Provision in Group or Blanket Policies for Medical or Surgical Services Generally

  1. Law
  2. Georgia Code
  3. Insurance
  4. Group or Blanket Accident and Sickness Insurance
  5. General Provisions
  6. Provision in Group or Blanket Policies for Medical or Surgical Services Generally

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  1. The benefits on account of medical or surgical services provided by a group or blanket policy of accident and sickness insurance may be limited by its terms to services performed by specifically defined professions, provided that in the absence of such definitions, the term "physician" or "surgeon," as used in such a policy, shall not be deemed limited solely to medical practitioners licensed under Chapter 34 of Title 43.
  2. When a group or blanket policy of accident and sickness insurance, except policies providing special coverage for limited diseases, accident protection only, or dental policies, provides for hospital care, there may be included within the scope of coverage hospital care rendered on account of mental illnesses and hospital care rendered by any psychiatric hospital duly licensed by this state. If the coverage is not included in the policy, a statement that the policy does not cover mental illnesses shall be printed in the policy in boldface type or stamped on the face of the policy and printed or stamped on any identification card issued pursuant to the policy.
  3. Any other laws to the contrary notwithstanding, whenever the term "physician" or "surgeon" is used in any policy of health or accident insurance issued in this state or in any contract for the provision of health care, services, or benefits issued by any health, medical, or other service corporation existing under, and by virtue of, any laws of this state, said term shall include, within its meaning, medical practitioners licensed under and in accordance with Chapter 11 of Title 43, relating to dentists, in respect to any care, services, procedures, or benefits covered by said policy of insurance or health care contract which the said persons are licensed to perform, any provisions in any such policy of insurance or health care contract to the contrary notwithstanding. This subsection shall be applicable to all policies in this state regardless of date of issue.

(Code 1933, § 56-3110, enacted by Ga. L. 1960, p. 289, § 1; Ga. L. 1970, p. 526, § 2; Ga. L. 1974, p. 436, § 2; Ga. L. 1996, p. 6, § 33.)

RESEARCH REFERENCES

ALR.

- Mental incapacity or disease as constituting total or permanent disability within insurance coverage, 22 A.L.R.3d 1000.


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