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| [ Engrossed ] | [ Enrolled ] | [ House Amendment 001 ] |
90_SB1901
215 ILCS 5/4 from Ch. 73, par. 616
Amends the Illinois Insurance Code. Provides that a
policy that allows payment of a percentage of the face amount
of benefits in advance upon a diagnosis that the insured has
incurred a medical condition listed in the policy may pay up
to 75%, rather than 25%, of the benefits in advance.
Provides that total and permanent disability or any condition
approved by the Department of Insurance may qualify for
advance payments. Effective immediately.
LRB9011659JSgc
LRB9011659JSgc
1 AN ACT to amend the Illinois Insurance Code by changing
2 Section 4.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Illinois Insurance Code is amended by
6 changing Section 4 as follows:
7 (215 ILCS 5/4) (from Ch. 73, par. 616)
8 Sec. 4. Classes of insurance. Insurance and insurance
9 business shall be classified as follows:
10 Class 1. Life, Accident and Health.
11 (a) Life. Insurance on the lives of persons and every
12 insurance appertaining thereto or connected therewith and
13 granting, purchasing or disposing of annuities. Policies of
14 life or endowment insurance or annuity contracts or contracts
15 supplemental thereto which contain provisions for additional
16 benefits in case of death by accidental means and provisions
17 operating to safeguard such policies or contracts against
18 lapse, to give a special surrender value, or special benefit,
19 or an annuity, in the event, that the insured or annuitant
20 shall become totally and permanently disabled as defined by
21 the policy or contract, or which contain benefits providing
22 acceleration of life or endowment or annuity benefits in
23 advance of the time they would otherwise be payable, as an
24 indemnity for long term care which is certified or ordered by
25 a physician, including but not limited to, professional
26 nursing care, medical care expenses, custodial nursing care,
27 non-nursing custodial care provided in a nursing home or at a
28 residence of the insured, or which contain benefits providing
29 acceleration of life or endowment or annuity benefits in
30 advance of the time they would otherwise be payable, at any
31 time during the insured's lifetime, as an indemnity for a
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1 terminal illness shall be deemed to be policies of life or
2 endowment insurance or annuity contracts within the intent of
3 this clause.
4 Also to be deemed as policies of life or endowment
5 insurance or annuity contracts within the intent of this
6 clause shall be those policies or riders that provide for the
7 payment of up to 75% 25% of the face amount of benefits in
8 advance of the time they would otherwise be payable upon a
9 diagnosis by a physician licensed to practice medicine in all
10 of its branches that the insured has incurred a one of the
11 covered condition conditions listed in the policy or rider.
12 Every such policy or rider shall contain a majority of
13 the following "Covered condition", as used in this clause,
14 means conditions: heart attack,; stroke,; coronary artery
15 surgery,; life threatening cancer,; renal failure,;
16 alzheimer's disease,; paraplegia,; major organ
17 transplantation, total and permanent disability, and any
18 other medical condition that the Department may approve for
19 any particular filing.
20 The Director may issue rules that specify prohibited
21 policy provisions, not otherwise specifically prohibited by
22 law, which in the opinion of the Director are unjust, unfair,
23 or unfairly discriminatory to the policyholder, any person
24 insured under the policy, or beneficiary.
25 (b) Accident and health. Insurance against bodily
26 injury, disablement or death by accident and against
27 disablement resulting from sickness or old age and every
28 insurance appertaining thereto, including stop-loss
29 insurance. Stop-loss insurance is insurance against the risk
30 of economic loss issued to a single employer self-funded
31 employee disability benefit plan or an employee welfare
32 benefit plan as described in 29 U.S.C. 100 et seq.
33 (c) Legal Expense Insurance. Insurance which involves
34 the assumption of a contractual obligation to reimburse the
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1 beneficiary against or pay on behalf of the beneficiary, all
2 or a portion of his fees, costs, or expenses related to or
3 arising out of services performed by or under the supervision
4 of an attorney licensed to practice in the jurisdiction
5 wherein the services are performed, regardless of whether the
6 payment is made by the beneficiaries individually or by a
7 third person for them, but does not include the provision of
8 or reimbursement for legal services incidental to other
9 insurance coverages. The insurance laws of this State,
10 including this Act do not apply to:
11 (i) Retainer contracts made by attorneys at law
12 with individual clients with fees based on estimates of
13 the nature and amount of services to be provided to the
14 specific client, and similar contracts made with a group
15 of clients involved in the same or closely related legal
16 matters;
17 (ii) Plans owned or operated by attorneys who are
18 the providers of legal services to the plan;
19 (iii) Plans providing legal service benefits to
20 groups where such plans are owned or operated by
21 authority of a state, county, local or other bar
22 association;
23 (iv) Any lawyer referral service authorized or
24 operated by a state, county, local or other bar
25 association;
26 (v) The furnishing of legal assistance by labor
27 unions and other employee organizations to their members
28 in matters relating to employment or occupation;
29 (vi) The furnishing of legal assistance to members
30 or dependents, by churches, consumer organizations,
31 cooperatives, educational institutions, credit unions, or
32 organizations of employees, where such organizations
33 contract directly with lawyers or law firms for the
34 provision of legal services, and the administration and
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1 marketing of such legal services is wholly conducted by
2 the organization or its subsidiary;
3 (vii) Legal services provided by an employee
4 welfare benefit plan defined by the Employee Retirement
5 Income Security Act of 1974;
6 (viii) Any collectively bargained plan for legal
7 services between a labor union and an employer negotiated
8 pursuant to Section 302 of the Labor Management Relations
9 Act as now or hereafter amended, under which plan legal
10 services will be provided for employees of the employer
11 whether or not payments for such services are funded to
12 or through an insurance company.
13 Class 2. Casualty, Fidelity and Surety.
14 (a) Accident and health. Insurance against bodily
15 injury, disablement or death by accident and against
16 disablement resulting from sickness or old age and every
17 insurance appertaining thereto, including stop-loss
18 insurance. Stop-loss insurance is insurance against the risk
19 of economic loss issued to a single employer self-funded
20 employee disability benefit plan or an employee welfare
21 benefit plan as described in 29 U.S.C. 1001 et seq.
22 (b) Vehicle. Insurance against any loss or liability
23 resulting from or incident to the ownership, maintenance or
24 use of any vehicle (motor or otherwise), draft animal or
25 aircraft. Any policy insuring against any loss or liability
26 on account of the bodily injury or death of any person may
27 contain a provision for payment of disability benefits to
28 injured persons and death benefits to dependents,
29 beneficiaries or personal representatives of persons who are
30 killed, including the named insured, irrespective of legal
31 liability of the insured, if the injury or death for which
32 benefits are provided is caused by accident and sustained
33 while in or upon or while entering into or alighting from or
34 through being struck by a vehicle (motor or otherwise), draft
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1 animal or aircraft, and such provision shall not be deemed to
2 be accident insurance.
3 (c) Liability. Insurance against the liability of the
4 insured for the death, injury or disability of an employee or
5 other person, and insurance against the liability of the
6 insured for damage to or destruction of another person's
7 property.
8 (d) Workers' compensation. Insurance of the obligations
9 accepted by or imposed upon employers under laws for workers'
10 compensation.
11 (e) Burglary and forgery. Insurance against loss or
12 damage by burglary, theft, larceny, robbery, forgery, fraud
13 or otherwise; including all householders' personal property
14 floater risks.
15 (f) Glass. Insurance against loss or damage to glass
16 including lettering, ornamentation and fittings from any
17 cause.
18 (g) Fidelity and surety. Become surety or guarantor for
19 any person, copartnership or corporation in any position or
20 place of trust or as custodian of money or property, public
21 or private; or, becoming a surety or guarantor for the
22 performance of any person, copartnership or corporation of
23 any lawful obligation, undertaking, agreement or contract of
24 any kind, except contracts or policies of insurance; and
25 underwriting blanket bonds. Such obligations shall be known
26 and treated as suretyship obligations and such business shall
27 be known as surety business.
28 (h) Miscellaneous. Insurance against loss or damage to
29 property and any liability of the insured caused by accidents
30 to boilers, pipes, pressure containers, machinery and
31 apparatus of any kind and any apparatus connected thereto, or
32 used for creating, transmitting or applying power, light,
33 heat, steam or refrigeration, making inspection of and
34 issuing certificates of inspection upon elevators, boilers,
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1 machinery and apparatus of any kind and all mechanical
2 apparatus and appliances appertaining thereto; insurance
3 against loss or damage by water entering through leaks or
4 openings in buildings, or from the breakage or leakage of a
5 sprinkler, pumps, water pipes, plumbing and all tanks,
6 apparatus, conduits and containers designed to bring water
7 into buildings or for its storage or utilization therein, or
8 caused by the falling of a tank, tank platform or supports,
9 or against loss or damage from any cause (other than causes
10 specifically enumerated under Class 3 of this Section) to
11 such sprinkler, pumps, water pipes, plumbing, tanks,
12 apparatus, conduits or containers; insurance against loss or
13 damage which may result from the failure of debtors to pay
14 their obligations to the insured; and insurance of the
15 payment of money for personal services under contracts of
16 hiring.
17 (i) Other casualty risks. Insurance against any other
18 casualty risk not otherwise specified under Classes 1 or 3,
19 which may lawfully be the subject of insurance and may
20 properly be classified under Class 2.
21 (j) Contingent losses. Contingent, consequential and
22 indirect coverages wherein the proximate cause of the loss is
23 attributable to any one of the causes enumerated under Class
24 2. Such coverages shall, for the purpose of classification,
25 be included in the specific grouping of the kinds of
26 insurance wherein such cause is specified.
27 (k) Livestock and domestic animals. Insurance against
28 mortality, accident and health of livestock and domestic
29 animals.
30 (l) Legal expense insurance. Insurance against risk
31 resulting from the cost of legal services as defined under
32 Class 1(c).
33 Class 3. Fire and Marine, etc.
34 (a) Fire. Insurance against loss or damage by fire,
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1 smoke and smudge, lightning or other electrical disturbances.
2 (b) Elements. Insurance against loss or damage by
3 earthquake, windstorms, cyclone, tornado, tempests, hail,
4 frost, snow, ice, sleet, flood, rain, drought or other
5 weather or climatic conditions including excess or deficiency
6 of moisture, rising of the waters of the ocean or its
7 tributaries.
8 (c) War, riot and explosion. Insurance against loss or
9 damage by bombardment, invasion, insurrection, riot, strikes,
10 civil war or commotion, military or usurped power, or
11 explosion (other than explosion of steam boilers and the
12 breaking of fly wheels on premises owned, controlled,
13 managed, or maintained by the insured.)
14 (d) Marine and transportation. Insurance against loss or
15 damage to vessels, craft, aircraft, vehicles of every kind,
16 (excluding vehicles operating under their own power or while
17 in storage not incidental to transportation) as well as all
18 goods, freights, cargoes, merchandise, effects,
19 disbursements, profits, moneys, bullion, precious stones,
20 securities, chooses in action, evidences of debt, valuable
21 papers, bottomry and respondentia interests and all other
22 kinds of property and interests therein, in respect to,
23 appertaining to or in connection with any or all risks or
24 perils of navigation, transit, or transportation, including
25 war risks, on or under any seas or other waters, on land or
26 in the air, or while being assembled, packed, crated, baled,
27 compressed or similarly prepared for shipment or while
28 awaiting the same or during any delays, storage,
29 transshipment, or reshipment incident thereto, including
30 marine builder's risks and all personal property floater
31 risks; and for loss or damage to persons or property in
32 connection with or appertaining to marine, inland marine,
33 transit or transportation insurance, including liability for
34 loss of or damage to either arising out of or in connection
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1 with the construction, repair, operation, maintenance, or use
2 of the subject matter of such insurance, (but not including
3 life insurance or surety bonds); but, except as herein
4 specified, shall not mean insurances against loss by reason
5 of bodily injury to the person; and insurance against loss or
6 damage to precious stones, jewels, jewelry, gold, silver and
7 other precious metals whether used in business or trade or
8 otherwise and whether the same be in course of transportation
9 or otherwise, which shall include jewelers' block insurance;
10 and insurance against loss or damage to bridges, tunnels and
11 other instrumentalities of transportation and communication
12 (excluding buildings, their furniture and furnishings, fixed
13 contents and supplies held in storage) unless fire, tornado,
14 sprinkler leakage, hail, explosion, earthquake, riot and
15 civil commotion are the only hazards to be covered; and to
16 piers, wharves, docks and slips, excluding the risks of fire,
17 tornado, sprinkler leakage, hail, explosion, earthquake, riot
18 and civil commotion; and to other aids to navigation and
19 transportation, including dry docks and marine railways,
20 against all risk.
21 (e) Vehicle. Insurance against loss or liability
22 resulting from or incident to the ownership, maintenance or
23 use of any vehicle (motor or otherwise), draft animal or
24 aircraft, excluding the liability of the insured for the
25 death, injury or disability of another person.
26 (f) Property damage, sprinkler leakage and crop.
27 Insurance against the liability of the insured for loss or
28 damage to another person's property or property interests
29 from any cause enumerated in this class; insurance against
30 loss or damage by water entering through leaks or openings in
31 buildings, or from the breakage or leakage of a sprinkler,
32 pumps, water pipes, plumbing and all tanks, apparatus,
33 conduits and containers designed to bring water into
34 buildings or for its storage or utilization therein, or
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1 caused by the falling of a tank, tank platform or supports or
2 against loss or damage from any cause to such sprinklers,
3 pumps, water pipes, plumbing, tanks, apparatus, conduits or
4 containers; insurance against loss or damage from insects,
5 diseases or other causes to trees, crops or other products of
6 the soil.
7 (g) Other fire and marine risks. Insurance against any
8 other property risk not otherwise specified under Classes 1
9 or 2, which may lawfully be the subject of insurance and may
10 properly be classified under Class 3.
11 (h) Contingent losses. Contingent, consequential and
12 indirect coverages wherein the proximate cause of the loss is
13 attributable to any of the causes enumerated under Class 3.
14 Such coverages shall, for the purpose of classification, be
15 included in the specific grouping of the kinds of insurance
16 wherein such cause is specified.
17 (i) Legal expense insurance. Insurance against risk
18 resulting from the cost of legal services as defined under
19 Class 1(c).
20 (Source: P.A. 88-364.)
21 Section 99. Effective date. This Act takes effect upon
22 becoming law.