O.C.G.A. § 33-23-205 (2019)
Applicability
The provisions of this article shall not apply to patient navigators as defined in paragraph (4) of Code Section 33-23-201.
History
Code 1981, § 33-23-205, enacted by Ga. L. 2013, p. 780, § 1/HB 198.
CHAPTER 24 INSURANCE GENERALLY Sec.
Article 1 General Provisions Sec.
Definitions. Applicability of chapter. Insurable interest; personal insurance. Insurable interest; property insurance. Persons having capacity to contract for insurance; purchase of insurance by or for minors; rescission, avoidance, or repudiation of contracts by minors. Consent of insured to insurance contract; exceptions; reliance by insurer on statements in application. Prerequisites for replacement life insurance exceeding insurance being surrendered. Statements and descriptions in applications or in negotiations deemed representations and not warranties; effect of misrepresentations upon recovery under policies. Admissibility in evidence of applications in actions between insurer and insured. Approval or disapproval of forms. Grounds for disapproval of forms. Standard or uniform claim form. Waiver by Commissioner of use of standard or uniform provisions in policies or contracts; approval of use of substitute provisions. Noncomplying conditions or provisions; cancellation of contracts covering uninsurable subjects.
Execution of policies; use of facsimile signatures. (See Editor’s notes.) Delivery of policies; applicability of Uniform Electronic Transactions Act; additional mailings. When policies or contracts become effective. Construction of policies. Clarification of term ‘‘actual charge’’ or ‘‘actual fee’’. Assignment of policies. Contents of insurance policies and annuity contracts generally. Incorporation of constituent documents in policies. Certificate of insurance forms to be approved by Commissioner; definitions; required provisions of certificate. Provision in accident and sickness policies for termination of coverage of surviving spouse or as result of break in marital relationship; issuance of policy to spouse. Provision in accident and sickness policies for termination of group coverage of surviving spouse or as result of break in marital relationship; issuance of policy to spouse. Group accident and sickness contracts; conversion privilege and continuation right provisions; impact of federal legislation. Continuation of coverage under group accident and sickness plans for persons 60 years of age or older. Provision in health insurance policies for coverage of newly born or adopted children.
Sec.
Sec. Provision in group policies of accident and sickness insurance for exclusion or reduction of benefits. Provision in group or blanket accident and sickness policies of coverage for complications of pregnancy. Provisions in group or blanket policies excluding or reducing coverage of persons eligible for or receiving medical assistance. Provisions limiting or restricting payment of benefits for preexisting illnesses or conditions. Provisions required in group policies or contracts of disability income insurance covering preexisting conditions; restrictions on preexisting condition limitations or exclusions. Provision for reimbursement for services within the lawful scope of practice of psychologists or chiropractors. Provision for reimbursement for services within the lawful scope of practice of optometrists. Provision for reimbursement for services within the lawful scope of practice of athletic trainers. Termination of coverage of dependent child upon attainment of specified age. Coverage of treatment of mental disorders. Coverage of outpatient surgery. Policies not to exclude payment to hospitals specializing in treatment of alcoholics or drug addicts. Coverage of general anesthesia and hospital or ambulatory surgical facility charges for certain dental care. Coverage for treatment of
mental disorders under accident and sickness insurance benefit plans providing major medical benefits covering small groups; federal law. Coverage for mental disorders under accident and sickness insurance benefit plans providing major medical benefits covering all groups except small groups. Excluding or denying coverage on basis of violation of civil air regulations. Excluding or denying coverage on basis of lawful firearms possession. Provision in group disability income policies for offsetting of increased social security benefits. Underwriters’ and combination policies. Binders and other contracts for temporary insurance. Authorization of group insurance for government employees; deduction of premiums from wages or salaries. Withdrawal or retirement from group insurance plan. Effect of government employee group insurance upon rights under Workers’ Compensation Act. Effect of government employee group insurance upon local and special laws [Repealed]. Renewal or extension of policies by certificate or endorsement. Insurers to furnish forms for proof of loss; effect of furnishing or failure to furnish forms. Acts of claims administration not to be deemed waiver of policies or defenses under policies. Discharge of insurer by payment generally. Motor vehicle accident
Sec.
Sec. claim covered by two or more insurance carriers; limited release. Written notice by insurer to claimant of payment of claim in third-party settlement. Payment of claims in event of simultaneous deaths. Medium of payment. Cancellation of policies generally. Procedure for cancellation by insured and notice. Cancellation or nonrenewal of automobile or motorcycle policies; procedure for review by Commissioner. Cancellation or nonrenewal of certain property insurance policies. Notice required of termination or nonrenewal, increase in premium rates, or change restricting or reducing coverage; failure of insurer to comply. Notice prior to cancellation or nonrenewal of individual or group accident and sickness policy. Acceptance of surety insurance companies as sureties upon bonds of persons or corporations; rights and liabilities of corporate sureties. Deposit of funds covered by bonds. Action as sureties upon guaranteed arrest bond certificates; acceptance of certificates. Purchase of insurance covering injuries resulting from governmental ownership and use of motor vehicles; waiver of governmental immunity; limitation of liabilities. Direct response insurance business. Solicitation, release, or sale of automobile accident infor-
mation prohibited; definitions; exceptions; penalties. Payments to nonparticipating or nonpreferred providers of health care services. Health insurance; recovery rights of state for payments made under Medicaid; rights of children to coverage; requirements for insurers under orders to provide coverage. Prohibition against requiring referral from primary care physician to dermatologist. Reimbursement of medical expense or disability benefit providers in personal injury cases; subrogation prohibited; notice. Surveillance tests for ovarian cancer. Colorectal cancer screening and testing. Short title; definitions; payment for telehealth services. Health benefit policy to provide coverage for orally administered chemotherapy for the treatment of cancer; definitions. Health insurance; provision that coverage cannot be terminated due to individual claims experience required. Health insurance identification card; issue required; contents; updating; social security numbers not to be displayed. Newborn Baby and Mother Protection Act; short title. Newborn Baby and Mother Protection Act; legislative findings and declaration. Newborn Baby and Mother Protection Act; minimum health benefit policy coverage; prohibited actions by insurance providers; required notice to mother. Women’s access to health care; health insurance; pro-
Sec. vision disclosing insured’s right to direct access to obstetricians and gynecologists required.
Annotations
Editor's notes. - Ga. L. 1989, p. 492, § 1, designated Code Sections 33-24-1 through 33-24-51 as Article 1.
Administrative Rules and Regulations. - Regulations regarding insurance contract, Official Compilation of the Rules and Regulations of the State of Georgia, Rules of Comptroller General, Insurance Department, Chapter 120-2-10.
Law reviews. - For article surveying recent legislative and judicial developments regarding Georgia's insurance laws, see 31 Mercer L. Rev. 117 (1979). For annual survey of law of insurance, see 38 Mercer L. Rev. 247 (1986). For annual survey article discussing developments in insurance law, see 51 Mercer L. Rev. 313 (1999).
JUDICIAL DECISIONS
In 1960, the Insurance Code became, by law, a part of every policy thereafter issued in the state. Chicago Ins. Co. v. Camors, 296 F. Supp. 1335 (N.D. Ga. 1969), aff'd, 420 F.2d 376 (5th Cir. 1970).
Cited in Pennsylvania Thresherman & Farmers Mut. Cas. Ins. Co. v. Gardner, 107 Ga. App. 472, 130 S.E.2d 507 (1963).
RESEARCH REFERENCES
Insurer's Wrongful Refusal to Settle Within Policy Limits, 6 POF2d 247.
Insurer's Breach of Covenant of Good Faith and Fair Dealing - First Party Claims, 31 POF2d 323.
Civil Conspiracy to Deny First-Party Insurance Benefits, 49 POF2d 473.
Insurance Bad-Faith Actions - "Advice - of-Counsel" Defense, 16 POF3d 419.
Punitive Damages Against an Insurer for the Bad-Faith Handling of a First-Party Claim, 18 POF3d 323.
Insured's Proof That Pollution Exclusion Clause Does Not Bar Coverage for Environmental Claims, 38 POF3d 477.
Insurer's Failure to Investigate Claim in Good Faith, 46 POF3d 289.
Loss by Storm Damage Under Property Insurance, 49 POF3d 501.
ALR. - Subsequent denial of liability following promise or negotiations as affecting contractual limitation for action upon insurance policy, 3 A.L.R. 218.
Duty of insurer to give notice of termination of agency, 14 A.L.R. 846.
What rights are waived by insurer who pays money into court, 15 A.L.R. 1260.
Reasonableness of insurer's demand for production of books or papers as regards time or place of production, 63 A.L.R. 510.
Incontestable clause of statute or policy as applicable to claims other than for death benefits, 94 A.L.R. 1133; 121 A.L.R. 1437; 147 A.L.R. 1015.
Full faith and credit provisions as affecting insurance contracts, 114 A.L.R. 250; 119 A.L.R. 483; 173 A.L.R. 1138.
Theory of waiver as applicable where provisions of policy or acts of insurer are inconsistent with statutory requirements, 9 A.L.R.2d 1436.
Misrepresentation by one other than insurance agent as to coverage, exclusion, or legal effect of insurance policy, as actionable, 29 A.L.R.2d 213.
Construction and effect of arrangement under which insurance premiums are paid automatically via insurer's draft on insured's bank account, 45 A.L.R.3d 1349.
Liability of insurer for damages resulting from delay in passing upon application for health insurance, 18 A.L.R.4th 1115.
Liability to refund local taxes as within coverage of liability insurance, 21 A.L.R.4th 895.
Applicability of other insurance benefits exclusion, from coverage of hospital or health and accident policy, to governmental insurance benefits to which insured would have been entitled by prior subscription, 29 A.L.R.4th 361.
Coverage and exclusions of liability or indemnity policy on physicians, surgeons, and other healers, 33 A.L.R.4th 14.
Criminal conviction as rendering conduct for which insured convicted within provision of liability insurance policy expressly excluding coverage for damage or injury intended or expected by insured, 35 A.L.R.4th 1063.
Construction and application of pollution exclusion clause in liability insurance policy, 39 A.L.R.4th 1047.
What services, equipment, or supplies are "medically necessary" for purposes of coverage under medical insurance, 75 A.L.R.4th 763.
Event triggering liability insurance coverage as occurring within period of time covered by liability insurance policy where injury or damage is delayed - Modern cases, 14 A.L.R.5th 695.
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ARTICLE 1 GENERAL PROVISIONS
Law reviews. - For note on 1995 amendments and enactments of Code sections in this article, see 12 Ga. St. U.L. Rev. 264 and 268 (1995).