§33-16A-6. Inquiries by insurer.
A converted policy may include a provision whereby the
insurer may request information in advance of any premium due
date of such policy of any person covered thereunder as to
whether (i) he is covered for similar benefits by another
hospital, surgical, medical or major medical expense insurance
policy or hospital or medical service subscriber contract or
medical practice or other prepayment plan or by any other plan or
program, (ii) he is covered for similar benefits under any
arrangement of coverage for individuals in a group, whether on an
insured or uninsured basis, or (iii) similar benefits are
provided for or available to such person, pursuant to or in
accordance with the requirements of any state or federal law. The
converted policy may provide that the insurer may refuse to renew
the policy or the coverage of any person insured thereunder for
the following reasons only:
(a) Either the benefits provided under the sources referred
to in (i) and (ii) above for such person or benefits provided or
available under the sources referred to in (iii) above for such
person, together with the benefits provided by the converted
policy, would result in overinsurance according to the insurer's
standards on file with the commissioner or the converted
policyholder fails to provide the requested information;
(b) Fraud or material misrepresentation in applying for any
benefits under the converted policy;
(c) Eligibility of the insured person for coverage under
medicare (Title XVIII of the United States Social Security Act as supplemented by the Social Security Amendments of 1965 or as
later amended or superseded) or under any other state or federal
law providing for benefits similar to those provided by the
converted policy;
(d) Other reasons approved by the commissioner.