SB 51 - Insurance - policy cancel- lation, penalties

Georgia Senate - 1995/1996 Sessions

SB 51 - Insurance - policy cancel- lation, penalties

Page Numbers - 1/ 2/ 3/ 4/ 5/ 6/ 7/ 8
Code Sections - 33-29-3.3/ 33-30-4.4
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1. Langford  29th         2. Madden  47th

Senate Comm: I&L / House Comm: Ins / Senate Vote: Yeas 51 Nays 3 --------------------------------------------- Senate Action House --------------------------------------------- 1/11/95 Read 1st time 1/31/95 1/26/95 Favorably Reported 2/8/95 Am Committee Amend/Sub 1/27/95 Read 2nd Time 2/1/95 1/30/95 Read 3rd Time 3/8/95 1/30/95 Passed/Adopted 3/8/95 CAs Comm/Floor Amend/Sub FS/FA 3/9/95 Amend/Sub Agreed To 3/24/95 Sent To Governor 4/20/95 Signed by Governor 449 Act/Veto Number --------------------------------------------- Code Sections amended: 33-24-1, 33-24-44, 33-24-46
SB 51 SB51/AP SENATE BILL 51 By: Senators Langford of the 29th and Madden of the 47th A BILL TO BE ENTITLED AN ACT 1- 1 To amend Title 33 of the Official Code of Georgia Annotated, 1- 2 relating to insurance generally, so as to provide that the 1- 3 term "adjuster" does not include a salaried employee of an 1- 4 insurer who adjusts claims; to provide that a regular 1- 5 salaried officer or employee of an insurer or of an agent or 1- 6 subagent who performs only clerical or administrative 1- 7 services in connection with any insurance transaction and 1- 8 who is not involved in soliciting insurance or signing or 1- 9 countersigning contracts shall not be considered an agent, 1-10 subagent, counselor, or adjuster; to revise the definition 1-11 of premium; to authorize the charging of a penalty on the 1-12 refund of unearned premium with regard to the cancellation 1-13 of policies under certain conditions; to clarify what shall 1-14 be considered a nonrenewal with regard to certain property 1-15 insurance policies; to provide that individual accident and 1-16 sickness insurance policies and group or blanket accident 1-17 and sickness insurance policies shall be required to provide 1-18 basic coverage for child wellness services for any insured 1-19 child from birth through the age of five years; to authorize 1-20 the Commissioner of Insurance to define child wellness 1-21 services by regulation; to authorize certain limitations in 1-22 such coverage; to provide that such coverage shall not be 1-23 subject to deductibles; to provide for construction; to 1-24 provide for applicability; to provide for information 1-25 concerning the cost of such coverage to be supplied to the 1-26 members of the General Assembly; to provide that when a 1-27 check or money order issued in payment of certain types of 1-28 motor vehicle insurance policies is dishonored, the coverage 1-29 may be cancelled as provided in Code Section 33-24-44; to 1-30 provide that acceptance of an instrument which is so 1-31 dishonored shall constitute compliance with prepayment 1-32 requirements; to provide for matters relative to the 1-33 foregoing; to provide effective dates; to repeal conflicting 1-34 laws; and for other purposes. 1-35 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA: S. B. 51 -1- (Index) SB 51/AP SECTION 1. 2- 1 Title 33 of the Official Code of Georgia Annotated, relating 2- 2 to insurance, is amended by striking paragraph (1) of 2- 3 subsection (a) of Code Section 33-23-1, relating to 2- 4 definitions of terms applicable to licensing of insurance 2- 5 agents, subagents, counselors, and adjusters, and inserting 2- 6 in lieu thereof a new paragraph (1) of subsection (a) to 2- 7 read as follows: 2- 8 "(1) 'Adjuster' means any person who for a fee, 2- 9 commission, salary, or other compensation investigates, 2-10 settles, or adjusts and reports to his or her employer 2-11 or principal with respect to claims arising under 2-12 insurance contracts on behalf of the insurer or the 2-13 insured or a person who directly supervises or manages 2-14 such person. The term 'adjuster' does not include: 2-15 (A) Persons who adjust claims arising under contracts 2-16 of life or marine insurance or annuities; or 2-17 (B) An agent or a salaried employee of an agent or a 2-18 salaried employee of an insurer who adjusts or assists 2-19 in adjusting losses under policies issued by such 2-20 agent or insurer." SECTION 2. 2-21 Said title is further amended by striking in its entirety 2-22 paragraph (1) of subsection (b) of said Code section and 2-23 inserting in lieu thereof a new paragraph (1) of subsection 2-24 (b) to read as follows: 2-25 "(1) Any regular salaried officer or employee of an 2-26 insurer or of an agent or subagent who performs only 2-27 clerical or administrative services in connection with 2-28 any insurance transaction so long as such person is not 2-29 involved in soliciting insurance, or signing or 2-30 countersigning contracts, or receiving premiums;". SECTION 3. 2-31 Said title is further amended by striking paragraph (2) of 2-32 Code Section 33-24-1, relating to definitions, and inserting 2-33 in lieu thereof the following: 2-34 "(2) 'Premium' means the consideration for insurance, by 2-35 whatever name called. Any assessment, or any membership, 2-36 policy, survey, inspection, service, or similar fee or 2-37 charge in consideration for an insurance contract is 2-38 deemed part of the premium. The term 'premium' shall S. B. 51 -2- (Index) SB 51/AP 3- 1 not include any amount deposited and held for the 3- 2 account of the insured which is returnable upon 3- 3 cancellation of the insurance contract and upon which no 3- 4 commission has been paid." SECTION 4. 3- 5 Said title is further amended by adding a new subsection (g) 3- 6 to Code Section 33-24-44, relating to cancellation of 3- 7 insurance policies generally, to read as follows: 3- 8 "(g) Any unearned premium which has been paid by the 3- 9 insured may be refunded to the insured on other than a pro 3-10 rata basis if: 3-11 (1) The cancellation results from failure of the insured 3-12 to pay, when due, any premium to the insurer or any 3-13 amount, when due, under a premium finance agreement; 3-14 (2) The policy contains language which specifies that a 3-15 penalty may be charged on unearned premium; and 3-16 (3) The method of computing such penalty is filed with 3-17 the Commissioner in accordance with Chapter 9 of this 3-18 title." SECTION 5. 3-19 Said title is further amended by striking paragraph (1) of 3-20 subsection (b) of Code Section 33-24-46, relating to the 3-21 cancellation or nonrenewal of certain property insurance 3-22 policies, and inserting in lieu thereof a new paragraph (1) 3-23 to read as follows: 3-24 "(1) 'Nonrenewal' or 'nonrenewed' means a refusal by a 3-25 insurer or an affiliate of an insurer to renew. Failure 3-26 of an insured to pay the premium as required of the 3-27 insured for renewal after the insurer has manifested a 3-28 willingness to renew by delivering a renewal policy, 3-29 renewal certificate, or other evidence of renewal to the 3-30 named insured or his or her representative or has 3-31 offered to issue a renewal policy, certificate, or other 3-32 evidence of renewal or has manifested such intention by 3-33 any other means shall not be construed to be a 3-34 nonrenewal." SECTION 6. 3-35 Said title is further amended by adding immediately 3-36 following Code Section 33-29-3.2, relating to coverage for 3-37 mammograms, Pap smears, and prostate specific antigen tests S. B. 51 -3- (Index) SB 51/AP 4- 1 in individual policies of accident and sickness insurance, a 4- 2 new Code Section 33-29-3.3 to read as follows: 4- 3 "33-29-3.3. (Index) 4- 4 (a) As used in this Code section, the term: 4- 5 (1) 'Child wellness services' means the periodic review 4- 6 of a child's physical and emotional status conducted by 4- 7 a physician or conducted pursuant to a physician's 4- 8 supervision, but shall not include periodic dental 4- 9 examinations or other dental services. The review shall 4-10 include a medical history, complete physical 4-11 examination, developmental assessment, appropriate 4-12 immunizations, anticipatory guidance for the parent or 4-13 parents, and laboratory testing in keeping with 4-14 prevailing medical standards. 4-15 (2) 'Policy' means any health benefit plan, contract, or 4-16 policy except a disability income policy, specified 4-17 disease policy, or hospital indemnity policy. 4-18 (b) Every insurer authorized to issue an individual 4-19 accident and sickness policy in this state shall include, 4-20 either as a part of or as a required endorsement to each 4-21 such policy issued, delivered, issued for delivery, or 4-22 renewed in this state on or after July 1, 1995, basic 4-23 coverage for child wellness services for an insured child 4-24 from birth through the age of five years. Any such policy 4-25 may provide that the child wellness services which are 4-26 rendered during a periodic review shall only be covered to 4-27 the extent that such services are provided by or under the 4-28 supervision of a single physician during the course of one 4-29 visit. The Commissioner shall define by regulation the 4-30 basic coverage for child wellness services and shall 4-31 consider the current recommendations for preventive 4-32 pediatric health care by the American Academy for 4-33 Pediatrics, prevailing medical standards, and any other 4-34 relevant data or information in the promulgation of such 4-35 regulation. 4-36 (c) The coverage required under subsection (b) of this 4-37 Code section may be subject to exclusions, reductions, or 4-38 other limitations as to coverages or coinsurance 4-39 provisions as may be approved by the Commissioner, but 4-40 shall not be subject to deductibles. 4-41 (d) Nothing in this Code section shall be construed to 4-42 prohibit the issuance of individual accident and sickness S. B. 51 -4- (Index) SB 51/AP 5- 1 policies which provide benefits greater than those 5- 2 required by subsection (b) of this Code section or more 5- 3 favorable to the insured than those required by subsection 5- 4 (b) of this Code section. 5- 5 (e) The provisions of this Code section shall apply to 5- 6 individual basic or major medical accident and sickness 5- 7 insurance policies issued by a fraternal benefit society, 5- 8 a nonprofit hospital service corporation, a nonprofit 5- 9 medical service corporation, a health care corporation, a 5-10 health maintenance organization, or any similar entity. 5-11 (f) Nothing contained in this Code section shall be deemed 5-12 to prohibit the payment of different levels of benefits or 5-13 from having differences in coinsurance percentages 5-14 applicable to benefit levels for services provided by 5-15 preferred and nonpreferred providers as otherwise 5-16 authorized under the provisions of Article 2 of Chapter 30 5-17 of this title, relating to preferred provider 5-18 arrangements. 5-19 (g) Beginning July 1, 2000, the Commissioner shall conduct 5-20 a review of the cost associated with the coverage required 5-21 by this Code section and shall provide the members of the 5-22 General Assembly with such information not later than 5-23 December 31, 2000." SECTION 7. 5-24 Said title is further amended by adding immediately 5-25 following Code Section 33-30-4.3, relating to utilization of 5-26 mail-order pharmaceutical distributors in policies, plans, 5-27 contracts, or funds, a new Code Section 33-30-4.4 to read as 5-28 follows: 5-29 "33-30-4.4. (Index) 5-30 (a) As used in this Code section, the term: 5-31 (1) 'Child wellness services' means the periodic review 5-32 of a child's physical and emotional status conducted by 5-33 a physician or conducted pursuant to a physician's 5-34 supervision, but shall not include periodic dental 5-35 examinations or other dental services. The review shall 5-36 include a medical history, complete physical 5-37 examination, developmental assessment, appropriate 5-38 immunizations, anticipatory guidance for the parent or 5-39 parents, and laboratory testing in keeping with 5-40 prevailing medical standards. S. B. 51 -5- (Index) SB 51/AP 6- 1 (2) 'Policy' means any health benefit plan, contract, or 6- 2 policy except a disability income policy, specified 6- 3 disease policy, or hospital indemnity policy. 6- 4 (b) Every insurer authorized to issue a group or blanket 6- 5 accident and sickness policy in this state shall include, 6- 6 either as a part of or as a required endorsement to each 6- 7 such policy issued, delivered, issued for delivery, or 6- 8 renewed in this state on or after July 1, 1995, basic 6- 9 coverage for child wellness services for an insured child 6-10 from birth through the age of five years. Any such policy 6-11 may provide that the child wellness services which are 6-12 rendered during a periodic review shall only be covered to 6-13 the extent that such services are provided by or under the 6-14 supervision of a single physician during the course of one 6-15 visit. The Commissioner shall define by regulation the 6-16 basic coverage for child wellness services and shall 6-17 consider the current recommendations for preventive 6-18 pediatric health care by the American Academy for 6-19 Pediatrics, prevailing medical standards, and any other 6-20 relevant data or information in the promulgation of such 6-21 regulation. 6-22 (c) The coverage required under subsection (b) of this 6-23 Code section may be subject to exclusions, reductions, or 6-24 other limitations as to coverages or coinsurance 6-25 provisions as may be approved by the Commissioner, but 6-26 shall not be subject to deductibles. 6-27 (d) Nothing in this Code section shall be construed to 6-28 prohibit the issuance of group or blanket accident and 6-29 sickness policies which provide benefits greater than 6-30 those required by subsection (b) of this Code section or 6-31 more favorable to the insured than those required by 6-32 subsection (b) of this Code section. 6-33 (e) The provisions of this Code section shall apply to 6-34 group or blanket accident and sickness insurance policies 6-35 issued by a fraternal benefit society, a nonprofit 6-36 hospital service corporation, a nonprofit medical service 6-37 corporation, a health care corporation, a health 6-38 maintenance organization, or any similar entity. 6-39 (f) Nothing contained in this Code section shall be deemed 6-40 to prohibit the payment of different levels of benefits or 6-41 from having differences in coinsurance percentages 6-42 applicable to benefit levels for services provided by 6-43 preferred and nonpreferred providers as otherwise S. B. 51 -6- (Index) SB 51/AP 7- 1 authorized under the provisions of Article 2 of this 7- 2 chapter, relating to preferred provider arrangements. 7- 3 (g) Beginning July 1, 2000, the Commissioner shall conduct 7- 4 a review of the cost associated with the coverage required 7- 5 by this Code section and shall provide the members of the 7- 6 General Assembly with such information not later than 7- 7 December 31, 2000." SECTION 8. 7- 8 Said title is further amended by striking paragraph (4) of 7- 9 subsection (a) of Code Section 33-34-3, relating to 7-10 requirements concerning issuance of motor vehicle insurance 7-11 policies, and inserting in its place a new paragraph (4) of 7-12 subsection (a) to read as follows: 7-13 "(4)(A) No insurer shall issue a policy of motor 7-14 vehicle liability insurance without requiring advance 7-15 payment for the first 60 days of coverage. Insurers 7-16 may rely on the insured's statements in the policy 7-17 application for the purpose of calculating the initial 7-18 payment required by this paragraph. This paragraph 7-19 shall not apply to any renewal or continuation of a 7-20 policy, to any replacement of a policy where there is 7-21 no lapse of coverage, or to any personal automobile 7-22 policy issued in connection with an employer-sponsored 7-23 payroll deduction plan. This paragraph shall apply 7-24 only to personal automobile or family-type automobile 7-25 liability insurance policies. 7-26 (B) If an insurer, agent, or premium finance company 7-27 collects such advance payment in the form of a check 7-28 or money order which is not honored upon initial 7-29 presentation, such insurer, agent, or premium finance 7-30 company shall be deemed to have complied with 7-31 subparagraph (A) of this paragraph and may, 7-32 thereafter, cancel for nonpayment of premium as 7-33 provided in Code Section 33-24-44." SECTION 9. 7-34 (a) Except as provided in subsection (b) of this section, 7-35 this Act shall become effective upon its approval by the 7-36 Governor or upon its becoming law without such approval. 7-37 (b) Sections 1, 3, 4, 5, 6, 7, and 8 of this Act shall 7-38 become effective on July 1, 1995. S. B. 51 -7- (Index) SB 51/AP SECTION 10. 8- 1 All laws and parts of laws in conflict with this Act are 8- 2 repealed. S. B. 51 -8- (Index)

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