58-65-25. Hospital, physician, dentist, and optometrist contracts.
(a) Any full-service corporation organized under this Article may enter into contracts for the rendering of hospital service to any of its subscribers by hospitals approved by the American Medical Association or the North Carolina Hospital Association.
(a1) Any hospital service corporation may enter into contracts for the provision of, or the payment in whole or in part for, medical, dental, or vision services rendered to any of its subscribers by duly licensed physicians, dentists, or optometrists in accordance with this Article.
(a2) All obligations arising under contracts issued by a hospital service corporation to its subscribers shall be satisfied by payments made (i) directly to the hospitals or physicians, dentists, or optometrists rendering the service, or (ii) directly to the subscriber or the subscriber's legal representatives upon the receipt by the corporation from the subscriber of a statement marked paid by the hospitals, physicians, dentists, or optometrists rendering the applicable service. Nothing in this section shall be construed to discriminate against hospitals conducted by other schools of medical practice.
(b) All certificates, plans or contracts issued to subscribers or other persons by hospital service corporations operating under this Article shall contain in substance a provision as follows: "After two years from the date of issue of this certificate, contract or plan no misstatements, except fraudulent misstatements made by the applicant in the application for such certificate, contract or plan, shall be used to void said certificate, contract or plan, or to deny a claim for loss incurred or disability (as therein defined) commencing after the expiration of such two-year period." (1941, c. 338, s. 3; 1943, c. 537, s. 2; 1947, c. 820, s. 1; 1955, c. 850, s. 7; 1961, c. 1149; 1979, c. 755, s. 17; 1997-259, s. 16; 2021-169, s. 1.)
Structure North Carolina General Statutes
North Carolina General Statutes
Article 65 - Hospital Service Corporations.
§ 58-65-1.1 - Definitions applicable to this Article.
§ 58-65-2 - Other laws applicable to all service corporations.
§ 58-65-5 - Contract for joint assumption or underwriting of risks.
§ 58-65-10 - Premium or dues paid.
§ 58-65-20 - Members of governing boards.
§ 58-65-25 - Hospital, physician, dentist, and optometrist contracts.
§ 58-65-30 - Dentists' services.
§ 58-65-35 - Nurses' services.
§ 58-65-36 - Physician services provided by physician assistants.
§ 58-65-50 - Application for certificate of authority or license.
§ 58-65-55 - Issuance and continuation of license.
§ 58-65-60 - Subscribers' contracts; required and prohibited provisions.
§ 58-65-65 - Coverage for active medical treatment in tax-supported institutions.
§ 58-65-70 - Contracts to cover any person possessing the sickle cell trait or hemoglobin C trait.
§ 58-65-75 - Coverage for chemical dependency treatment.
§ 58-65-80 - Meaning of terms "accident", "accidental injury", and "accidental means".
§ 58-65-85 - Discriminatory practices prohibited.
§ 58-65-90 - No discrimination against mentally ill or chemically dependent individuals.
§ 58-65-91 - Coverage for certain treatment of diabetes.
§ 58-65-92 - Coverage for mammograms and cervical cancer screening.
§ 58-65-93 - Coverage for prostate-specific antigen (PSA) tests.
§ 58-65-94 - Coverage of certain prescribed drugs for cancer treatment.
§ 58-65-95 - Investments and reserves.
§ 58-65-96 - Coverage for reconstructive breast surgery following mastectomy.
§ 58-65-100 - Statements filed with Commissioner.
§ 58-65-105 - Visitations and examinations.
§ 58-65-115 - Licensing and regulation of agents.
§ 58-65-125 - Revocation and suspension of license; unfair trade practices.
§ 58-65-130 - Amendments to certificate of incorporation.
§ 58-65-131 - Findings; definitions; conversion plan.
§ 58-65-132 - Review and approval of conversion plan; new corporation.
§ 58-65-133 - Creation and operation of foundation.
§ 58-65-135 - Cost plus plans.
§ 58-65-145 - Preexisting hospital service corporations.
§ 58-65-150 - Construction of Chapter as to single employer plans; associations exempt.
§ 58-65-155 - Merger or consolidation, proceedings for.
§ 58-65-166 - Policy statement and definitions.
§ 58-65-167 - Authority to indemnify.
§ 58-65-168 - Mandatory indemnification.
§ 58-65-169 - Advance for expenses.
§ 58-65-170 - Court-ordered indemnification.
§ 58-65-171 - Determination and authorization of indemnification.
§ 58-65-172 - Indemnification of officers, employees, and agents.