Required Form and Contents of Policy

  1. Law
  2. Tennessee Code
  3. Insurance
  4. Accident and Sickness Insurance
  5. General Provisions
  6. Required Form and Contents of Policy

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No policy of sickness and accident insurance shall be delivered or issued for delivery to any person in this state, unless:

  1. The entire money and other considerations therefor are expressed in the policy;
  2. The time at which the insurance takes effect and terminates is expressed in the policy;
  3. The policy purports to insure only one (1) person, except that a policy may insure, originally or by subsequent amendment upon the application of an adult member of a family who shall be deemed the policyholder, any two (2) or more eligible members of that family, including husband, wife, dependent children or any children under a specified age that shall not exceed nineteen (19) years, and any other person dependent upon the policyholder;
  4. The style, arrangement, and overall appearance of the policy and any endorsements or attached papers give no undue prominence to any portion of the text. For purposes of this subdivision (4), “text” includes all printed matter except the name and address of the insurer, the name or title of the policy, and captions and subcaptions;
  5. The exceptions and reductions of indemnity are set forth in the policy and, except those which are set forth in §§ 56-26-108 — 56-26-114, are printed, at the insurer's option, either included with the benefit provision to which they apply or under an appropriate caption such as “EXCEPTIONS” or “EXCEPTIONS AND REDUCTIONS”; provided, that if an exception or reduction specifically applies only to a particular benefit of the policy, a statement of the exception or reduction shall be included with the benefit provision to which it applies;
  6. Each such form, including riders and endorsements, shall be identified by a form number in the lower left-hand corner of the first page of the form;
  7. The policy contains no provision purporting to make any portion of the charter, rules, constitution or bylaws of the insurer a part of the policy unless such portion is set forth in full in the policy, except in the case of the incorporation of, or reference to, a statement of rates or classification of risks, or short-rate table filed with the commissioner; and
  8. If the policy is a limited policy, which is defined as a policy that contains unusual exclusions, limitations, restrictions, reductions in benefits or conditions of such a nature that the payments of benefits under the policy are thereby substantially limited in frequency or in amount, it shall be so identified by having the words “THIS IS A LIMITED POLICY — READ IT CAREFULLY” imprinted diagonally across the face of the policy and the filing back in contrasting color from the text of the policy and in outline type not smaller than eighteen-point, or words which, in the opinion of the commissioner, have substantially the same meaning and effect; when appropriate, these words may be varied by the insurer in a manner to indicate the type of policy; as for example, “THIS POLICY IS LIMITED TO CANCER ONLY — READ IT CAREFULLY.”


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