Ohio Revised Code Search

...y the receiver shall be superior to any claims of the receiver. Priority among the receiver's mortgages shall be determined by the order in which they are recorded. (G) A receiver appointed pursuant to this section is not personally liable except for misfeasance, malfeasance, or nonfeasance in the performance of the functions of the office of receiver. (H)(1) The judge in a civil action described in division (B...

...t on the outcome of a casino game; (7) Claims, collects, takes, or attempts to claim, collect, or take money or anything of value in or from a casino game with the intent to defraud or without having made a wager contingent on winning a casino game; (8) Claims, collects, or takes an amount of money or thing of value of greater value than the amount won in a casino game; (9) Uses or possesses counterfeit chips, tok...

...(A) A provider and a third-party payer may do either of the following: (1) Enter into a contractual agreement under which time periods shorter than those set forth in section 3901.381 of the Revised Code are applicable to the third-party payer in paying a claim for any amount due for health care services rendered by the provider; (2) Enter into a contractual agreement under which the timing of payments by the thir...

...A third-party payer shall not do either of the following: (A) Engage in any business practice that unfairly or unnecessarily delays the processing of a claim or the payment of any amount due for health care services rendered by a provider to a beneficiary; (B) Refuse to process or pay within the time periods specified in section 3901.381 of the Revised Code a claim submitted by a provider on the grounds the benefic...

...(A) A plan of health coverage determines its order of benefits using the first of the following that applies: (1) A plan that does not coordinate with other plans is always the primary plan. (2) The benefits of the plan that covers a person as an employee, member, insured, or subscriber, other than a dependent, is the primary plan. The plan that covers the person as a dependent is the secondary plan. (3) When more...

...(A) The value of any security held by a secured creditor shall be determined in one of the following ways, as the court may direct: (1) By converting the same into money according to the terms of the agreement pursuant to which the security was delivered to such creditor; (2) By agreement, arbitration, compromise, or litigation between the creditor and the liquidator. (B) The determination shall be under the super...

...As used in sections 3904.01 to 3904.22 of the Revised Code: (A)(1) "Adverse underwriting decision" means any of the following actions with respect to insurance transactions involving life, health, or disability insurance coverage that is individually underwritten: (a) A declination of insurance coverage; (b) A termination of insurance coverage; (c) Failure of an agent to apply for insurance coverage with a sp...

...or premiums from, or adjusts or settles claims on residents of this state, in connection with travel insurance. The following persons shall not be considered a travel administrator if they engage in no other activities that would cause them to be considered a travel administrator: (1) A person working for a travel administrator to the extent that the person's activities are subject to the supervision and control o...

...years of experience in risk financing, claims administration, loss prevention and insurance analysis, or purchasing commercial lines of insurance or has one of the following designations: (i) A designation as a chartered property and casualty underwriter issued by the American institute for CPCU and the insurance institute of America; (ii) A designation as an associate in risk management issued by the America...

...r the ultimate payment of all losses or claims, whether reported or unreported, for which the company may be liable, if the losses or claims are incurred on or before the date that the annual or interim financial statement is filed and remain unpaid as of that date. (3) An amount that is estimated to provide for the expenses incurred in adjusting or settling the claims described in division (A)(2) of this section. ...

...f beneficiary if desired, free from all claims of the creditors of such insured person or annuitant. Subject to the statute of limitations, the amount of any premium upon such contracts, endowments, or annuities, paid in fraud of creditors, with interest thereon, shall inure to their benefit from the proceeds of the contracts, but the company issuing any such contract is discharged of all liability thereon by the pay...

...(A) Each health plan issuer shall include a description of its external review procedures, including the superintendent's contractual review, in, or attached to, the policy, certificate, membership booklet, or outline of coverage, or other evidence of coverage it provides to covered persons. This disclosure shall be in a form prescribed by the superintendent in any associated rules, policies, or procedures. ...

...The acknowledgment by an insurer of the receipt of notice given under any policy of sickness and accident insurance, or the furnishing by him of forms for filing proofs of loss, or his acceptance of such proofs, or his investigation of any claim thereunder, shall not operate as a waiver of any of the rights of the insurer in defense of any claim arising under such policy.

...r the ultimate payment of all losses or claims, whether reported or unreported, for which the company may be liable, if the losses or claims are incurred on or before the date that the annual or interim financial statement is filed and remain unpaid as of that date. (3) An amount that is estimated to provide for the expenses incurred in adjusting or settling the claims described in division (A)(2) of this section. ...

...sses due and unpaid; (2) The amount of claims for losses resisted by the company; (3) The amount of losses incurred during the year, including those claimed and not due, and those reported to the company upon which no action has been taken; (4) The amount of dividends declared, due, and unpaid; (5) The amount of dividends, either cash or scrip, declared but not due; (6) The amount of money borrowed and the se...

...such payments are allocated to specific claims or are unallocated; (C) The number of suits being defended, at the date of which the statement is made, under policies written during said ten-year period, except suits in which liability is not dependent upon negligence of the insured, and a charge of seven hundred fifty dollars for each suit; (D) The number of deaths for which the insured are liable without proof of ...

...sociation to provide administrative and claims adjusting services required by it. Such contract shall provide indemnification by the Ohio mine subsidence insurance underwriting association to the Ohio fair plan underwriting association, its members, members of its board of governors, and its officers, employees, and agents against all liability, loss, and expense resulting from acts done or omitted in good faith in p...

...s sufficient to satisfy all foreseeable claims upon the fund during the period of coverage, giving due consideration to relevant loss or claim experience or trends, to cover normal costs of operation of the fund, and to provide a reasonable reserve for unexpected contingencies. No deviation shall be allowed from the premium established by the plan, but the mine subsidence insurance governing board shall periodically ...

... premiums to extend coverage to include claims covered by the policy and discovered and reported after the policy period and for which written claim is made against the insured.

... premiums to extend coverage to include claims covered by such policy discovered and reported after the policy period, for which written claim is made against the insured. (3) The rates, rating plans, rating rules, rating classifications, territories, and policy forms applicable to the insurance written by the association, and statistics relating thereto, are subject to Chapter 3937. of the Revised Code, giving due ...

...metric, or chiropractic claim, as those claims are defined in section 2305.113 of the Revised Code. (B) After a policy of commercial property insurance, commercial fire insurance, or commercial casualty insurance other than fidelity or surety bonds, medical malpractice insurance, and automobile insurance as defined in section 3937.30 of the Revised Code, has been in effect for more than ninety days, a notice of canc...

...(A) An intrafamily liability exclusion shall not apply or be enforced by an insurer against the owner or operator of a motor vehicle in a claim or in a suit for damages made against the owner or operator under Chapter 2125. of the Revised Code. (B) The prohibition included in division (A) of this section does not apply if both of the following conditions are met: (1) The policy providing the liability coverag...

...(A) Each title insurance company shall at all times establish and maintain, in addition to other reserves, a reserve: (1) Against unpaid losses; (2) Against loss expense, and shall calculate such reserves by making a careful estimate in each case of the loss expense likely to be incurred, by reason of every claim presented, pursuant to notice from or on behalf of the insured, of a title defect in or lien or adverse...

...for the administration or processing of claims for payment for services provided pursuant to the health care contract with the participating provider. (b) The third party accessing the participating provider's services under the health care contract either is an affiliate or subsidiary of the contracting entity or is providing administrative services to, or receiving administrative services from, the contracting en...

... this section, in the discharge of the claims of creditors of the protected cell captive insurance company. (G)(1) A petition for a liquidation or rehabilitation order with respect to a protected cell of a protected cell captive insurance company may be made by any of the following: (a) The protected cell captive insurance company; (b) A majority of the directors of the protected cell captive insurance compan...