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[ Introduced ] | [ Enrolled ] | [ House Amendment 001 ] |
90_SB1901eng 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 SB1901 Engrossed 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 SB1901 Engrossed -2- LRB9011659JSgc 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 aone of the11 covered conditionconditionslisted in the policy or rider. 12Every such policy or rider shall contain a majority of13the following"Covered condition", as used in this clause, 14 meansconditions: 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 SB1901 Engrossed -3- LRB9011659JSgc 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 SB1901 Engrossed -4- LRB9011659JSgc 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 SB1901 Engrossed -5- LRB9011659JSgc 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, SB1901 Engrossed -6- LRB9011659JSgc 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, SB1901 Engrossed -7- LRB9011659JSgc 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 SB1901 Engrossed -8- LRB9011659JSgc 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 SB1901 Engrossed -9- LRB9011659JSgc 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.