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2. The insurer may limit its liability on the treatment of the temporomandibular joint to:
(a) No more than 50 percent of the usual and customary charges for such treatment actually received by an insured, but in no case more than 50 percent of the maximum benefits provided by the policy for such treatment; and
(b) Treatment which is medically necessary.
3. Any provision of a policy subject to the provisions of this chapter and issued or delivered on or after January 1, 1990, which is in conflict with this section is void.
(Added to NRS by 1989, 2137)
REIMBURSEMENT FOR CERTAIN MEDICALLY RELATED TREATMENT AND SERVICES
NRS 689A.0475 Acupuncture. If any policy of health insurance provides coverage for acupuncture performed by a physician, the insured is entitled to reimbursement for acupuncture performed by a person who is licensed pursuant to chapter 634A of NRS.
(Added to NRS by 1991, 1133)
NRS 689A.048 Treatment by licensed psychologist. If any policy of health insurance provides coverage for treatment of an illness which is within the authorized scope of the practice of a qualified psychologist, the insured is entitled to reimbursement for treatments by a psychologist who is licensed pursuant to chapter 641 of NRS.
(Added to NRS by 1979, 367; A 1989, 1553)
NRS 689A.0483 Treatment by licensed marriage and family therapist. If any policy of health insurance provides coverage for treatment of an illness which is within the authorized scope of the practice of a licensed marriage and family therapist, the insured is entitled to reimbursement for treatment by a marriage and family therapist who is licensed pursuant to chapter 641A of NRS.
(Added to NRS by 1987, 2133)
NRS 689A.0485 Treatment by licensed associate in social work, social worker, independent social worker or clinical social worker. If any policy of health insurance provides coverage for treatment of an illness which is within the authorized scope of the practice of a licensed associate in social work, social worker, independent social worker or clinical social worker, the insured is entitled to reimbursement for treatment by an associate in social work, social worker, independent social worker or clinical social worker who is licensed pursuant to chapter 641B of NRS.
(Added to NRS by 1987, 1123)
NRS 689A.049 Treatment by licensed chiropractor; restriction on policy limitations.
1. If any policy of health insurance provides coverage for treatment of an illness which is within the authorized scope of practice of a qualified chiropractor, the insured is entitled to reimbursement for treatments by a chiropractor who is licensed pursuant to chapter 634 of NRS.
2. The terms of the policy must not limit:
(a) Coverage for treatments by a chiropractor to a number less than for treatments by other physicians.
(b) Reimbursement for treatments by a chiropractor to an amount less than that reimbursed for similar treatments by other physicians.
(Added to NRS by 1981, 930; A 1983, 327)
NRS 689A.0495 Services provided by certain registered nurses; restriction on policy limitations; exception.
1. If any policy of health insurance provides coverage for services which are within the authorized scope of practice of a registered nurse who is authorized pursuant to chapter 632 of NRS to perform additional acts in an emergency or under other special conditions as prescribed by the State Board of Nursing, and which are reimbursed when provided by another provider of health care, the insured is entitled to reimbursement for services provided by such a registered nurse.
2. The terms of the policy must not limit:
(a) Coverage for services provided by such a registered nurse to a number of occasions less than for services provided by another provider of health care.
(b) Reimbursement for services provided by such a registered nurse to an amount less than that reimbursed for similar services provided by another provider of health care.
3. An insurer is not required to pay for services provided by such a registered nurse which duplicate services provided by another provider of health care.
(Added to NRS by 1985, 1446)
NRS 689A.0497 Provider of medical transportation.
1. Except as otherwise provided in subsection 3, every policy of health insurance amended, delivered or issued for delivery in this State after October 1, 1989, that provides coverage for medical transportation, must contain a provision for the direct reimbursement of a provider of medical transportation for covered services if that provider does not receive reimbursement from any other source.
2. The insured or the provider may submit the claim for reimbursement. The provider shall not demand payment from the insured until after that reimbursement has been granted or denied.
3. Subsection 1 does not apply to any agreement between an insurer and a provider of medical transportation for the direct payment by the insurer for the provider’s services.
(Added to NRS by 1989, 1273)
MISCELLANEOUS PROVISIONS
NRS 689A.050 Entire contract; changes. There shall be a provision as follows:
Entire Contract; Changes: This policy, including the endorsements and the attached papers, if any, constitutes the entire contract of insurance. No change in this policy shall be valid until approved by an executive officer of the insurer and unless such approval is endorsed hereon or attached hereto. No agent has authority to change this policy or to waive any of its provisions.
(Added to NRS by 1971, 1753)
NRS 689A.060 Time limit on certain defenses. There shall be a provision as follows:
Time Limit on Certain Defenses:
1. After 3 years from the date of issue of this policy no misstatements, except fraudulent misstatements, made by the applicant in the application for such policy shall be used to void the policy or to deny a claim for loss incurred or disability (as defined in the policy) commencing after the expiration of such 3-year period.
The foregoing policy provision shall not be so construed as to affect any legal requirement for avoidance of a policy or denial of a claim during such initial 3-year period, nor to limit the application of NRS 689A.200 to 689A.230, inclusive, in the event of misstatement with respect to age or occupation or other insurance. A policy which the insured has the right to continue in force subject to its terms by the timely payment of the premium until at least age 50 or, in the case of a policy issued after age 44, for at least 5 years from its date of issue, may contain in lieu of the foregoing the following provision (from which the clause in parentheses may be omitted at the insurer’s option): “Incontestable: After this policy has been in force for a period of three years during the lifetime of the insured (excluding any period during which the insured is disabled), it shall become incontestable as to the statements contained in the application.”
2. No claim for loss incurred or disability (as defined in the policy) commencing after 3 years from the date of issue of this policy shall be reduced or denied on the ground that a disease or physical condition not excluded from coverage by name or specific description effective on the date of loss had existed prior to the effective date of coverage of this policy.
(Added to NRS by 1971, 1753)
NRS 689A.070 Grace period. There shall be a provision as follows:
Grace Period: A grace period of ..... (insert a number not less than “7” for weekly premium policies, “10” for monthly premium policies and “31” for all other policies) days will be granted for the payment of each premium falling due after the first premium, during which grace period the policy shall continue in force.
A policy in which the insurer reserves the right to refuse any renewal
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