Benefits and payment — Level or stipulated plan insurers

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  1. (a) A level or stipulated rate plan insurer shall specify in its policy or membership certificate the contingencies insured against, the sum of money it promises to pay or the benefits it agrees to provide, and the number of days after satisfactory proof of loss is filed within which the payment will be made or the benefit will be provided.

  2. (b) Upon the occurrence of a contingency insured against, unless the contract has been voided by fraud or by breach of its conditions, the insurer shall be obligated to the beneficiary for payment of or providing benefits at the time and in the amount or value specified in the policy or certificate.

  3. (c) If the insurer fails to make the payment after final judgment has been obtained upon the claim, the Insurance Commissioner shall notify the insurer not to issue any new policy or certificates until the indebtedness is fully paid. No officer or agent of the insurer shall issue any policy or certificate while the notice is in force. In addition, the insurer's certificate of authority shall be subject to suspension or revocation under § 23-63-213.


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