(a) Any prepaid limited health services contract rider, endorsement, attachment, or addendum otherwise valid that contains any condition or provision not in compliance with the requirements of this chapter is not thereby rendered invalid, but must be construed and applied in accordance with the conditions and provisions as they would have applied had the contract, rider, endorsement, attachment, or addendum been in full compliance with this chapter. If an organization issues or delivers any contract for an amount that exceeds any limitations otherwise provided in this chapter, the organization is liable to the subscriber or the subscriber’s beneficiary for the full amount stated in the contract in addition to any other penalties that may be imposed under this chapter.
Terms Used In Tennessee Code 56-51-120
Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
Contract: A legal written agreement that becomes binding when signed.
State: when applied to the different parts of the United States, includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
Subscriber: means an individual on whose behalf a contract or arrangement has been entered into with a prepaid limited health service organization for health care services or other persons who also receive health care services as a result of the contract. See Tennessee Code 56-51-102
(b) Any prepaid limited health services contract delivered or issued for delivery in this state covering a subscriber, which subscriber pursuant to this chapter the organization may not lawfully cover under the contract, is cancelable at any time by the organization, any provision of the contract to the contrary notwithstanding, and the organization must promptly cancel the contract in accordance with the request of the department for cancellation. No illegality or cancellation may be deemed to relieve the organization of any liability incurred by it under the contract while in force or to prohibit the organization from retaining the pro rata earned premium or rate on the contract. This subsection (b) does not relieve the organization from any penalty otherwise incurred by the organization under this chapter for any such violation.
