise. In order to receive a refund, the borrower, in accordance with any applicable terms of the waiver, must provide a written request to the creditor, administrator or other party within ninety (90) days after the borrower's decision to cancel the waiver or the occurrence of the event terminating the finance agreement.
(c)
If the cancellation of a GAP waiver occurs as a result of a default under the finance agreement or the repossession of the motor vehicle associated with the finance agreement, or any other termination of the finance agreement, any refund due may be paid directly to the creditor or administrator and applied as set forth in subsection (d).
(d)
Any cancellation refund under subsections (a)-(c) may be applied by the creditor as a reduction of the amount owed under the finance agreement, unless the borrower can show that the finance agreement has been paid in full.
Acts 2008, ch. 1055, § 7.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 59 - GUARANTEED ASSET PROTECTION WAIVER ACT OF 2008 (§§ 56-59-101 — 56-59-109) › Section 56-59-107 - Lease or sale associated with a commercial transaction - Applicability of specified sections

(a)
Sections
56-59-103(c)
,
56-59-105
and
56-59-108
are not applicable to a GAP waiver offered in connection with a lease or sale associated with a commercial transaction.
(b)
For purposes of subsection (a), "commercial transaction" means a transaction involving the sale or lease of a motor vehicle that is intended or will be used primarily for a purpose other than personal, family or household use.
Acts 2008, ch. 1055, § 8.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 59 - GUARANTEED ASSET PROTECTION WAIVER ACT OF 2008 (§§ 56-59-101 — 56-59-109) › Section 56-59-108 - Powers and duties of commissioner - Violations and penalties

The commissioner may take action that is necessary or appropriate to enforce this chapter and to protect GAP waiver holders in this state. After proper notice and opportunity for hearing the commissioner may:
(1)
Order the creditor, administrator or any other person not in compliance with this section to cease and desist from further GAP waiver related operations that are in violation of this chapter;
(2)
Impose a penalty of not more than five hundred dollars ($500) per violation and no more than ten thousand dollars ($10,000) in the aggregate for all violations of similar nature. For purposes of this section, violations must be of a similar nature if the violation consists of the same or similar course of conduct, action or practice, regardless of the number of times the action, conduct or practice that is determined to be a violation of this chapter occurred; and
(3)
Order any person found to have violated this chapter to cease and desist from selling, soliciting, or negotiating a GAP waiver in this state.
Acts 2008, ch. 1055, § 9.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 59 - GUARANTEED ASSET PROTECTION WAIVER ACT OF 2008 (§§ 56-59-101 — 56-59-109) › Section 56-59-109 - Insurance laws - Exemptions

The general assembly finds that GAP waivers are not insurance. The general assembly also finds that GAP waivers complying with this chapter are exempt from the insurance laws of this state.
Acts 2008, ch. 1055, § 10.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 60 - PREFERRED PROVIDER ORGANIZATION TRANSPARENCY ACT (§§ 56-60-101 — 56-60-109) › Section 56-60-101 - Short title

This chapter shall be known and may be cited as the "Preferred Provider Organization Transparency Act."
Acts 2009, ch. 466, § 2.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 60 - PREFERRED PROVIDER ORGANIZATION TRANSPARENCY ACT (§§ 56-60-101 — 56-60-109) › Section 56-60-103 - Exceptions

This chapter does not apply:
(1)
In circumstances where access to the provider network contract is granted to an affiliate or a subsidiary of a contracting entity, or other entity if operating under the same brand licensee program as the contracting entity;
(2)
To a contract between a contracting entity and a discount medical plan organization; or
(3)
To the provision of any medical services for injuries covered by the Workers' Compensation Law, compiled in title 50, chapter 6.
Acts 2009, ch. 466, § 4.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 60 - PREFERRED PROVIDER ORGANIZATION TRANSPARENCY ACT (§§ 56-60-101 — 56-60-109) › Section 56-60-104 - Registration as a contracting entity

(a)
Any individual or entity that commences business as a contracting entity shall register with the department within thirty (30) days of commencing business in this state unless the individual or entity is licensed by the department as an insurer or third party administrator. Any contracting entity not licensed by the department as an insurer or third party administrator shall register with the department within ninety (90) days of January 1, 2010. If a contracting entity fails to register with the department in compliance with this section, then the commissioner may assess penalties as set forth in §
56-2-305(a)(1) or (a)(2)
.
(b)
(1)
Registration shall consist of the submission of the following information:
(A)
The official name of the contracting entity, including any doing business as (d/b/a) designations used in this state;
(B)
The mailing address and official telephone number for the contracting entity's principal headquarters;
(C)
The name and telephone number of the contracting entity's representative who will serve as the primary contact with the department; and
(D)
Any other information as requested by the department.
(2)
The information required by subdivision (b)(1) shall be submitted in written or electronic format, as prescribed by the department.
(c)
The department may impose a registration fee to defray the cost of administering this section.
Acts 2009, ch. 466, § 5.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 60 - PREFERRED PROVIDER ORGANIZATION TRANSPARENCY ACT (§§ 56-60-101 — 56-60-109) › Section 56-60-106 - Subsequent grants of access to another third party

(a)
Any third party, having itself been granted access to a provider's health care services and contractual discounts pursuant to a provider network contract, that subsequently grants access to another third party, is obligated to comply with the rights and responsibilities imposed on contracting entities under §§
56-60-104
and
56-60-105
.
(b)
Any third party that enters into a contract with another third party to access a provider's health care services and contractual discounts pursuant to a provider network contract is obligated to comply with the rights and responsibilities imposed on third parties under this section and §
56-60-105
.
(c)
Any third party that subsequently grants access to another third party will provide to the contracting entity the location of a web site or a telephone number that the contracting entity will make available to providers as provided in §
56-60-105(b)(2)
that will identify to providers any individual or entity to whom the third party has granted access to the provider's health care services and contractual discounts pursuant to the provider network contract. The third party shall update the listing on the web site or available through the telephone number on a routine basis as additional individuals or entities are granted access and shall review the listing no less frequently than quarterly to ensure the completeness and accuracy of the information available.
Acts 2009, ch. 466, § 7.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 60 - PREFERRED PROVIDER ORGANIZATION TRANSPARENCY ACT (§§ 56-60-101 — 56-60-109) › Section 56-60-107 - Requirements for granting a third party access to the contracting entity's provider network - Refusal to accept contractual discount

(a)
No contracting entity shall grant a third party access to the contracting entity's provider network contract by lease, rent or by any other means unless the third party accessing the provider network contract is:
(1)
A payer of claims or a third party administrator or other entity that administers or processes claims on behalf of the payer;
(2)
A preferred provider organization or preferred provider network including a physician organization or physician hospital organization; or
(3)
An entity engaged in the electronic claims transport between the contracting entity and the payer if the entity does not provide access to the provider's services and contractual discounts to any other third party.
(b)
(1)
A provider may refuse the discount taken on the remittance advice (RA) or explanation of payment (EOP) if the discount is taken without a contractual basis or if the provider cannot obtain information relative to the discount because of a violation of §
56-60-105(b)(2)
or §
56-60-106(c)
. The provider shall notify in writing the contracting entity or third party of the provider's refusal to accept the contractual discount.
(2)
The provider may require payment of the charge with no discount applied unless the contracting entity or third party within thirty (30) calendar days of receipt of notice of the apparent violation of the requirements of this section:
(A)
Notifies the provider that the apparent violation resulted from an administrative oversight or other unintentional error and advises the provider of steps taken to remedy and avoid recurrence of the error; and
(B)
Submits to the provider a corrected RA or EOP with documentation demonstrating eligibility for any discount applied.
Acts 2009, ch. 466, § 8.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 60 - PREFERRED PROVIDER ORGANIZATION TRANSPARENCY ACT (§§ 56-60-101 — 56-60-109) › Section 56-60-108 - Enforcement - Rules

(a)
The department shall enforce this chapter.
(b)
The department is authorized to promulgate rules to effectuate this chapter in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The initial rules promulgated by the department may be designated as emergency rules if the department finds that it cannot implement the rules by January 1, 2010, exercising the rulemaking procedures for the promulgation of permanent rules and if the department complies with §
4-5-208
.
Acts 2009, ch. 466, § 9.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 60 - PREFERRED PROVIDER ORGANIZATION TRANSPARENCY ACT (§§ 56-60-101 — 56-60-109) › Section 56-60-109 - Unfair insurance practice - Complaints for violations

(a)
It is an unfair insurance practice for the purposes of the Tennessee Unfair Trade Practices and Unfair Claims Settlement Act of 2009, compiled in chapter 8, part 1 of this title, to knowingly access a provider's services or exercise a provider's contractual discounts pursuant to a provider network contract if the access or exercise is not pursuant to a contractual relationship with the provider or with a contracting entity or third party who has a contractual relationship with the provider as specified in this chapter.
(b)
(1)
To effectuate the purposes of this section, the department shall develop a complaint form for providers or others to submit alleging violations of this chapter.
(2)
Information provided in good faith to the department shall not make the provider or other individual or entity providing the information liable for civil damages as a result of providing the information.
Acts 2009, ch. 466, § 10.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 61 - TENNESSEE HEALTH CARRIER GRIEVANCE AND EXTERNAL REVIEW PROCEDURE ACT (§§ 56-61-101 — 56-61-125) › Section 56-61-101 - Short title - Purpose

(a)
This chapter shall be known and may be cited as the "Tennessee Health Carrier Grievance and External Review Procedure Act."
(b)
The purpose of this chapter is to provide standards for the establishment and maintenance of procedures by health carriers to assure that covered persons and healthcare providers have the opportunity for the appropriate resolution of grievances, as defined in this chapter.
Acts 2010, ch. 980, § 2.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 61 - TENNESSEE HEALTH CARRIER GRIEVANCE AND EXTERNAL REVIEW PROCEDURE ACT (§§ 56-61-101 — 56-61-125) › Section 56-61-103 - Applicability and scope

(a)
Except as otherwise specified, this chapter shall apply to all health carriers.
(b)
This chapter shall not apply to a policy or certificate that provides:
(1)
Coverage only for a specified disease, specified accident or accident-only coverage, credit, dental, disability income, hospital indemnity, long-term care insurance, as defined by §
56-42-103
, vision care or any other limited supplemental benefit or to a medicare supplement policy of insurance as defined by the commissioner;
(2)
Coverage under a plan through medicare, medicaid or the federal employees health benefits program (FEHB);
(3)
Any coverage issued under
10 U.S.C. § 1072
and any coverage issued as supplement to that coverage;
(4)
Any coverage issued as supplemental to liability insurance; workers' compensation or similar insurance; automobile medical-payment insurance or any insurance under which benefits are payable without regard to fault; whether written on a group blanket or individual basis; or
(5)
Any plan exempt from regulation under this title due to the Employee Retirement Income Security Act of 1974 (ERISA) (
29 U.S.C. § 1144
).
Acts 2010, ch. 980, § 4.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 61 - TENNESSEE HEALTH CARRIER GRIEVANCE AND EXTERNAL REVIEW PROCEDURE ACT (§§ 56-61-101 — 56-61-125) › Section 56-61-104 - No limitations or restrictions on denying coverage of services not medically necessary

Nothing in this chapter shall limit or restrict the health carrier from denying coverage on the grounds that the services are determined not to be medically necessary.
Acts 2010, ch. 980, § 5.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 61 - TENNESSEE HEALTH CARRIER GRIEVANCE AND EXTERNAL REVIEW PROCEDURE ACT (§§ 56-61-101 — 56-61-125) › Section 56-61-105 - Maintenance of register of written records to document grievances

(a)
A health carrier shall maintain written records to document all grievances received during a calendar year. The register shall be maintained in a manner that is reasonably clear and accessible to the commissioner.
(b)
A request for a first level review of a grievance involving an adverse determination shall be processed in compliance with §
56-61-107
and is required to be included in the health carrier's register.
(c)
A request for a second level review of a grievance involving an adverse determination that may be conducted pursuant to §
56-61-108
shall be included in the health carrier's register.
(d)
For each grievance, the register shall contain, at a minimum, the following information:
(1)
A general description of the reason for the grievance;
(2)
The date the grievance was received;
(3)
The date of each review or, if applicable, review meeting;
(4)
The resolution at each level of the grievance, if applicable;
(5)
The date of resolution at each level, if applicable; and
(6)
The name of the aggrieved person for whom the grievance was filed.
(e)
(1)
A health carrier shall retain the register compiled for a calendar year for the shorter of five (5) years or until the commissioner has adopted a final report of an examination that contains a review of the register for such calendar year.
(2)
(A)
A health carrier shall submit to the commissioner, at least annually, a report in the format specified by the commissioner.
(B)
The report shall include for each type of health benefit plan offered by the health carrier:
(i)
The number of covered lives that fall under this chapter's protections;
(ii)
The total number of grievances;
(iii)
The number of grievances for which a covered person and healthcare provider requested a second level voluntary grievance review pursuant to §
56-61-108
;
(iv)
The number of grievances resolved at each level, if applicable, and their resolution; and
(v)
A synopsis of actions being taken to correct problems identified.
Acts 2010, ch. 980, § 6.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 61 - TENNESSEE HEALTH CARRIER GRIEVANCE AND EXTERNAL REVIEW PROCEDURE ACT (§§ 56-61-101 — 56-61-125) › Section 56-61-106 - Written procedures for grievances

(a)
Except as specified in §
56-61-109
, a health carrier shall use written procedures for receiving and resolving grievances from aggrieved persons, as provided in §§
56-61-107
and
56-61-108
, unless otherwise provided by this chapter.
(b)
A health carrier shall file with the commissioner a copy of the procedures required under subsection (a), including all forms used to process requests made pursuant to §§
56-61-107
and
56-61-108
. Any subsequent material modifications to the documents also shall be filed.
(c)
A description of the grievance procedures required under this section shall be set forth in or attached to the membership booklet, provider manual, and health carrier's web site. The health carrier may include a description of the grievance procedures in the policy, certificate, outline of coverage or other evidence of coverage provided to aggrieved persons.
Acts 2010, ch. 980, § 7.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 61 - TENNESSEE HEALTH CARRIER GRIEVANCE AND EXTERNAL REVIEW PROCEDURE ACT (§§ 56-61-101 — 56-61-125) › Section 56-61-110 - Rules and regulations

The commissioner may, after notice and hearing, promulgate reasonable rules and regulations to carry out this chapter. Such rules and regulations shall be subject to review in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
Acts 2010, ch. 980, § 11.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 61 - TENNESSEE HEALTH CARRIER GRIEVANCE AND EXTERNAL REVIEW PROCEDURE ACT (§§ 56-61-101 — 56-61-125) › Section 56-61-111 - Penalties for violations

A person that violates this chapter shall be subject to the penalties set forth in §
56-2-305
.
Acts 2010, ch. 980, § 12.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 61 - TENNESSEE HEALTH CARRIER GRIEVANCE AND EXTERNAL REVIEW PROCEDURE ACT (§§ 56-61-101 — 56-61-125) › Section 56-61-112 - Elections for conducting external review program

(a)
For purposes of this section, "approved entity" means:
(1)
The utilization review accreditation commission (URAC); or
(2)
Other nationally recognized private accrediting entity employing standards for the accreditation of external review programs that the commissioner deems are substantially equivalent to the standards for conducting an external review pursuant to §§
56-61-113
- 56-61-118.
(b)
A health carrier may elect, in writing to the commissioner, to conduct its external review program in accordance with:
(1)
Sections
56-61-113
- 56-61-118, or
(2)
The external review program of an approved entity; provided, that the health carrier receives and maintains accreditation from the approved entity. Sections
56-61-120
and
56-61-121
shall not apply to a health carrier that receives and maintains accreditation from the approved entity.
(c)
The commissioner may evaluate the external review procedures of an approved entity. If after a hearing is conducted in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, the commissioner finds that an approved entity has amended its external review procedures to the extent that such procedures are no longer consistent with the purposes of this chapter, the commissioner shall issue a written order specifying in what respects those procedures are inconsistent.
(d)
A health carrier that has elected to conduct its external review program in accordance with the standards of an approved entity, that is the subject of the commissioner's order issued pursuant to subsection (c), shall have sixty (60) days from the effective date of the commissioner's order to:
(1)
Elect, in writing, to utilize another external review program under subsection (b); or
(2)
Demonstrate to the commissioner's satisfaction that the approved entity has subsequently amended its procedures so that such procedures are consistent with the purposes of this chapter.
Acts 2010, ch. 980, § 13.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 61 - TENNESSEE HEALTH CARRIER GRIEVANCE AND EXTERNAL REVIEW PROCEDURE ACT (§§ 56-61-101 — 56-61-125) › Section 56-61-114 - Request for external review

(a)
Except for a request for an expedited external review as set forth in §
56-61-117
or §
56-61-118(n)
, all requests for external review shall be made in writing to the health carrier.
(b)
Unless otherwise set forth by this chapter, an aggrieved person may file a request for external review after the receipt of a final adverse determination.
Acts 2010, ch. 980, § 15.