§ 27-4-28. Discretionary clauses.
(a) No new or existing policy or certificate may contain any provision:
(1) Purporting to reserve sole discretion to the insurance company to determine eligibility for benefits or interpret the terms of a policy or certificate; or
(2) Specifying or affecting a standard of review upon which a court may review denial of a claim or any other decision made by an insurance company with respect to a policyholder or certificate holder.
(b) Any such clause or language included in a contract, policy or certificate issued to or covering a resident of this state that is contrary to or inconsistent with the provisions of this section is void and unenforceable.
(c) Nothing in this section prohibits an insurer from including a provision in a contract that informs an insured that as part of its routine operations the insurer applies the terms of its contracts for making decisions, including making determinations regarding eligibility, receipt of benefits and claims, or explaining policies, procedures, and processes, so long as the provision could not give rise to a deferential standard of review by any reviewing court.
History of Section.P.L. 2013, ch. 85, § 1; P.L. 2013, ch. 94, § 1.
Structure Rhode Island General Laws
Chapter 27-4 - Life Insurance Policies and Reserves
Section 27-4-0.1. - Definitions.
Section 27-4-1. - Discrimination in rates or amounts payable on death.
Section 27-4-1.1. - Denial of applicant based on naloxone prescription.
Section 27-4-2. - Preexisting contracts unaffected by discrimination provisions.
Section 27-4-3. - Distinctions by insurance producers as to collections.
Section 27-4-4. - Penalty for unlawful discrimination.
Section 27-4-5. - Misrepresentation as to policies — Penalty — Revocation of license.
Section 27-4-6.1. - Right to examine and return policy.
Section 27-4-6.2. - Individual life insurance policy standard provisions.
Section 27-4-7. - Privilege against self-incrimination.
Section 27-4-9. - Preexisting contracts unaffected by policy terms provisions.
Section 27-4-10. - Effect of misstatements in application for policy.
Section 27-4-12. - Provision for exemption from encumbrance, transfer, or claims of creditors.
Section 27-4-13. - Deprivation of court jurisdiction — Limitation of actions.
Section 27-4-13.1. - Policy loan interest rates.
Section 27-4-14, 27-4-15. - Repealed.
Section 27-4-16. - Preliminary term policies.
Section 27-4-22. - Assignment of interest under group life insurance.
Section 27-4-22.1. - Continuation of group life insurance — Labor disputes — Involuntary layoffs.
Section 27-4-23. - Rules and regulations.
Section 27-4-24. - Filing of life insurance policy forms.
Section 27-4-24.1. - Waiting period — Effective date of filings.
Section 27-4-24.2. - Notice of disapproval.
Section 27-4-24.3. - Suspension or revocation of licenses.
Section 27-4-24.4. - Hearing on decisions of commissioner.
Section 27-4-24.5. - Judicial review of orders and decisions.
Section 27-4-24.6. - Severability.
Section 27-4-25. - Physical exam by insurance company.
Section 27-4-26. - Interest upon proceeds of life insurance policies.
Section 27-4-27. - Insurable interest.
Section 27-4-28. - Discretionary clauses.