Code of Virginia
Chapter 35 - Accident and Sickness Insurance Policies
§ 38.2-3500. Form of policy

A. No individual accident and sickness insurance policy shall be delivered or issued for delivery to any person in this Commonwealth unless:
1. The entire consideration for the policy is expressed in the policy;
2. The time at which the insurance takes effect and terminates is expressed in the policy;
3. The policy insures only one person, except that it may insure eligible family members, originally or by subsequent amendment, upon the application of an adult member of a family who shall be deemed the policyowner;
4. The exceptions and reductions are set forth in the policy and, except those that are set forth in §§ 38.2-3503 through 38.2-3508, are printed with the benefit provisions to which they apply, or under an appropriate caption, but 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 that benefit provision;
5. Each form, including riders and endorsements, is identified by a form number in the lower left-hand corner of the first page of the form;
6. It contains no provision making any portion of the charter, rules, constitution, or bylaws of the insurer a part of the policy unless that portion is set forth 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 Commission; and
7. It contains a statement about the provisions of subsections A and B of § 32.1-325.2 regarding the status of the Department of Medical Assistance Services as the payor of last resort.
B. If any policy is issued by an insurer domiciled in this Commonwealth for delivery to a person residing in another state, and if the insurance supervisory official of the other state advises the Commission that any such policy is not subject to approval or disapproval by such official, the Commission may by ruling require that such policy meet the standards set forth in this chapter.
C. "Eligible family member" means the (i) spouse, (ii) dependent children, without regard to whether such children reside in the same household as the policyowner, (iii) children under a specified age not greater than 19 years, and (iv) any person dependent on the policyowner.
D. The provisions of this section shall not apply in any instance in which the provisions of this section are inconsistent or in conflict with a provision of Article 6 (§ 38.2-3438 et seq.) of Chapter 34.
1952, c. 317, § 38.1-348; 1986, cc. 550, 562; 1993, c. 306; 1994, c. 316; 2011, c. 882.

Structure Code of Virginia

Code of Virginia

Title 38.2 - Insurance

Chapter 35 - Accident and Sickness Insurance Policies

§ 38.2-3500. Form of policy

§ 38.2-3501. Policy forms; powers of Commission

§ 38.2-3502. Notice to be printed on policy; return of policy to insurer

§ 38.2-3503. Required accident and sickness policy provisions

§ 38.2-3504. Other provisions

§ 38.2-3505. Inapplicable or inconsistent provisions

§ 38.2-3506. Order of certain policy provisions

§ 38.2-3507. Third-party ownership

§ 38.2-3508. Requirements of other jurisdictions

§ 38.2-3509. Denial or reduction of benefits because of existence of other like insurance

§ 38.2-3510. Conforming to statute

§ 38.2-3511. Application

§ 38.2-3512. Notice; waiver

§ 38.2-3513. Age limit

§ 38.2-3514. When liability not to be denied because of preexisting disease, physical impairment or defect

§ 38.2-3514.1. Preexisting conditions provisions

§ 38.2-3514.2. Renewability of coverage

§ 38.2-3515. Repealed

§ 38.2-3516. Purpose

§ 38.2-3517. Definitions

§ 38.2-3518. Standards for policy provisions

§ 38.2-3519. Minimum standards for excepted benefits

§ 38.2-3520. Coverage of preexisting conditions

§ 38.2-3521. Repealed

§ 38.2-3521.1. Group accident and sickness insurance definitions

§ 38.2-3521.2. Blanket accident and sickness insurance

§ 38.2-3522. Repealed

§ 38.2-3522.1. Limits of group accident and sickness insurance

§ 38.2-3523. Repealed

§ 38.2-3523.1. Review of records

§ 38.2-3523.2. Policies issued outside of the Commonwealth of Virginia

§ 38.2-3523.3. Requirements for those marketing group accident and sickness insurance

§ 38.2-3523.4. Minimum number of persons covered

§ 38.2-3524. Repealed

§ 38.2-3525. Group accident and sickness insurance coverages of spouses, dependent children or other persons

§ 38.2-3526. Standard provisions required; exceptions

§ 38.2-3527. Grace period

§ 38.2-3528. Incontestability

§ 38.2-3529. Entire contract; statements deemed representations

§ 38.2-3530. Evidence of individual insurability

§ 38.2-3531. Additional exclusions and limitations

§ 38.2-3532. Misstatement of age

§ 38.2-3533. Individual certificates

§ 38.2-3534. Notice of claim

§ 38.2-3535. Claim forms

§ 38.2-3536. Proofs of loss

§ 38.2-3537. Time of payment of claims

§ 38.2-3538. Payment of benefits

§ 38.2-3539. Physical examinations and autopsy

§ 38.2-3540. Legal actions

§ 38.2-3540.1. Claims experience

§ 38.2-3540.2. Employee wellness program

§ 38.2-3541. Continuation on termination of eligibility

§ 38.2-3541.1. Repealed

§ 38.2-3541.2. Enrollment following change in eligibility status under assistance programs

§ 38.2-3542. Notice to employees upon termination of coverage; penalty for failure to remit funds

§ 38.2-3543. Provisions required by other jurisdictions

§ 38.2-3543.1. Regulations

§ 38.2-3543.2. Applicability of laws

§ 38.2-3544. Definition of industrial sick benefit insurance

§ 38.2-3545. Further restrictions as to beneficiaries

§ 38.2-3546. Cancellation of sick benefit portion of policy

§ 38.2-3547. Excessive insurance; remedy

§ 38.2-3548. Agents subject to other insurance laws

§ 38.2-3549. Benefits not subject to legal process

§ 38.2-3550. Effective date

§ 38.2-3551. Definitions

§ 38.2-3552. Small employer health group cooperatives

§ 38.2-3553. Membership in a small employer health group cooperative

§ 38.2-3554. Provisions relating to health insurance issuers

§ 38.2-3555. Authority of the Commission