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Session Laws, 1963
Volume 671, Page 1209   View pdf image (33K)
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J. MILLARD TAWES, Governor                     1211

(1)   A provision that, in the absence of fraud, all statements made
by applicants or the policyholder or by an insured person shall be
deemed representations and not warranties, and that no statement
made for the purpose of effecting insurance shall avoid such insur-
ance or reduce benefits unless contained in a written instrument
signed by the policyholder or the insured person, a copy of which
has been furnished to such policyholder or to such person or his
beneficiary.

(2)   A provision that the insurer will furnish to the policyholder
for delivery to each employee or member of the insured group, a
statement in summary form of the essential features of the insur-
ance coverage of such employee or member and to whom benefits
thereunder are payable. If dependents are included in the coverage,
only one statement need be issued for each family unit.

(3)   A provision that to the group originally insured may be
added from time to time eligible new employees or members or
dependents, as the case may be, in accordance with the terms of
the policy.

473.    Direct Payment of Hospital, Medical Services.

Any group health policy may on request by the group policyholder
provide that all or any portion of any indemnities provided by any
such policy on account of hospital, nursing, medical or surgical serv-
ices may, at the insurer's option, be paid directly to the hospital or
person rendering such services; out the policy may not require that
the service be rendered by a particular hospital or person. Payment
so made shall discharge the insurer's obligation with respect to the
amount of insurance so paid.

474.    Blanket Health Insurance Defined.

Blanket health insurance is hereby declared to be that form of
health insurance covering groups of persons as enumerated in one
of the following subdivisions:

(1)   Under a policy or contract issued to any common carrier or
to any operator, owner or lessee of a means of transportation, who
or which shall be deemed the policyholder, covering a group defined
as all persons or all persons of a class who may become passengers
on such common carrier or such means of transportation.

(2)   Under a policy or contract issued to an employer, who shall
be deemed the policyholder, covering all employees, dependents or
guests, defined by reference to specified hazards incident to the activi-
ties or operations of the employer or any class of employees, de-
pendents or guests similarly defined.

(3)   Under a policy or contract issued to a school, or other insti-
tution of learning, camp or sponsor thereof; or to the head or princi-
pal thereof, who or which shall be deemed the policyholder, covering
students or campers. Supervisors and employees may be included.

(4)  Under a policy or contract issued in the name of any religious,
charitable, recreational, educational, or civic organization, which
shall be deemed the policyholder, covering participants in activities
sponsored by the organization.

(5)   Under a policy or contract issued to a sports team or sponsors

 

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Session Laws, 1963
Volume 671, Page 1209   View pdf image (33K)
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