HB2616 99TH GENERAL ASSEMBLY

LRB099 08039 MLM 28183 b

99TH GENERAL ASSEMBLY
State of Illinois
2015 and 2016
HB2616

Introduced , by Rep. Frank J. Mautino

SYNOPSIS AS INTRODUCED:

215 ILCS 5/367a

from Ch. 73, par. 979a

Amends the Illinois Insurance Code. Clarifies certain provisions defining "blanket accident and health insurance" coverage and expands the definition of the term to include certain kinds of coverage in other types of businesses and organizations.

A BILL FOR

AN ACT concerning insurance.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Illinois Insurance Code is amended by changing Section 367a as follows:

(215 ILCS 5/367a) (from Ch. 73, par. 979a)

Sec. 367a. Blanket accident and health insurance.

(1) Blanket accident and health insurance is that form of accident and health insurance covering special groups of persons as enumerated in one of the following paragraphs (a) to (n) (g), inclusive:

(a) Under a policy or contract issued to any carrier for hire or to any owner, operator, or lessee of a means of transportation, which shall be deemed the policyholder, covering a group defined as all persons who may become passengers on such carrier or means of transportation.

(b) Under a policy or contract issued to an employer, which who shall be deemed the policyholder, covering all workers employees or any group of workers, dependents, or guests employees defined by reference to exceptional hazards incident to an activity or activities or operations of the policy holder such employment.

(c) Under a policy or contract issued to a college, school, or other institution of learning or to the head or principal thereof, who or which shall be deemed the policyholder, covering students or teachers, or employees, and may include dependents.

(d) Under a policy or contract issued in the name of any volunteer fire department, first aid, civil defense, or other such volunteer group, or an agency having jurisdiction over these groups, which shall be deemed the policyholder, covering all or any group of the members of such department, or group, or any group of participants defined by reference to activities or operations sponsored or supervised by the policyholder.

(e) Under a policy or contract issued to a creditor, who shall be deemed the policyholder, to insure debtors of the creditors; Provided, however, that in the case of a loan which is subject to the Small Loans Act, no insurance premium or other cost shall be directly or indirectly charged or assessed against, or collected or received from the borrower.

(f) Under a policy or contract issued to a sports team or to a camp, or to a sponsor of either, which team or camp sponsor shall be deemed the policyholder, covering members, or campers, employees, officials, supervisors, or volunteers.

(g) Under a policy or contract issued to any religious, charitable, recreational, educational, or civic organization, or branch thereof, which organization shall be deemed the policyholder, covering any group of persons while engaged in any activity, activities, or operations sponsored or supervised by or on the premises of the policyholder.

(h) Under a policy or contract issued to a newspaper or other publisher, which shall be deemed the policyholder, covering its carriers.

(i) Under a policy or contract issued to a restaurant, hotel, motel, innkeeper, or other group with a high degree of customer liability, which shall be deemed the policyholder, covering patrons or guests.

(j) Under a policy or contract issued to a health maintenance organization, health care provider, or other arranger of health services, which shall be deemed the policyholder, covering subscribers, patients, donors, or surrogates, provided that this coverage is not made a condition of receiving care.

(k) Under a policy or contract issued to a bank, savings and loan association, credit union, or other similar financial institution or vendor, to a parent holding company, or to the trustee, trustees, or agents designated by one or more banks, savings and loan associations, credit unions, or other similar financial institutions or vendors, which shall be deemed the policyholder, covering account holders, depositors, members, debtors, or guarantors.

(l) Under a policy or contract issued to an incorporated or unincorporated association of persons having a common interest or calling, which association shall be deemed the policyholder, formed for purposes other than obtaining insurance, covering members of the association.

(m) Under a policy or contract issued to a travel agency or other organization that provides travel-related services, which agency or organization shall be deemed the policyholder, to cover all persons for which travel-related services are provided.

(n) (g) Under a policy or contract issued to any other individual risk or class of risk that substantially similar group which, in the discretion of the Director, may be subject to the issuance of a blanket accident and health policy or contract.

(2) Any insurance company authorized to write accident and health insurance in this state shall have the power to issue blanket accident and health insurance. No such blanket policy may be issued or delivered in this State unless a copy of the form thereof shall have been filed in accordance with Section 355, and it contains in substance such of those provisions contained in Sections 357.1 through 357.30 as may be applicable to blanket accident and health insurance and the following provisions:

(a) A provision that the policy and the application shall constitute the entire contract between the parties, and that all statements made by the policyholder shall, in absence of fraud, be deemed representations and not warranties, and that no such statements shall be used in defense to a claim under the policy, unless it is contained in a written application.

(b) A provision that to the group or class thereof originally insured shall be added from time to time all new persons or individuals eligible for coverage.

(3) An individual application shall not be required from a person covered under a blanket accident or health policy or contract, nor shall it be necessary for the insurer to furnish each person a certificate.

(4) All benefits under any blanket accident and health policy shall be payable to the person insured, or to his designated beneficiary or beneficiaries, or to his or her estate, except that if the person insured be a minor or person under legal disability, such benefits may be made payable to his or her parent, guardian, or other person actually supporting him or her. Provided further, however, that the policy may provide that all or any portion of any indemnities provided by any such policy on account of hospital, nursing, medical or surgical services may, at the insurer's option, be paid directly to the hospital or person rendering such services; but the policy may not require that the service be rendered by a particular hospital or person. Payment so made shall discharge the insurer's obligation with respect to the amount of insurance so paid.

(5) Nothing contained in this section shall be deemed to affect the legal liability of policyholders for the death of or injury to, any such member of such group.

(Source: P.A. 83-1362.)