South Dakota Administrative Rules
Title 20 - PUBLIC SAFETY
Article 20:06 - INSURANCE
Chapter 20:06:52 - Discretionary clauses
Section 20:06:52:01 - Definitions
Current through Register Vol. 50, page 114, March 25, 2024
Terms used in this chapter mean:
(1) "Appeal," any review or appeal before an administrative agency, arbitrator, court or mediator;
(2) "Discretionary clause," a provision in a policy that purports to bind the claimant to, or grant deference in, proceedings subsequent to the insurer's decision, denial, or interpretation on terms, coverage, or eligibility for benefits, including a policy provision that provides any of the following:
(3) "Policy," any plan, certificate, contract, policy, and agreement that provides for health insurance as defined by SDCL 58-9-3 or otherwise provides health or disability benefits.
General Authority: SDCL 58-2-39, 58-17-87, 58-18-79, 58-18-79(14), 58-29D-34.
Law Implemented: SDCL 58-17-87, 58-18-79, 58-29D-23, 58-29D-31(2)(6), 58-33-67.