§ 38-71-1910 Short title
§ 38-71-1920 Definitions
§ 38-71-1930 Application of this article
§ 38-71-1940 Notice of right to request a review; notice of adverse determination
§ 38-71-1950 Requests for external review
§ 38-71-1960 Exhaustion of internal appeal process
§ 38-71-1970 Requests for external review
§ 38-71-1980 Expedited external review
§ 38-71-1990 External review decisions final; exceptions
§ 38-71-2000 Approval of independent review organizations
§ 38-71-2010 Standards for approval of independent review organizations
§ 38-71-2020 Liability of independent review organizations and personnel
§ 38-71-2030 External review; written records; reports
§ 38-71-2040 Health carrier to pay for external review
§ 38-71-2050 Health carrier to inform covered persons of rights related to external review
§ 38-71-2060 Regulations

Terms Used In South Carolina Code > Title 38 > Chapter 71 > Article 19 - Health Carrier External Review Act

  • Administrator: means the individual to whom the director has delegated authority to administer the programs of a specific board or of a professional or occupational group for which the department has regulatory authority or has delegated authority to administer the programs of a specific board;

    (2) "Authorization to practice" or "Practice authorization" means the approval to practice the specified profession, engage in the specified occupation, or use a title protected under this article, which has been granted by the applicable board. See South Carolina Code 40-1-20
  • Advice and consent: Under the Constitution, presidential nominations for executive and judicial posts take effect only when confirmed by the Senate, and international treaties become effective only when the Senate approves them by a two-thirds vote.
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Department: means the Department of Insurance of South Carolina. See South Carolina Code 38-1-20
  • Department: means the Department of Labor, Licensing and Regulation;

    (5) "Director" means the Director of the Department of Labor, Licensing and Regulation or the director's official designee;

    (6) "Licensee" means a person granted an authorization to practice pursuant to this article and refers to a person holding a license, permit, certification, or registration granted pursuant to this article;

    (7) "Licensing act" means the individual statute or regulations, or both, of each regulated profession or occupation which include, but are not limited to, board governance, the qualifications and requirements for authorization to practice, prohibitions, and disciplinary procedures;

    (8) "Person" means an individual, partnership, or corporation;

    (9) "Profession" or "occupation" means a profession or occupation regulated or administered, or both, by the department pursuant to this article. See South Carolina Code 40-1-20
  • Director: means the person who is appointed by the Governor upon the advice and consent of the Senate and who is responsible for the operation and management of the department. See South Carolina Code 38-1-20
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • insurance: includes annuities. See South Carolina Code 38-1-20
  • Insurance company: means an "insurer". See South Carolina Code 38-1-20
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • License: means a document issued by the state's director or his designee authorizing a person to act as an insurance producer for the lines of authority specified in the document. See South Carolina Code 38-1-20
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • Person: means a corporation, agency, partnership, association, voluntary organization, individual, or another entity, organization, or aggregation of individuals. See South Carolina Code 38-1-20
  • Policy: means a contract of insurance. See South Carolina Code 38-1-20
  • Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
  • Terminate: means the cancellation of the relationship between an insurance producer and the insurer or the termination of a producer's authority to transact insurance. See South Carolina Code 38-1-20
  • Uphold: The decision of an appellate court not to reverse a lower court decision.