Ohio Revised Code Search
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Section 3921.36 | False or misleading statements.
... on any insurance contract; (3) Any incomplete comparison of an insurance contract of one society with an insurance contract of another society or insurer for the purpose of inducing the lapse, forfeiture, or surrender of any insurance contract. A comparison of insurance contracts is incomplete if either of the following applies: (a) The comparison does not compare in detail the gross rates, the gross rates less an... |
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Section 3921.37 | Exceptions to chapter.
...ders, societies, or associations; (3) Domestic societies that limit their membership to employees of a particular city or town, designated firm, business house, or corporation that provide for a death benefit of not more than four hundred dollars or disability benefits of not more than three hundred fifty dollars to any person in any one year, or both; (4) Domestic societies or associations of a purely religious, c... |
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Section 3921.38 | Review of superintendent's decisions and findings.
...the proper proceedings in any court of competent jurisdiction in this state. |
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Section 3921.99 | Penalty.
... a civil penalty in the amount of three times the sum received by the violator as compensation or commission, which penalty may be sued for and recovered by any person or society aggrieved for the person's or society's own use and benefit in accordance with the provisions of civil practice. (B) Whoever violates division (B) of section 3921.36 of the Revised Code shall be fined not less than fifty nor more than two h... |
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Section 3923.01 | Policy of sickness and accident insurance defined.
...nce against loss or expense resulting from the sickness of the insured, or from the bodily injury or death of the insured by accident, or both, that is delivered, issued for delivery, renewed, or used in this state on or after the date occurring six months after the effective date of this amendment. |
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Section 3923.011 | Sickness and accident insurance definitions.
... fitted by training, experience, and accomplishment. (B) "Confinement to house" includes the activities of a convalescent not able to be gainfully employed. (C) "Accidental death" means death by accident exclusively and independently of all other causes. |
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Section 3923.02 | Form of policy filed with superintendent.
... the filing of any such form, or at any time after the superintendent has given written approval thereof, the superintendent may, after a hearing of which at least twenty days' written notice has been given to the insurer issuing such form, withdraw approval on any ground stated in this section. Such disapproval shall be effected by written order of the superintendent which shall state the ground for disapproval and ... |
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Section 3923.021 | Approval or disapproval of premium rates.
...nsurer a written approval. (C) At any time after any filing has been approved pursuant to this section, the superintendent may, after a hearing of which at least twenty days' written notice has been given to the insurer that has made such filing and for which such public notice as the superintendent considers appropriate has been given, withdraw approval of such filing after finding that the benefits provided are u... |
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Section 3923.022 | Maximum aggregate administrative expenses.
... long-term care, disability income, one-time-limited-duration policy that is less than twelve months, or other policy that offers only supplemental benefits; or coverage provided to individuals who are not residents of this state. (4) "Individual business" includes both individual sickness and accident insurance and sickness and accident insurance made available by insurers in the individual market to individuals, w... |
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Section 3923.03 | Necessary provisions.
...herefor are expressed therein. (B) The time at which insurance takes effect and terminates is expressed therein. (C) It purports to insure only one person, except that a policy may be issued to the head of a family, who for this purpose may be the husband or the wife and who is considered the policyholder, covering any two or more members of any one family, including husband, wife, dependent children, any children ... |
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Section 3923.04 | Policy standard provisions.
...rtain defenses. (1) After two years from the date of issue of this policy no misstatements, except fraudulent misstatements, made by the applicant in the application for this policy shall be used to void this policy or to deny a claim for loss incurred or disability (as defined in this policy) commencing after the expiration of such two -year period. The policy provision in division (B)(1) of this section shall n... |
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Section 3923.041 | Policies with prior authorization requirement provisions.
...or a condition where application of the timeframe for making routine or non-life threatening care determinations is either of the following: (a) Could seriously jeopardize the life, health, or safety of the patient or others due to the patient's psychological state; (b) In the opinion of a practitioner with knowledge of the patient's medical or behavioral condition, would subject the patient to adverse health conse... |
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Section 3923.05 | Provisions to conform to prescribed wording.
...state where the insured resided at the time this policy was issued; but if such filing was not required, then the classification of occupational risk and the premium rates shall be those last made effective by the insurer in such state prior to the occurrence of the loss or prior to the date of proof of change in occupation. (B) A provision as follows: Misstatement of age. If the age of the insured has been miss... |
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Section 3923.06 | Order of presentation of policy provisions.
...use, or likely to mislead a person to whom such policy is offered, delivered, or issued. As used in sections 3923.01, 3923.04, 3923.05, 3923.06, 3923.07, 3923.10, 3923.13, 3923.15, 3923.19 and 3923.20 of the Revised Code, "insured" shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy of sickness and accident insurance co... |
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Section 3923.061 | Interest on proceeds payable due to death by sickness or accident.
... terms of a policy of sickness and accident insurance due to the death of the insured by sickness or accident. (B) The interest payable pursuant to division (A) of this section shall be computed from the date of the death of the insured to the date of the payment of the proceeds and shall be at whichever of the following rates is greater: (1) The annual short-term applicable federal rate for purposes of section 127... |
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Section 3923.07 | Omission or substitution of provisions.
...val of the superintendent of insurance, omit from such policy any inapplicable provision or part of a provision and shall, with the approval of the superintendent, modify any inconsistent provision or part of a provision in such manner as to make the provision as contained in the policy consistent with the coverage provided by the policy. In any such policy an insurer may at its option substitute for, or use in lie... |
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Section 3923.071 | Policies, applications, riders or indorsements issued prior to 10-1-53.
...d approved by the superintendent at any time after October 1, 1953, for subsequent delivery, issuance for delivery, and use in this state until January 1, 1956, without being subject to sections 3923.04 to 3923.07, inclusive, of the Revised Code. A copy of the form of any rider or indorsement which could have been lawfully delivered, issued for delivery, or used in this state on October 1, 1953, may be filed with an... |
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Section 3923.08 | Nonconflicting provisions permitted in policy.
...r the country in which such insurer is domiciled, if such provision is not substantially in conflict with any law of this state. Any domestic insurer may insert in any such policy issued for delivery in another state or foreign country, and governed by the laws thereof, any provision required by the laws of such other state or country applicable to such policy. |
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Section 3923.09 | Validity of nonconforming policy.
...A policy of sickness and accident insurance issued in violation of sections 3923.01 to 3923.22, inclusive, of the Revised Code, is valid but shall be construed as provided by such sections, and when any provision in such policy is in conflict with such sections, the rights, duties, and obligations of the insurer, the policyholder, and the beneficiary shall be governed by such sections. |
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Section 3923.10 | Industrial sickness and accident insurance.
...y written notice to the insurer at its home office, accompanied by the policy for indorsement of the change thereon by the insurer. The insurer may refuse to designate a beneficiary if evidence satisfactory to the company of such beneficiary's insurable interest in the life of the insured is not furnished on request. Any such policy may provide in substance that any payment thereunder may be made to the insured or th... |
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Section 3923.11 | Sickness and accident insurance on a franchise plan.
...ect to long-term care or disability income insurance, two or more employees of any corporation, copartnership, or individual employer, or of any governmental corporation or agency or a department thereof; (2) Ten or more or, with respect to long-term care or disability income insurance, two or more members of any trade or professional association, or labor union, or any other association having had an active e... |
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Section 3923.12 | Group sickness and accident insurance.
...up originally insured may be added from time to time eligible new employees or members, their dependents, or members of their immediate families, in accordance with the terms of the policy. (D) Each such policy together with any application in connection therewith shall be available for inspection at all reasonable times at the place of business or principal residence of the policyholder where the policy is on file,... |
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Section 3923.121 | Association of insurers to provide basic medical coverage to persons 65 or older.
...on. (2) "Insurer" means any insurance company authorized to do the business of sickness and accident insurance in this state. (3) "Insured" means a person covered under a group policy issued pursuant to this section. (B) Any insurer may join with one or more other insurers, in an association, to offer, sell, and issue to a policyholder selected by the association a policy of group insurance against major financial... |
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Section 3923.123 | Association of insurers to provide group health coverage to qualified unemployed persons.
... (2) "Insurer" includes any insurance company authorized to do the business of sickness and accident insurance in this state and any health insuring corporation holding a certificate of authority under Chapter 1751. of the Revised Code. (3) "Insured" means a person covered under a group policy or contract issued pursuant to this section. (4) "Qualified unemployed person" means one who became unemployed while a res... |
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Section 3923.13 | Blanket sickness and accident insurance.
...ons: (A) Under a policy issued to any common carrier, which shall be deemed the policyholder, covering a group defined as all persons who may become passengers on such common carrier; (B) Under a policy issued to an employer, who shall be deemed the policyholder, covering any group of employees defined by reference to exceptional hazards incident to such employment; (C) Under a policy issued to a college, school, ... |