California

Insurance Code

4,514 sections, each with the official text and a plain-English explanation of what it means for you.

• § 10199.46 — (a) On or after January 1, 1994, every nonprofit hospital service plan issued, amended, or renewed that covers hospital, medical, or surgical expenses on a group basis shall notify the group contracth
• § 10199.48 — (a) No health insurer shall, with regard to a group contract, change the premium rates or applicable copayments or coinsurances or deductibles for the length of the contract, except as specified in su
• § 10199.49 — (a) This section shall apply to grandfathered health insurance policies and nongrandfathered health insurance policies in the individual or small group markets that are issued, amended, or renewed on
• § 10199.5 — The commissioner may, as conditions warrant, pursuant to Chapter 3.
• § 10199.6 — (a) The commissioner shall have the administrative authority to assess penalties against insurers, nonprofit hospital service plans, administrators, and insurance producers, and other entities engaged
• § 10199.7 — (a) Any production agent, administrator, or other person or entity engaged in the business of insurance, other than an insurer, who violates this chapter is liable for administrative penalties of not
• § 10199.8 — In addition to any other penalty provided by law or the availability of any administrative procedure, if an insurer, after notice and hearing, is found to have violated this chapter, or regulations ad
• § 10199.9 — This chapter applies to all master group policies and master group nonprofit hospital service plan contracts providing hospital, medical, or surgical benefits, regardless of policy or contract situs,
• § 102 — Fire insurance includes: (a) Insurance against loss by fire, lightning, windstorm, tornado, or earthquake.
• § 1020 — Upon the issuance of an order either under Section 1011 or 1016, or at any time thereafter, the court shall issue such other injunctions or orders as may be deemed necessary to prevent any or all of t
• § 10200 — Any life insurer may issue life, disability, term, and endowment insurance on the group plan, with or without annuities, and with premium rates less than the usual rates for such insurance.
• § 10200.2 — An insurer may, in the discretion of the contracting parties, enter into a contract with a group policyholder or other contracting entity under any group, selected group, or franchise policy issued by
• § 10200.5 — The term “franchise” or “wholesale” insurance shall mean a life insurance plan under which a number of individual life insurance policies are issued at special rates to a selected group.
• § 10201 — The only forms of group life insurance are those set forth in this chapter.
• § 10202 — Life insurance conforming to all the following conditions is one form of group life insurance: (a) Written under a policy covering when issued not less than two public or private employees.
• § 10202.5 — (a) The term “employees” as used in Section 10202 may include the officers, managers, and employees of subsidiary or affiliated corporations, and the individual proprietors, partners, and employees of
• § 10202.8 — A group life policy conforming to all the following conditions may be issued to the trustees of a fund established by employer members of a trade association, or by a trade association maintained by c
• § 10202.81 — The State and any political subdivisions thereof and any municipality, may provide for the type of insurance set forth in Section 10202.
• § 10202.82 — The term “employees” as used in subdivision (a) of Section 10202.
• § 10202.85 — A policy conforming to Section 10202.
• § 10203 — Life insurance conforming to all of the following conditions is another form of group life insurance: (a) Written under a policy covering, when issued, not less than 25 members of any of the following
• § 10203.1 — Life insurance conforming to all the following conditions is another form of group life insurance: (a) Written under a policy covering, when issued, not less than 25 employees of the Trustees of the C
• § 10203.10 — (a) Life insurance conforming to all of the following conditions is another form of group life insurance: (1) Written under a policy issued and delivered in connection with the payment of benefits aga
• § 10203.2 — Life insurance conforming to all the following conditions is another form of group life insurance: (a) Written under a policy covering, when issued, not less than 25 employees in eligible classes or p
• § 10203.4 — (a) Insurance under a group life insurance policy issued pursuant to Sections 10202, 10202.
• § 10203.5 — (a) Life insurance conforming to all the following conditions is another form of group life insurance: (1) Covering one of the following groups: (A) All members are or become borrowers from one financ
• § 10203.55 — An agricultural or horticultural loan commitment as used in Section 10203.
• § 10203.7 — Life insurance conforming to all the following conditions is another form of group life insurance: (a) Written under a policy covering when issued, not less than 10 agents.
• § 10203.8 — Life insurance conforming to all of the following conditions is another form of group life insurance: (a) Covering the lives of every eligible member of a group of persons who become or are named depo
• § 10203.9 — In addition to the other specific circumstances under which a group life policy may be issued under this chapter a group life policy may be issued to an existing insured to replace an existing valid g
• § 10204 — For the purpose of this chapter, the term “employer” includes the association or union designated by Section 10203, and the institution, vendor, credit union, or creditor designated by Sections 10203.
• § 10204.5 — (a) In addition to the issuance of group life insurance to groups in this state as permitted elsewhere in this chapter, the commissioner may approve the issuance of group life insurance if the insurer
• § 10205 — A policy of group life insurance shall not be issued or delivered in this State nor, except as otherwise provided in Section 10205.
• § 10205.5 — An insurer is permitted to provide group life coverage prior to the approval of the form of the policy if all of the conditions of (a) are met prior thereto and if thereafter it acts as required by (b
• § 10205.6 — The commissioner may suspend or revoke the permission granted any insurer in Section 10205.
• § 10206 — (a) The policy shall provide that the validity of the policy shall not be contested, except for nonpayment of premiums, after it has been in force for two years from its date of issue; and that no sta
• § 10206.5 — The policy may provide that the insurer is not liable, or is liable only in a reduced amount, for losses arising from conditions: (a) Relating to war or act of war; (b) Relating to military or naval s
• § 10207 — The policy shall contain a provision that: (a) The policy, the application of the employer and the individual applications, if any, of the employees constitute the entire contract of insurance.
• § 10208 — The policy shall contain a provision for the equitable adjustment of the premium or the amount of insurance payable in the event of a misstatement of the age of an employee.
• § 10209 — (a) Except as provided by Sections 10203.
• § 10209.1 — An individual certificate shall be individualized, except that in the case of an individual certificate issued under a group policy which requires no regular contribution toward the payment of the pre
• § 10209.3 — (a) Subject to the terms of the policy, or pursuant to an agreement between the insured, the group policyholder, and the insurer, any person insured under a group life insurance policy may make to any
• § 1021 — (a) Upon the making of an order to liquidate the business of such person, the commissioner shall publish notice to its policyholders, creditors, shareholders, and all other persons interested in its a
• § 10210 — The policy shall contain a provision that to the groups or classes originally insured there will be added from time to time all new employees of the employer eligible for insurance in such groups or c
• § 10210.5 — Whenever any provision of this chapter requires the payment of a premium by any person, such requirement relates to the responsibility for the payment of the premium and not to the transmission or col
• § 10211 — Policies of group life insurance may conform to the following conditions, any other provisions of this chapter notwithstanding: (a) When issued in this State by any foreign insurer, they may contain a
• § 10212 — Except as provided in this chapter, in every group policy issued by a domestic life insurer, the employer is the policyholder for all purposes within the meaning of this code.
• § 10214 — If hereafter any dividend is paid or any premium refunded under any policy of group life insurance heretofore or hereafter issued, the excess, if any, of the aggregate dividends or premium refunds und
• § 1022 — The notice shall be published in newspapers of general circulation in geographic areas pertinent to the liquidation.
• § 10220 — Any life insurer may issue policies of blanket life insurance for a term not exceeding one year with premium rates less than the usual rates for such insurance.
• § 10221 — The only forms of blanket life insurance are those set forth in this chapter.
• § 10222 — Life insurance conforming to all the following conditions is one form of blanket life insurance: (a) Written under a policy issued to a newspaper, farm paper, magazine, or other periodical publication
• § 10223 — A blanket life insurance policy may provide that the insurer is not liable, or is liable only in a reduced amount, for losses arising from conditions: (a) Relating to war or acts of war; (b) Relating
• § 10224 — Policies of blanket life insurance may conform to the following conditions, any other provisions of this chapter notwithstanding: (a) When issued in this State by any foreign insurer, such policies ma
• § 10225 — A policy of blanket insurance shall not be delivered or issued for delivery in this State until a copy of the form of the policy is filed with and approved by the commissioner.
• § 1023 — A claim must set forth, under oath, on the form prescribed by the commissioner: (a) The particulars thereof, and the consideration therefor.
• § 10231 — Unless the context requires otherwise, the definitions in this article shall govern the construction of this chapter.
• § 10231.2 — “Long-term care insurance” includes any insurance policy, certificate, or rider advertised, marketed, offered, solicited, or designed to provide coverage for diagnostic, preventive, therapeutic, rehab
• § 10231.3 — (a) For the purposes of this section, the following definitions apply: (1) An “alternate plan of care” means a plan of care that includes a specification of long-term care services, providers, or plac
• § 10231.4 — “Applicant” means either of the following: (a) In the case of an individual long-term care insurance policy, the person who seeks to contract for benefits.
• § 10231.5 — “Certificate” means any certificate issued under a group long-term care insurance policy, which policy has been delivered or issued for delivery in this state.
• § 10231.6 — “Group long-term care insurance” means a long-term care insurance policy which is delivered or issued for delivery in this state and issued to any of the following: (a) One or more employers or labor
• § 10231.8 — “Policy” means any policy, contract, subscriber agreement, rider or endorsement delivered or issued for delivery in this state by an insurer, fraternal benefit society, nonprofit hospital service plan
• § 10232 — (a) No group long-term care insurance coverage may be offered or sold to a resident of this state under a group policy issued in another state to a group described in subdivision (d) of Section 10231.
• § 10232.1 — (a) Every policy that is intended to be a qualified long-term care insurance contract as provided by Public Law 104-191 shall be identified as such by prominently displaying and printing on page one o
• § 10232.2 — (a) Every insurer that offers policies or certificates that are intended to be federally qualified long-term care insurance contracts, including riders to life insurance policies providing long-term c
• § 10232.3 — (a) All applications for long-term care insurance except that which is guaranteed issue, shall contain clear, unambiguous, short, simple questions designed to ascertain the health condition of the app
• § 10232.4 — (a) No long-term care insurance policy or certificate other than a group policy or certificate, as described in subdivision (a) of Section 10231.
• § 10232.5 — On or after January 1, 1990, no long-term care insurance policy may be delivered or issued for delivery in this state which does any of the following: (a) Preconditions the availability of benefits on
• § 10232.6 — The commissioner may adopt regulations establishing loss ratio standards for long-term care insurance policies provided that a specific reference to long-term care insurance policies is contained in t
• § 10232.65 — In addition to any other requirements of law, the following shall apply to a long-term care insurance policy: (a) The insurer shall not require an amount greater than one month’s premium to be submitt
• § 10232.7 — (a) An applicant for a long-term care insurance policy or a certificate, other than an applicant for a certificate issued under a group long-term care insurance policy issued to a group as described i
• § 10232.8 — (a) In every long-term care policy or certificate that is not intended to be a federally qualified long-term care insurance contract and provides home care benefits, the threshold establishing eligibi
• § 10232.81 — Every long-term care policy, certificate, or rider that purports to provide benefits of home care, community-based services, and residential care facility services under the California Partnership for
• § 10232.9 — (a) Every long-term care policy or certificate that purports to provide benefits of home care or community-based services, shall provide at least the following: (1) Home health care.
• § 10232.92 — Every long-term care policy or certificate covering confinement in a nursing facility shall also include a provision with the following features: (a) Care in a residential care facility must be covere
• § 10232.93 — Every long-term care policy or certificate shall define the maximum lifetime benefit as a single dollar amount that may be used interchangeably for any home- and community-based services defined in Se
• § 10232.95 — Every long-term care policy or certificate that provides reimbursement for care in a nursing facility shall cover and reimburse for per diem expenses, as well as the costs of ancillary supplies and se
• § 10232.96 — When a policy or certificate holder of an insurance contract issued prior to December 31, 1996, requests a material modification to the contract as defined by federal law or regulations, the insurer,
• § 10232.97 — In every long-term care policy or certificate that covers care in a nursing facility, the threshold establishing eligibility for nursing facility care shall be no more restrictive than a provision tha
• § 10233 — Precedent to the payment of benefits for any care covered by the terms of the policy, any insurer offering long-term care insurance as described in Section 10231.
• § 10233.2 — Long-term care insurance may not: (a) Be canceled, nonrenewed, or otherwise terminated on the grounds of the age or the deterioration of the mental or physical health of the insured individual or cert
• § 10233.25 — No long-term care policy or certificate that is issued, amended, renewed, or delivered on and after January 1, 2002, shall contain a provision that prohibits or restricts any health facilities’ compli
• § 10233.3 — If a policy or certificate replaces another long-term care policy or certificate, the replacing insurer shall waive any time periods applicable to preexisting conditions and probationary periods to th
• § 10233.4 — No long-term care insurance benefits may be reduced because of out-of-pocket expenditures by the insured or on behalf of the insured by a family member of the insured or by any other individual.
• § 10233.5 — (a) An outline of coverage shall be delivered to a prospective applicant for long-term care insurance at the time of initial solicitation through means which prominently direct the attention of the re
• § 10233.6 — A certificate issued pursuant to a group long-term care insurance policy, which policy is delivered or issued for delivery in this state, shall include all of the following: (a) A description of the p
• § 10233.7 — No policy may be advertised, marketed, or offered as long-term care or nursing home insurance unless it complies with this chapter.
• § 10233.8 — (a) A long-term care insurance policy or certificate issued, amended, renewed, or delivered on or after January 1, 2020, shall not do any of the following based solely and without any additional actua
• § 10234 — The commissioner shall, as required by this chapter, or from time to time as conditions warrant, pursuant to Chapter 3.
• § 10234.2 — (a) In addition to all other powers and remedies vested in the commissioner by law, the commissioner shall have administrative authority to assess the penalties prescribed in this article for violatio
• § 10234.3 — (a) Any broker, agent, or other entity determined by the commissioner to engage in the business of insurance, other than an insurer, who violates this chapter is liable for an administrative penalty o
• § 10234.4 — In addition to the assessment of penalties and other applicable remedies, the commissioner may take the following actions upon determination that a violation of this chapter, or a regulation adopted p
• § 10234.5 — (a) Any broker, agent, insurer, or other entity within the jurisdiction of the department who is charged with a violation of this chapter shall be afforded due process through proper notice and public
• § 10234.6 — (a) The commissioner shall, by June 1 of each year, jointly design the format and content of a consumer rate guide for long-term care insurance with a working group that includes representatives of th
• § 10234.7 — The commissioner’s annual report to the Legislature, as required by Section 10234.
• § 10234.8 — (a) With regard to long-term care insurance, all insurers, brokers, agents, and others engaged in the business of insurance owe a policyholder or a prospective policyholder a duty of honesty, and a du
• § 10234.85 — No insurer, broker, agent, or other person shall cause a policyholder to replace a long term care insurance policy unnecessarily.
• § 10234.86 — (a) Every insurer shall maintain records for each agent of that agent’s amount of replacement sales as a percent of the agent’s total annual sales and the amount of lapses of long-term care insurance
• § 10234.87 — (a) If an insurer replaces a policy or certificate that it has previously issued, the insurer shall recognize past insured status by granting premium credits toward the premiums for the replacement po
• § 10234.9 — (a) Every insurer providing long-term care coverage in California shall provide a copy of any advertisement intended for use in California to the commissioner for review at least 30 days before dissem
• § 10234.93 — (a) Every insurer of long-term care in California shall: (1) Establish marketing procedures to ensure that any comparison of policies by its agents or other producers will be fair and accurate.
• § 10234.95 — (a) Every insurer or other entity marketing long-term care insurance shall: (1) Develop and use suitability standards to determine whether the purchase or replacement of long-term care insurance is ap
• § 10234.97 — (a) Any time long-term care coverage is replaced, the sales commission that is paid by the insurer and that represents the percentage of the sale normally paid for first year sales of long-term care p
• § 10235 — Except as provided in Section 10235.
• § 10235.10 — Termination of long-term care insurance shall be without prejudice to any benefits payable for institutionalization if that institutionalization began while the long-term care insurance was in force a
• § 10235.14 — (a) Individual long-term care insurance policies shall contain a renewability provision.
• § 10235.16 — (a) Long-term care insurance application forms shall include a question designed to elicit information as to whether the proposed insurance is intended to replace any other accident and sickness or lo
• § 10235.17 — For purposes of this chapter, the commissioner shall define inappropriate replacement of long-term care insurance in consultation with other interested parties.
• § 10235.18 — (a) Insurers using direct response solicitation methods shall deliver a notice regarding replacement of accident and sickness or long-term care coverage to the applicant upon issuance of the policy or
• § 10235.2 — No long-term care insurance policy delivered or issued for delivery in this state shall use the terms set forth below, unless the terms are defined in the policy and the definitions satisfy the follow
• § 10235.20 — The commissioner may waive a specific provision or provisions of this article with respect to a specific long-term care insurance policy or certificate upon making written findings specified in subdiv
• § 10235.30 — (a) No insurer may deliver or issue for delivery a long-term care policy in this state unless the insurer offers at the time of application an option to purchase a shortened benefit period nonforfeitu
• § 10235.35 — (a) Notwithstanding any other law, the commissioner may require the administration by an insurer of the contingent benefit upon lapse, as described in Section 28 (A), (D) (3), (E), (F), (G), and (J) o
• § 10235.36 — (a) When a shortened benefit period nonforfeiture benefit, as described in Section 10235.
• § 10235.40 — (a) An individual long-term care policy or certificate shall not be issued until the applicant has been given the right to designate at least one individual, in addition to the applicant, to receive n
• § 10235.45 — (a) If a life insurance policy contains long-term care benefits and permits policy loans or cash withdrawals, then access to those loans or withdrawals shall not be prohibited or limited due to the pa
• § 10235.50 — (a) A policy or certificate shall include a provision that gives the policyholder or certificate holder the right, exercisable any time after the first year, to retain the policy or certificate while
• § 10235.51 — (a) Every policy or certificate shall include a provision that gives the insured the option to elect, no less frequently than on each anniversary date after the policy or certificate is issued, to pay
• § 10235.52 — (a) Each policy shall contain a provision that, if the insurer develops new benefits or benefit eligibility or new policies with new benefits or benefit eligibility not included in the previously issu
• § 10235.8 — No policy may be delivered or issued for delivery in this state as long-term care insurance if the policy limits or excludes coverage by type of illness, treatment, medical condition, or accident, exc
• § 10235.9 — (a) Every insurer shall report annually by June 30 the total number of claims denied by each class of business in the state and the number of these claims denied for failure to meet the waiting period
• § 10235.91 — In the event a non-medicaid national or state long-term care program is created through public funding that substantially duplicates benefits covered by the policy or certificate, the policyholder or
• § 10235.94 — Every policy or certificate shall include a provision giving the policyholder or certificate holder the right to appeal decisions regarding benefit eligibility, care plans, services and providers, and
• § 10235.95 — (a) Notwithstanding Section 10235, this section applies to all long-term care policies in force, regardless of their dates of issuance.
• § 10235.9a — For policies or certificates issued on or after January 1, 2017, that contain an alternate plan of care provision pursuant to Section 10231.
• § 10236 — Every individual and group long-term care policy and certificate under a group long-term care policy shall be either guaranteed renewable or noncancelable.
• § 10236.1 — (a) Benefits under individual long-term care insurance policies issued before new premium rate schedules are approved under Section 10236.
• § 10236.11 — The premium rate schedules for all individual and group long-term care insurance policies issued in this state shall be filed with and receive the prior approval of the commissioner before the policy
• § 10236.12 — All actuaries used by the commissioner to review rate applications submitted by insurers pursuant to this chapter who are employees of the department shall be members of the American Academy of Actuar
• § 10236.13 — No insurer may increase the premium for an individual or group long-term care insurance policy or certificate approved for sale under this chapter unless the insurer has received prior approval for th
• § 10236.14 — Approval of all premium rate schedule increases shall be subject to the following requirements: (a) (1) Premium rate schedule increases shall demonstrate that the sum of the accumulated value of incur
• § 10236.15 — Premium rate schedule increases that have been approved shall be subject to the following: (a) For each rate increase that is implemented, the insurer shall file for approval by the commissioner updat
• § 10236.2 — Except where the provisions of a group contract provide otherwise, the provisions of subdivisions (d) and (e) of Section 10236.
• § 10236.5 — (a) Every certificate of group insurance issued or delivered in California shall provide for continuation or conversion coverage for the certificate holder if the group coverage terminates for any rea
• § 10236.8 — If a group long-term care policy is replaced by another policy to the same master policyholder issued, the replacing insurer shall do all of the following: (a) Provide benefits identical to the termin
• § 10237 — This article applies to all long-term care insurance policies delivered or issued for delivery in this state on or after January 1, 1991.
• § 10237.1 — No insurer may deliver or issue for delivery a long-term care insurance policy or certificate in this state unless the insurer offers to each policyholder and certificate holder, in addition to any ot
• § 10237.2 — If the policy is issued to a group, the required offering in Section 10237.
• § 10237.3 — The offer in Section 10237.
• § 10237.4 — (a) Inflation protection benefit increases under a policy that contains these benefits shall continue without regard to an insured’s age, claim status or claim history, or the length of time the perso
• § 10237.5 — (a) An inflation protection provision that increases benefit levels annually in a manner so that the increases are compounded annually at a rate not less than 5 percent shall be included in a long-ter
• § 10237.6 — (a) An insurer shall include the following information in or with the outline of coverage: (1) A graphic comparison of the benefit levels of a policy that increases benefits at a compounded annual rat
• § 1024 — Unless such claim is filed in the manner and within the time provided in section 1021, it shall not be entitled to filing or allowance, and no action may be maintained thereon.
• § 10240 — A “funeral insurance contract” is a life policy embodying an agreement, for a valuable consideration, to embalm or dispose of, or expressly to procure or pay or to provide funds for, in whole or in pa
• § 10242 — The provisions of this chapter shall apply to all funeral insurance contracts issued or delivered in this State upon the life of any person in this State and to any insurer issuing or delivering such
• § 10244 — Anything in this code or elsewhere to the contrary notwithstanding, no funeral insurance contract shall be issued or delivered in this State upon the life of any person in this State unless it contain
• § 10246 — All funeral insurance contracts shall be subject in all respects to the provisions of Sections 10150 to 10167 inclusive, and of Sections 10478 to 10489.
• § 10247 — Limited death benefit insurance contracts may be issued and delivered in this state upon the life of any person in this state who makes premium payments over a period of time to purchase a funeral ins
• § 10248 — (a) Except as permitted in Section 10247, no funeral insurance contract issued or delivered in this state upon the life of any person in this state shall contain any provision scaling down or reducing
• § 1025 — Claims founded upon unliquidated or undetermined demands must be filed within the time limit provided in this article for the filing of claims, but claims founded upon such demands shall not share in
• § 1025.5 — Notwithstanding the provisions of Sections 1021 to 1025, inclusive, the commissioner may, in lieu of requiring claimants to file separate claims: (a) File a claim himself or herself on behalf of all c
• § 10250 — No funeral insurance contract shall be issued or delivered in this State except by an admitted insurer issuing policies on a legal reserve basis.
• § 10252 — No person shall sell or offer for sale any such funeral insurance contract in this state unless he or she is licensed as a life agent pursuant to the provisions of Chapter 5 (commencing with Section 1
• § 1026 — Whenever any person has a cause of action against an insured and such cause is covered by a liability policy, such person, if the insurer is adjudged insolvent, may file a claim in the liquidation pro
• § 1026.1 — Where a claim arising out of a policy of insurance has been filed by a third party and approved by the liquidator and such claim has subsequently been paid or satisfied, either wholly or in part, by t
• § 1027 — A claim by a third party founded upon an insurance policy may be allowed by the liquidator without requiring such claim to be reduced to judgment, provided it can be reasonably inferred from the proof
• § 10270 — (a) This chapter shall not apply to workers’ compensation insurance, any policy of liability insurance with or without supplementary coverage, or any policy or contract of reinsurance.
• § 10270.1 — (a) As used in this section: (1) “Institution” means any school, college or other institution of learning or the principal or head thereof.
• § 10270.2 — (a) Blanket insurance is that form of insurance providing coverage for specified circumstances and insuring by description all or nearly all persons within a class of persons defined in a policy issue
• § 10270.2.5 — (a) In addition to the permitted types of blanket insurance issued to entities described in Section 10270.
• § 10270.3 — (a) A blanket disability policy of a type permitted under paragraph (2) or (5) of subdivision (a) of Section 10270.
• § 10270.4 — Any disability insurer may issue policies of group disability insurance and family expense disability insurance as defined in this article but shall not issue any form of policy of group disability in
• § 10270.5 — Group disability insurance is that form of disability insurance which conforms to all of the following conditions: (a) Written under a master policy, issued to any of the following: (1) The federal or
• § 10270.505 — Another permitted form of group disability insurance is that which conforms to all of the following conditions.
• § 10270.507 — Except as provided in Section 10195 with respect to regulation of group Medicare supplemental insurance, and provisions of law regulating group long-term care insurance, no certificate of group disabi
• § 10270.51 — The state and any political subdivisions thereof and any municipality, may provide for the type of insurance set forth in Section 10270.
• § 10270.55 — (a) With respect to a policy issued to a corporation, copartnership or individual employer eligible for group insurance pursuant to Section 10270.
• § 10270.57 — Another form of group disability insurance is that form of disability insurance conforming to the following conditions: (a) Written under a master policy issued to the trustee of any self-employed ind
• § 10270.6 — Every group disability master policy shall contain the following provisions: (a) A provision that the policy, the application of the policyholder, and the individual applications, if any, of the indiv
• § 10270.63 — An individual certificate shall be individualized, except that in the case of an individual certificate under a group policy which requires no regular contribution toward the payment of the premium to
• § 10270.65 — If hereafter any dividend is paid or any premium refunded under any policy of group disability insurance heretofore or hereafter issued, the excess, if any, of the aggregate dividends or premium refun
• § 10270.7 — Family expense disability insurance is that form of disability insurance insuring more than one person and issued to the head of a family or his spouse indemnifying him, or his spouse, or both, agains
• § 10270.8 — Family expense disability policies shall also contain the following provisions: (a) A provision that the policy and the application, if any, of the head of the family shall constitute the entire contr
• § 10270.9 — No group disability policy shall be issued or delivered in this state nor, except as otherwise provided in Sections 10270.
• § 10270.91 — An insurer is permitted to provide group disability coverage prior to the approval of the form of the policy if all of the conditions of (a) are met prior thereto and if thereafter it acts as required
• § 10270.92 — The commissioner may suspend or revoke the permission granted any insurer in Section 10270.
• § 10270.93 — No family expense disability policy shall be issued or delivered in this State unless a copy of the form thereof is filed with the commissioner and approved by him in accordance with Article 2 of this
• § 10270.94 — The commissioner shall promulgate forms of provisions which incorporate in substance the applicable provisions set forth in Articles 4 (commencing with Section 10329), 4a (commencing with Section 1035
• § 10270.95 — Without affecting the applicability or degree of applicability of other sections of this chapter, it is hereby specified that the provisions of Sections 10321, 10325, 10401, of subdivisions (a), (c),
• § 10270.97 — Selected group disability insurance is that form of disability insurance conforming to the following conditions: (a) Written under individual policies (1) Issued to not less than three employees of th
• § 10270.98 — Group disability policies may provide, among other things, that the benefits payable thereunder are subject to reduction if the individual insured has any other coverage (other than individual policie
• § 10270.99 — The term “individual policies or contracts,” as used in the first paragraph of Section 10270.
• § 10271 — (a) Except as set forth in this section and in Sections 10271.
• § 10271.1 — (a) (1) Supplemental benefits that operate to safeguard life insurance contracts against lapse are defined as a waiver of premium benefit or a waiver of monthly deduction benefit, as applicable, in wh
• § 10272 — The term “indemnity,” as used in this chapter means benefits promised.
• § 10273 — The term “noncancelable policy” or “noncancelable and guaranteed renewable policy” as used in this chapter means a policy which the insured has the right to continue in force subject to its terms by t
• § 10273.3 — The term “guaranteed renewable policy” as used in this chapter (commencing with Section 10270) means a policy which the insured has the right to continue in force subject to its terms by the timely pa
• § 10273.4 — All disability insurers writing, issuing, or administering group health benefit plans shall make all of these health benefit plans renewable with respect to the policyholder, contractholder, or employ
• § 10273.5 — No person shall cause or permit to be issued, circulated or used any representation that a policy defined in Section 10273.
• § 10273.6 — All individual health benefit plans shall be renewable with respect to all eligible individuals or dependents at the option of the individual except as follows: (a) (1) Except as otherwise specified i
• § 10273.7 — (a) A policyholder, certificate holder, or other insured who alleges that a policy or coverage has been or will be canceled, rescinded, or not renewed in violation of Section 10713, 10273.
• § 10274 — The term “endorsement” as used in this chapter means any amendment, change, limitation, alteration or restriction of the printed text of a policy by a rider upon a separate piece of paper made a part
• § 10275 — The term “policy of accident and sickness insurance” as used in this chapter includes any policy or contract covering the kind or kinds of insurance described in Section 106.
• § 10276 — Every individual accident and health policy or contract, except single premium nonrenewable policies or contracts, issued for delivery in this state on or after July 1, 1962, by an insurance company,
• § 10277 — (a) A group health insurance policy that provides that coverage of a dependent child of an employee or other member of the covered group shall terminate upon attainment of the limiting age for depende
• § 10278 — (a) An individual health insurance policy that provides that coverage of a dependent child shall terminate upon attainment of the limiting age for dependent children specified in the policy, shall als
• § 10278.1 — (a) An individual health insurance policy issued, amended, or renewed on or after January 1, 2023, that provides dependent coverage shall make dependent coverage available to a parent or stepparent wh
• § 10279 — (a) Every disability insurer that provides group or individual policies of disability, or both, that provides, operates, or contracts for, telephone medical advice services to its insureds shall do al
• § 1028 — A judgment taken by default, or by collusion, against an insured shall not be considered as evidence, in the liquidation proceeding, either of the liability of such insured to such claimant upon such