695D.219 - Organization for dental care prohibited from denying coverage solely because member was intoxicated or under the influence of controlled substance; exceptions.
695D.219 Organization for dental care prohibited from denying coverage solely because member was intoxicated or under the influence of controlled substance; exceptions.
1. Except as otherwise provided in subsection 2, an organization for dental care shall not:
(a) Deny a claim under a plan for dental care solely because the claim involves an injury sustained by a member as a consequence of being intoxicated or under the influence of a controlled substance.
(b) Cancel participation under a plan for dental care solely because a member has made a claim involving an injury sustained by the member as a consequence of being intoxicated or under the influence of a controlled substance.
(c) Refuse participation under a plan for dental care to an eligible applicant solely because the applicant has made a claim involving an injury sustained by the applicant as a consequence of being intoxicated or under the influence of a controlled substance.
2. The provisions of this section do not prohibit an organization for dental care from enforcing a provision included in a plan for dental care to:
(a) Deny a claim which involves an injury to which a contributing cause was the insured’s commission of or attempt to commit a felony;
(b) Cancel participation under a plan for dental care solely because of such a claim; or
(c) Refuse participation under a plan for dental care to an eligible applicant solely because of such a claim.
(Added to NRS by 2005, 2346)