Current through the 2024 Fourth Special Session
Section 31A-21-314 - Prohibited provisions(1) As used in this section:(a) "Reserving discretionary authority" means a policy provision that:(i) has the effect of conferring discretion on an insurer, or other claim administrator, to:(A) determine eligibility for benefits; or(B) interpret the terms or provisions of the policy, contract, certificate, or agreement; and(ii) could lead to a deferential standard of review by a reviewing court.(b) "Reserving discretionary authority" does not include a policy provision that:(i) informs an insured that, as part of the insurer's routine operations, the insurer applies the terms of the contract for: (A) making a decision, including making a determination regarding eligibility, or receipt of benefits or claims; or(B) explaining the insurer's policies and procedures; and(ii) does not give rise to a deferential standard of review by a reviewing court.(2) An insurance policy subject to this chapter may not contain a provision:(a) requiring the insurance policy to be construed according to the laws of another jurisdiction except as necessary to meet the requirements of compulsory insurance laws of other jurisdictions;(b) depriving Utah courts of jurisdiction over an action against the insurer, except as provided in permissible arbitration provisions;(c) limiting the right of action against the insurer to less than three years from the date the cause of action accrues; or(d) for life insurance or accident and health insurance, reserving discretionary authority.(3) For purposes of Subsection (2)(c), the cause of action accrues on a fidelity bond on the date the insurer first denies all or part of a claim made under the fidelity bond.Amended by Chapter 351, 2018 General Session ,§ 1, eff. 5/8/2018.Amended by Chapter 244, 2015 General Session ,§ 25, eff. 5/12/2015.Amended by Chapter 95, 1987 General Session