2021 Tennessee Code
Part 1 - General Provisions
§ 56-26-109. Form of Permissible Policy Provisions

Except as provided in § 56-26-110, no such policy delivered or issued for delivery to any person in this state shall contain provisions respecting the matters set forth in subdivisions (1)-(11), unless the provisions are in the substance of the words in which the same appear in this section; provided, that the insurer may, at its option, use in lieu of any such provision a corresponding provision of different wording, approved by the commissioner, which is not less favorable in any respect to the insured or the beneficiary. Any such provision contained in the policy shall be preceded individually by the appropriate caption appearing in this section or, at the option of the insurer, by the appropriate individual or group captions or subcaptions as the commissioner may approve.
“Insurance effective at any one time on the insured under a like policy or policies in this insurer is limited to the one (1) such policy elected by the insured, the insured's beneficiary or the insured's estate, as the case may be, and the insurer will return all premiums paid for all other such policies.”
If the foregoing policy provision is included in a policy that also contains the next following policy provision, there shall be added to the caption of the foregoing provision the phrase “EXPENSE INCURRED BENEFITS.” The insurer may, at its option, include in this provision a definition of “other valid coverage,” approved as to form by the commissioner, which definition shall be limited in subject matter to coverage provided by organizations subject to regulation by insurance law or by insurance authorities of this or any other state of the United States or any province of Canada, and by hospital or medical service organizations, and to any other coverage, the inclusion of which may be approved by the commissioner. In the absence of the definition, the term shall not include group insurance, automobile medical payments insurance, or coverage provided by hospital or medical service organizations or by union welfare plans or employer or employee benefit organizations. For the purpose of applying the foregoing policy provision with respect to any insured, any amount of benefit provided for the insured pursuant to any compulsory benefit statute (including any workers' compensation or employer's liability statute), whether provided by a governmental agency or otherwise, shall in all cases be deemed to be “other valid coverage” of which the insurer has had notice. In applying the foregoing policy provision, no third-party liability coverage shall be included as “other valid coverage.”
The policy provision in this subdivision (6)(A) may be inserted only in a policy that the insured has the right to continue in force, subject to its terms by the timely payment of premiums:
The insurer may, at its option, include in this provision a definition of “valid loss of time coverage,” approved as to form by the commissioner, which definition shall be limited in subject matter to coverage provided by governmental agencies or by organizations subject to regulation by insurance law or by insurance authorities of this, or any other state of the United States or any province of Canada, or to any other coverage, the inclusion of which may be approved by the commissioner, or any combination of the coverages. In the absence of the definition, the term shall not include any coverage provided for the insured pursuant to any compulsory benefit statute, including any workers' compensation or employer's liability statute, or benefits provided by union welfare plans or by employer or employee benefit organization.
For purposes of this provision:

Structure 2021 Tennessee Code

2021 Tennessee Code

Title 56 - Insurance

Chapter 26 - Accident and Sickness Insurance

Part 1 - General Provisions

§ 56-26-101. Part Definitions

§ 56-26-103. Withdrawal of Approval — Notice of Hearing

§ 56-26-104. Disapproval of Policy — Limitations and Exceptions

§ 56-26-105. Review — Certiorari

§ 56-26-106. Required Form and Contents of Policy

§ 56-26-107. Policy Deliverable in Another State

§ 56-26-108. Standard Form — Required Provisions

§ 56-26-109. Form of Permissible Policy Provisions

§ 56-26-110. Inapplicable or Inconsistent Provisions

§ 56-26-111. Sequence of Policy Provisions

§ 56-26-112. Third-Party Ownership

§ 56-26-114. Filing Procedure

§ 56-26-115. Policy Provisions Not Specifically Covered

§ 56-26-117. Application as Part of Policy — Copy on Request

§ 56-26-118. Alteration of Application

§ 56-26-119. False Statements in Application

§ 56-26-120. Acts Not Constituting Waiver of Defenses

§ 56-26-121. Acceptance of Premiums After Expiration of Policy — Misstatement of Age

§ 56-26-124. Accident and Sickness Insurance — Patients in Tax Supported Institutions Not to Be Excluded

§ 56-26-125. Insurer's Right of Cancellation to Be Stated on Face of Policy

§ 56-26-126. Insurer's Option to Renew to Be Stated on Face of Policy

§ 56-26-127. Group or Franchise Policies Excluded

§ 56-26-128. Violations — Penalty

§ 56-26-129. Ten-Day Free Look on Health Insurance

§ 56-26-132. Health Care Insurance Advice for Senior Citizens

§ 56-26-134. No Coverage for Abortion Services in Health Plans Required to Be Established Under Federal Health Care Reform Plans