GEORGIA CODE (Last Updated: August 20, 2013) |
Title 33. INSURANCE |
Chapter 29. INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE |
§ 33-29-1. "Accident and sickness policy" defined; applicability of chapter |
§ 33-29-2. Requirements as to policies generally |
§ 33-29-3. Required policy provisions |
§ 33-29-3.1. Coverage for human heart transplants; optional endorsement; requirements; guidelines |
§ 33-29-3.2. Coverage for mammograms, Pap smears, and prostate specific antigen tests |
§ 33-29-3.3. Coverage for bone marrow transplants for the treatment of breast cancer and Hodgkin's disease; optional endorsement; requirements; guidelines; applicability |
§ 33-29-3.4. Insurance coverage for child wellness services |
§ 33-29-4. Optional policy provisions |
§ 33-29-5. Order of printing of provisions |
§ 33-29-6. Provision in policies for medical or surgical services |
§ 33-29-7. Provision in policies for refusal of renewal generally |
§ 33-29-8. Provision in policies renewable or cancelable at option of insurer for refund of premiums |
§ 33-29-10. Operation of provision establishing age for termination of coverage generally; effect of misstatement of age of insured |
§ 33-29-11. Right of person to whom policy or contract issued to return policy or contract and receive premium refund; effect of return; proof of return |
§ 33-29-12. Policies issued for delivery or delivered within state by foreign or alien insurers; policies of domestic insurers issued for delivery in other states or countries |
§ 33-29-13. Furnishing of written outline of coverage to applicants for insurance; approval of outline |
§ 33-29-14. Application for, and ownership of, policies by persons other than insured |
§ 33-29-15. Exemption of policy proceeds from liability for debts of insured and beneficiary |
§ 33-29-16. Compliance with chapter by attachment of rider or endorsement to policy |
§ 33-29-17. Validity and construction of policies delivered or issued for delivery in violation of chapter; effect of conflict between provisions subject to chapter and other provisions |
§ 33-29-18. Franchise insurance |
§ 33-29-19. Rate modification on individual accident and sickness policies providing for optional loss ratio guarantee |
§ 33-29-20. Insurance coverage for treatment of temporomandibular joint dysfunction or surgery for deformities of maxilla or mandible |
§ 33-29-21. Renewal or continuation at option of insured |
§ 33-29-21.1. Availability of accident and sickness policy upon termination of dependent coverage based on age of dependent |
§ 33-29-22. Notice of premium increase; notification of impact of Patient Protection and Affordable Care Act. |
REFS & ANNOS
TITLE 33 Chapter 29 NOTE
CROSS REFERENCES. --Definition of accident and sickness insurance, § 33-7-2. Offering of accident, sickness, and disability insurance by fraternal benefit societies, § 33-15-60. Contents of accident and sickness, insurance policies generally, § 33-24-20 et seq.
ADMINISTRATIVE RULES AND REGULATIONS. --Credit life, accident and sickness insurance, Official Compilation of the Rules and Regulations of the State of Georgia, Rules of Comptroller General, Insurance Department, Chapters 120-2-13, 120-2-27.
LAW REVIEWS. --For note, "Paying the Piper: Third-party Payor Liability for Medical Treatment Decisions," see 25 Ga. L. Rev. 861 (1991).
For comment criticizing Gaskins v. New York Life Ins. Co., 235 La. 461, 104 So. 2d 171 (1958), holding death caused by anaphylactic shock produced by rare blood transfusion reaction was "accidental," see 10 Mercer L. Rev. 209 (1958).
RESEARCH REFERENCES
Am. Jur. Proof of Facts. --Accidental Death -- Food Asphyxiation, 2 POF2d 49.
Business Travel Insurance, 17 POF3d 489.
ALR. --Health insurance: provisions excluding or limiting liability in case of chronic diseases, 4 ALR 875, 15 ALR 1239.
Accident insurance: provisions regarding voluntary exposure to danger as applicable to dangers incident to automobiling, 4 ALR 1244.
Accident insurance: injury by insect, 9 ALR 529.
Accident insurance: taxicab as a public conveyance provided by a common carrier within provision for double or increased indemnity, 9 ALR 1555.
Insurance: death or injury resulting from insured's voluntary act as caused by accident or accidental means, 14 ALR 788; 35 ALR 1191; 42 ALR 243; 45 ALR 1528; 71 ALR 1437; 111 ALR 628.
Duty of insurer to give notice of termination of agency, 14 ALR 846.
Conflict between provision in accident insurance policy defining risks covered and provision limiting liability in case of loss from certain cause, 14 ALR 1333.
Accident insurance: aiding peace officer as voluntary exposure to unnecessary danger, 17 ALR 191.
Accident insurance: infection through a wound previously received, 18 ALR 113.
Death as within provision exempting insurer or limiting liability in case of injury or disability intentionally inflicted, 22 ALR 299.
Accident insurance: provision for reduced indemnity for injury while doing act pertaining to more hazardous occupation, 22 ALR 780; 26 ALR 123.
Accident insurance: when insured deemed to be totally and continuously unable to transact all business duties, 24 ALR 203.
Infection through boil, or similar condition, as an accident or accidental means within accident policy, 24 ALR 730.
Accident insurance: provision for reduced indemnity for injury while doing act pertaining to more hazardous occupation, 26 ALR 123.
Insurance: applicability of provisions as to injuries intentionally inflicted, where insured is injured because of mistake of identity, 26 ALR 129.
Attempt to board or alight from moving train, car, or locomotive, as within general provisions of accident policy avoiding liability for policyholder's negligence or exposure to obvious danger, 29 ALR 712.
"Permanent disability" within insurance policy as confined to disability lasting until death, 40 ALR 1386; 97 ALR 126.
Provision in accident insurance policy in relation to train wreck, 51 ALR 1331.
Provision limiting indemnity to permanent disability as affected by clause providing for payment for life and during disability, 54 ALR 294.
Burden of proof as regards payment or nonpayment of renewal premiums or assessments on policy of life or accident insurance, 95 ALR 745.
When insured deemed to be totally and continuously disabled or unable to transact all business duties, 98 ALR 788.
What constitutes bodily injury within policy of accident insurance or accident feature of life policy, 117 ALR 739.
Failure or refusal of insured to submit to corrective surgical or medical treatment as affecting right to recover insurance benefits, or to avoid payment of premiums, 126 ALR 136.
Requisites and sufficiency of proofs of loss where disease or other physical condition which in itself is not within, or is expressly excluded from, the coverage of an accident policy or double indemnity provision of a life policy results from, or is attributable to, a cause within the coverage, 126 ALR 616.
Necessity of payment of loss by reinsured as prerequisite to recovery from reinsurer, 127 ALR 181.
Construction and application of provisions of liability or indemnity policy regarding injury or death incident to construction, repairs, alterations, demolition, or wrecking of structure, or installation of elevators or other equipment, 130 ALR 239.
Construction and application of specific provision of accident policy as to death or injury while standing in or on public street or highway, 130 ALR 1155.
Insurance: death or injury in battle as due to accident or accidental means, 137 ALR 1286; 140 ALR 1533; 141 ALR 1510.
Scope and application of provisions of accident policy, or accident feature of life policy, relating to accident in connection with automobile or other motor vehicle, 138 ALR 404; 78 ALR2d 1044.
Burn as an accident or caused by accidental means within coverage of life or accident insurance policy, 138 ALR 1514.
Burden of proof, in action upon an accident policy or accident feature of life policy, as regards conditions which, by the terms of the policy, limit or exclude coverage, 142 ALR 742.
Insanity of insured as excusing lack of, or delay in, notice or proof of accident or disability, 142 ALR 852.
Burden of proof in action upon accident policy, or accident feature of life policy, as to whether injury or death was result of antecedent disease or other abnormal bodily or mental condition, 144 ALR 1416.
Construction and application of provision of accident policy or accident feature of life policy extending benefits to one disabled from engaging in any occupation or employment for wage or profit, 149 ALR 7; 153 ALR 430.
Loss or impairment of vision as within meaning of total disability clause, 1 ALR2d 756.
Loss of hearing as within meaning of total disability clause, 1 ALR2d 952.
Scope of clause of insurance policy covering injuries sustained from being "accidentally thrown from" a vehicle, 24 ALR2d 1454.
Construction and effect of clause of life, health, or similar policy insuring against "loss of business time," 31 ALR2d 1222.
Rupture of blood vessel following exertion or exercise as within terms of accident provision of insurance policy, 35 ALR2d 1105.
Death or injury from sunstroke as accident or result of accidental means within terms of accident provision of insurance policy, 36 ALR2d 1090.
Repeated absorption of poisonous substance as "accident" within coverage clause of comprehensive general liability policy, 49 ALR2d 1263.
Death or injury resulting from insured's voluntary act in taking overdose of medicine, drugs, or the like, as caused by accident or accidental means, 52 ALR2d 1083.
Effect of provision for coverage or double indemnity in case of injury or death in consequence of burning of building, 55 ALR2d 398.
What constitutes "hernia" within exclusionary clause of health or accident insurance policy, 55 ALR2d 1020.
Hernia following exertion or exercise as within terms of accident provision of insurance policy, 55 ALR2d 1180.
Coverage and exceptions under student accident policy, 74 ALR2d 1253.
Arteriosclerosis as affecting right to recovery under accident policy or accident provision of life policy, 82 ALR2d 611.
Preexisting physical condition as affecting liability under accident policy or accident feature of life policy, 84 ALR2d 176.
Provision of accident or health insurance policy that insured shall be under care of physician or surgeon, 84 ALR2d 375.
Death or injury resulting from shock, fright, or other "psychic trauma," as within coverage of accident policy or accident provisions of life policy, 93 ALR2d 578.
Liability under accident policy, or accident feature of life policy, for injury or death from freezing or exposure to cold, 4 ALR3d 1177.
When is medical expense "incurred" under policy providing for payment of medical expenses incurred within fixed period of time from date of injury, 10 ALR3d 468.
Right of tortfeasor or liability insurer to credit for amounts already disbursed to injured party under medical payments or funeral expense clause in liability policy, 11 ALR3d 1115.
Insurance: "total disability" or the like as referring to inability to work in usual occupation or in other occupations, 21 ALR3d 1155.
Heart or vascular condition as constituting total or permanent disability within insurance coverage, 21 ALR3d 1383.
What constitutes total or permanent disability within the coverage of disability insurance coverage issued to farmer or agricultural worker, 26 ALR3d 714.
Beneficiary's ignorance of existence of life or accident policy as excusing failure to give notice, make proofs of loss, or bring action within time limited by policy or statute, 28 ALR3d 292.
What constitutes permanent or total disability within coverage of insurance policy issued to physical laborer or workman, 32 ALR3d 922.
Life or accident insurance: sufficiency of showing that death from drowning was due to accident or accidental means, 43 ALR3d 1168.
What is "conveyance," "passenger conveyance," or "public conveyance" within coverage of accident policy, 60 ALR3d 858.
Who is "fare-paying passenger" within coverage provision of life or accident insurance policy, 60 ALR3d 1273.
Elimination of particular coverage, or termination, of health, hospitalization, or medical care insurance policy as affecting insurer's liability for insured's continuing hospitalization or medical expenses relating to previously covered illness, 66 ALR3d 1205.
Liability insurance: assault as an "accident," or injuries therefrom as "accidentally" sustained, within coverage clause, 72 ALR3d 1090; 31 ALR4th 957; 33 ALR4th 983; 34 ALR4th 761; 35 ALR4th 1063.
Death allegedly resulting from surgery as accidental or from accidental means within coverage of health or accident insurance policy, 91 ALR3d 1042.
Who is "resident" or "member" of same "household" or "family" as named insured, within liability insurance provision defining additional insureds, 93 ALR3d 420.
Heart attack following exertion or exercise as within terms of accident provision of insurance policy, 1 ALR4th 1319.
Applicability of other insurance benefits exclusion, from coverage of hospital or health and accident policy, to governmental insurance benefits to which insured would have been entitled by prior subscription, 29 ALR4th 361.
Accident insurance: death or disability incident to partaking of food or drink as within provision as to external, violent, and accidental means, 29 ALR4th 1230.
Accident insurance: what is "loss" of body member, 51 ALR4th 156.
Accident or life insurance: death by autoerotic asphyxiation as accidental, 62 ALR4th 823.
What constitutes single accident or occurrence within liability policy limiting insurer's liability to a specified amount per accident or occurrence, 64 ALR4th 668.
What services, equipment, or supplies are "medically necessary" for purposes of coverage under medical insurance, 75 ALR4th 763.
Coverage under medical and health insurance plans for services performed by dentists, oral surgeons, and orthodontists, 43 ALR5th 657.
ADMINISTRATIVE RULES AND REGULATIONS. --Credit life, accident and sickness insurance, Official Compilation of the Rules and Regulations of the State of Georgia, Rules of Comptroller General, Insurance Department, Chapters 120-2-13, 120-2-27.
LAW REVIEWS. --For note, "Paying the Piper: Third-party Payor Liability for Medical Treatment Decisions," see 25 Ga. L. Rev. 861 (1991).
For comment criticizing Gaskins v. New York Life Ins. Co., 235 La. 461, 104 So. 2d 171 (1958), holding death caused by anaphylactic shock produced by rare blood transfusion reaction was "accidental," see 10 Mercer L. Rev. 209 (1958).
RESEARCH REFERENCES
Am. Jur. Proof of Facts. --Accidental Death -- Food Asphyxiation, 2 POF2d 49.
Business Travel Insurance, 17 POF3d 489.
ALR. --Health insurance: provisions excluding or limiting liability in case of chronic diseases, 4 ALR 875, 15 ALR 1239.
Accident insurance: provisions regarding voluntary exposure to danger as applicable to dangers incident to automobiling, 4 ALR 1244.
Accident insurance: injury by insect, 9 ALR 529.
Accident insurance: taxicab as a public conveyance provided by a common carrier within provision for double or increased indemnity, 9 ALR 1555.
Insurance: death or injury resulting from insured's voluntary act as caused by accident or accidental means, 14 ALR 788; 35 ALR 1191; 42 ALR 243; 45 ALR 1528; 71 ALR 1437; 111 ALR 628.
Duty of insurer to give notice of termination of agency, 14 ALR 846.
Conflict between provision in accident insurance policy defining risks covered and provision limiting liability in case of loss from certain cause, 14 ALR 1333.
Accident insurance: aiding peace officer as voluntary exposure to unnecessary danger, 17 ALR 191.
Accident insurance: infection through a wound previously received, 18 ALR 113.
Death as within provision exempting insurer or limiting liability in case of injury or disability intentionally inflicted, 22 ALR 299.
Accident insurance: provision for reduced indemnity for injury while doing act pertaining to more hazardous occupation, 22 ALR 780; 26 ALR 123.
Accident insurance: when insured deemed to be totally and continuously unable to transact all business duties, 24 ALR 203.
Infection through boil, or similar condition, as an accident or accidental means within accident policy, 24 ALR 730.
Accident insurance: provision for reduced indemnity for injury while doing act pertaining to more hazardous occupation, 26 ALR 123.
Insurance: applicability of provisions as to injuries intentionally inflicted, where insured is injured because of mistake of identity, 26 ALR 129.
Attempt to board or alight from moving train, car, or locomotive, as within general provisions of accident policy avoiding liability for policyholder's negligence or exposure to obvious danger, 29 ALR 712.
"Permanent disability" within insurance policy as confined to disability lasting until death, 40 ALR 1386; 97 ALR 126.
Provision in accident insurance policy in relation to train wreck, 51 ALR 1331.
Provision limiting indemnity to permanent disability as affected by clause providing for payment for life and during disability, 54 ALR 294.
Burden of proof as regards payment or nonpayment of renewal premiums or assessments on policy of life or accident insurance, 95 ALR 745.
When insured deemed to be totally and continuously disabled or unable to transact all business duties, 98 ALR 788.
What constitutes bodily injury within policy of accident insurance or accident feature of life policy, 117 ALR 739.
Failure or refusal of insured to submit to corrective surgical or medical treatment as affecting right to recover insurance benefits, or to avoid payment of premiums, 126 ALR 136.
Requisites and sufficiency of proofs of loss where disease or other physical condition which in itself is not within, or is expressly excluded from, the coverage of an accident policy or double indemnity provision of a life policy results from, or is attributable to, a cause within the coverage, 126 ALR 616.
Necessity of payment of loss by reinsured as prerequisite to recovery from reinsurer, 127 ALR 181.
Construction and application of provisions of liability or indemnity policy regarding injury or death incident to construction, repairs, alterations, demolition, or wrecking of structure, or installation of elevators or other equipment, 130 ALR 239.
Construction and application of specific provision of accident policy as to death or injury while standing in or on public street or highway, 130 ALR 1155.
Insurance: death or injury in battle as due to accident or accidental means, 137 ALR 1286; 140 ALR 1533; 141 ALR 1510.
Scope and application of provisions of accident policy, or accident feature of life policy, relating to accident in connection with automobile or other motor vehicle, 138 ALR 404; 78 ALR2d 1044.
Burn as an accident or caused by accidental means within coverage of life or accident insurance policy, 138 ALR 1514.
Burden of proof, in action upon an accident policy or accident feature of life policy, as regards conditions which, by the terms of the policy, limit or exclude coverage, 142 ALR 742.
Insanity of insured as excusing lack of, or delay in, notice or proof of accident or disability, 142 ALR 852.
Burden of proof in action upon accident policy, or accident feature of life policy, as to whether injury or death was result of antecedent disease or other abnormal bodily or mental condition, 144 ALR 1416.
Construction and application of provision of accident policy or accident feature of life policy extending benefits to one disabled from engaging in any occupation or employment for wage or profit, 149 ALR 7; 153 ALR 430.
Loss or impairment of vision as within meaning of total disability clause, 1 ALR2d 756.
Loss of hearing as within meaning of total disability clause, 1 ALR2d 952.
Scope of clause of insurance policy covering injuries sustained from being "accidentally thrown from" a vehicle, 24 ALR2d 1454.
Construction and effect of clause of life, health, or similar policy insuring against "loss of business time," 31 ALR2d 1222.
Rupture of blood vessel following exertion or exercise as within terms of accident provision of insurance policy, 35 ALR2d 1105.
Death or injury from sunstroke as accident or result of accidental means within terms of accident provision of insurance policy, 36 ALR2d 1090.
Repeated absorption of poisonous substance as "accident" within coverage clause of comprehensive general liability policy, 49 ALR2d 1263.
Death or injury resulting from insured's voluntary act in taking overdose of medicine, drugs, or the like, as caused by accident or accidental means, 52 ALR2d 1083.
Effect of provision for coverage or double indemnity in case of injury or death in consequence of burning of building, 55 ALR2d 398.
What constitutes "hernia" within exclusionary clause of health or accident insurance policy, 55 ALR2d 1020.
Hernia following exertion or exercise as within terms of accident provision of insurance policy, 55 ALR2d 1180.
Coverage and exceptions under student accident policy, 74 ALR2d 1253.
Arteriosclerosis as affecting right to recovery under accident policy or accident provision of life policy, 82 ALR2d 611.
Preexisting physical condition as affecting liability under accident policy or accident feature of life policy, 84 ALR2d 176.
Provision of accident or health insurance policy that insured shall be under care of physician or surgeon, 84 ALR2d 375.
Death or injury resulting from shock, fright, or other "psychic trauma," as within coverage of accident policy or accident provisions of life policy, 93 ALR2d 578.
Liability under accident policy, or accident feature of life policy, for injury or death from freezing or exposure to cold, 4 ALR3d 1177.
When is medical expense "incurred" under policy providing for payment of medical expenses incurred within fixed period of time from date of injury, 10 ALR3d 468.
Right of tortfeasor or liability insurer to credit for amounts already disbursed to injured party under medical payments or funeral expense clause in liability policy, 11 ALR3d 1115.
Insurance: "total disability" or the like as referring to inability to work in usual occupation or in other occupations, 21 ALR3d 1155.
Heart or vascular condition as constituting total or permanent disability within insurance coverage, 21 ALR3d 1383.
What constitutes total or permanent disability within the coverage of disability insurance coverage issued to farmer or agricultural worker, 26 ALR3d 714.
Beneficiary's ignorance of existence of life or accident policy as excusing failure to give notice, make proofs of loss, or bring action within time limited by policy or statute, 28 ALR3d 292.
What constitutes permanent or total disability within coverage of insurance policy issued to physical laborer or workman, 32 ALR3d 922.
Life or accident insurance: sufficiency of showing that death from drowning was due to accident or accidental means, 43 ALR3d 1168.
What is "conveyance," "passenger conveyance," or "public conveyance" within coverage of accident policy, 60 ALR3d 858.
Who is "fare-paying passenger" within coverage provision of life or accident insurance policy, 60 ALR3d 1273.
Elimination of particular coverage, or termination, of health, hospitalization, or medical care insurance policy as affecting insurer's liability for insured's continuing hospitalization or medical expenses relating to previously covered illness, 66 ALR3d 1205.
Liability insurance: assault as an "accident," or injuries therefrom as "accidentally" sustained, within coverage clause, 72 ALR3d 1090; 31 ALR4th 957; 33 ALR4th 983; 34 ALR4th 761; 35 ALR4th 1063.
Death allegedly resulting from surgery as accidental or from accidental means within coverage of health or accident insurance policy, 91 ALR3d 1042.
Who is "resident" or "member" of same "household" or "family" as named insured, within liability insurance provision defining additional insureds, 93 ALR3d 420.
Heart attack following exertion or exercise as within terms of accident provision of insurance policy, 1 ALR4th 1319.
Applicability of other insurance benefits exclusion, from coverage of hospital or health and accident policy, to governmental insurance benefits to which insured would have been entitled by prior subscription, 29 ALR4th 361.
Accident insurance: death or disability incident to partaking of food or drink as within provision as to external, violent, and accidental means, 29 ALR4th 1230.
Accident insurance: what is "loss" of body member, 51 ALR4th 156.
Accident or life insurance: death by autoerotic asphyxiation as accidental, 62 ALR4th 823.
What constitutes single accident or occurrence within liability policy limiting insurer's liability to a specified amount per accident or occurrence, 64 ALR4th 668.
What services, equipment, or supplies are "medically necessary" for purposes of coverage under medical insurance, 75 ALR4th 763.
Coverage under medical and health insurance plans for services performed by dentists, oral surgeons, and orthodontists, 43 ALR5th 657.