Required provisions

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  1. (a)

    1. (1) Except as provided in subsection (b) of this section, each accident and health policy delivered or issued for delivery to any person in this state shall contain the provisions specified in §§ 23-85-106 — 23-85-117 in the words in which the provisions appear.

    2. (2) However, the insurer, at its option, may substitute for one (1) or more of the provisions, corresponding provisions of different wording approved by the Insurance Commissioner that are, in each instance, not less favorable in any respect to the insured or the beneficiary. Each provision shall be preceded individually by the applicable caption shown, or at the option of the insurer, by the appropriate individual or group captions or subcaptions as the commissioner may approve.

    3. (3) For the purpose of protecting the public against misrepresentations and misleading representations regarding the benefits provided in any policy of accident and health insurance, the commissioner is directed to prescribe minimum benefit provisions that shall be included in and made a part of every policy of accident and health insurance sold or offered for sale in this state.

  2. (b) If any provision is in whole or in part inapplicable to or inconsistent with the coverage provided by a particular form of policy, the insurer, with the approval of the commissioner, shall omit from the policy any inapplicable provision or part of a provision and shall modify any inconsistent provision or part of a provision in such manner as to make the provisions, as contained in the policy, consistent with the coverage provided by the policy.


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