Nevada Revised Statutes 695B.1931 – Contract prohibited from excluding coverage relating to treatment of temporomandibular joint; exception
1. Except as otherwise provided in this section, no contract for hospital or medical service may be delivered or issued for delivery in this state if it contains an exclusion of coverage of the treatment of the temporomandibular joint whether by specific language in the contract or by a claims settlement practice. A contract for hospital or medical service may exclude coverage of those methods of treatment which are recognized as dental procedures, including, but not limited to, the extraction of teeth and the application of orthodontic devices and splints.
Terms Used In Nevada Revised Statutes 695B.1931
- Contract: A legal written agreement that becomes binding when signed.
- Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
- Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
2. Pursuant to a contract for hospital or medical service, a corporation 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 a subscriber, but in no case more than 50 percent of the maximum benefits provided by the contract for such treatment; and
(b) Treatment which is medically necessary.
3. Any provision of a contract 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.