California Insurance Code

§ 10144.1

INS § 10144.1 Effective Jan 1, 1995Div. 2 · Part 2 · Ch. 1 · Art. 2.5

Statute text

A disability insurer that denies coverage for an experimental medical procedure or plan of treatment for a claimant with a terminal illness, which for the purposes of this section refers to an incurable or irreversible condition that has a high probability of causing death within one year or less, under a disability insurance policy that includes hospital, medical, or surgical coverage issued in this state shall provide written notification directly to the claimant or representative, which shall include all of the following:

(a)The specific medical and scientific reasons for the denial and specific references to pertinent policy provisions upon which the denial is based.

(b)A description of the alternative medical procedures or treatments covered by the policy, if any. Compliance with this subdivision by an insurer shall not be construed to mean that the insurer is engaging in the unlawful practice of medicine.

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Legislative history

Added by Stats. 1994, Ch. 582, Sec. 2. Effective January 1, 1995.