P.R. Laws tit. 26, § 1701

2019-02-20 00:00:00+00
§ 1701. Group and blanket disability insurance coverages, authorized

A disability insurer may grant or issue disability insurance coverages under the group or blanket plans, for delivery in Puerto Rico, under the following conditions:

(1) The premium rate may be lower than for similar coverages issued individually.

(2) Except as provided in § 1702 of this title, the blanket disability insurance policies shall contain such provisions, and be issued pursuant to such arrangements as may be usual and customary, and are approved or determined by the Commissioner.

(3) No group disability insurance policy shall be issued for delivery in Puerto Rico, unless it is in agreement with one of the descriptions contained in § 1401 of this title.

(4) Any group disability insurance policy issued to the groups described in subsections (1), (3), (4), and (5) of § 1401 of this title may be extended to cover the spouse and/or dependent children of the employee or insured member, subject to the following requirements;

(a) The premium corresponding to this insurance policy shall be paid by the policyholder, either wholly from his own funds, or wholly from funds contributed by the employees or insured members, or from both funds. If all or part of the premium is to be paid from funds contributed by the employees or insured members, the extension of insurance to the spouse and dependent children shall become effective only if 75% or more of those employed at that time, or eligible members, decide to pay the required contribution, excluding anyone whose spouse and/or dependent children do not show evidence of insurability satisfactory to the insurer. In the case that the premium is not paid partially or totally by the insured individuals, the policy shall have to insure all spouses and/or dependent children, except someone whose evidence of individual insurability is not satisfactory to the insurer.

(b) If the insurance coverage of the spouse and/or dependent children of the employee or insured member ceases due to the termination of his employment or membership, said spouse or dependent child shall be entitled to the conversion benefit as provided in § 1707 of this title.

(c) Notwithstanding the provisions of § 1706 of this title, a single certificate may be issued to the employee or insured member, if the spouse and dependent children are included therein.

History —Ins. Code § 17.010; June 30, 1975, No. 115, p. 345, § 1; June 24, 1977, No. 112, p. 281, § 1, eff. 6 months after June 24, 1977.