- (a) A policy providing coverage for fractures or dislocations shall not provide benefits only for “full or complete” fractures or dislocations.
- (b) Benefits shall not be assignable to a health care provider but shall be paid directly to the insured. The policy and certificate shall contain a provision prohibiting assignment of the benefit to a health care provider.
- (c) Pre-existing condition exclusions shall be prohibited.
- (d) Coordination of benefits shall be prohibited.
- (e) Managed care and network requirements shall be prohibited. The policy shall not include a provision requiring pre-certification.
- (f) Coverage for sickness, illness, or wellness shall be prohibited.
- (g) Specific dismemberment benefits shall not be in lieu of other benefits unless the specific benefit equals or exceeds the other benefits.
- (h) Loss of time benefits, if provided, shall not require the loss to commence less than 30 days after the date of accident nor shall any policy that the insurer cancels or refuses to renew require that it be in force at the time the disability commences, if the accident occurred while the coverage was in force.
Source. (See Revision Note #3 at chapter heading for Ins 6200) #12855, eff 8-26-19; ss by #13137, eff 11-24-20