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Me. Rev. Stat. tit. 24-A, § 2847-V

Absolute discretion clauses

Known as the Group or Blanket Health Insurance Law

The act spans §§ 2801–2847 (103 sections).

PL 2019, c. 179, §2 (NEW).

A group health insurance policy, contract or certificate, including, but not limited to, a group disability income insurance policy, contract or certificate, may not contain a provision purporting to reserve sole or absolute discretion to the insurer to interpret the terms of the contract, to provide standards of interpretation or review, to determine eligibility for benefits, to determine the amount of benefits or to resolve factual disputes. An insurer may not enforce a provision in a policy, contract or certificate that was offered, executed, delivered or issued for delivery in this State and has been continued or renewed by a group policy holder in this State that purports to reserve sole or absolute discretion to the insurer to interpret the terms of the contract, to provide standards of interpretation or review, to determine eligibility for benefits, to determine the amount of benefits or to resolve factual disputes.

Official source: Maine Legislature. Reproduced from public-domain Maine statutes; confirm against the official source for the current text. Not legal advice.