(1) Compulsory binding arbitration is not a
permissible arbitration provision.
(2) Compulsory non-binding arbitration is a
permissible arbitration provision when used as an internal review of an adverse
benefit determination under
29 CFR
2560.503-1(c)(4).
(3) Voluntary binding arbitration, at the
election of an insured, is a permissible arbitration provision, and may only be
used as a voluntary level of review under
29 CFR
2560.503-1(c)(3)(iii).
(4) A policy form containing a compulsory
binding or a voluntary binding arbitration provision for the exclusive election
of an insurer will be disapproved under Subsection
31A-21-201(3)(a)(iv),
and these provisions in any previously filed form are declared not
enforceable.
(5)
(a) Each application for an individual or
group health benefit plan or income replacement insurance policy that contains
a voluntary arbitration provision shall include or have attached a prominent
statement substantially as follows:
ANY MATTER IN DISPUTE BETWEEN YOU AND THE COMPANY MAY BE
SUBJECT TO ARBITRATION AS AN ALTERNATIVE TO COURT ACTION PURSUANT TO THE RULES
OF (THE AMERICAN ARBITRATION ASSOCIATION OR OTHER RECOGNIZED ARBITRATOR), A
COPY OF WHICH IS AVAILABLE ON REQUEST FROM THE COMPANY. THE COMPANY SHALL BEAR
THE COSTS OF ARBITRATION, FILING FEES, ADMINISTRATIVE FEES AND ARBITRATOR FEES.
OTHER EXPENSES OF ARBITRATION, INCLUDING, BUT NOT LIMITED TO: ATTORNEY FEES,
EXPENSES OF DISCOVERY, WITNESSES, STENOGRAPHER, TRANSLATORS, AND SIMILAR
EXPENSES, WILL BE BORNE BY THE PARTY INCURRING THOSE EXPENSES. ANY DECISION
REACHED BY ARBITRATION SHALL BE BINDING UPON BOTH YOU AND THE COMPANY. THE
ARBITRATION AWARD MAY INCLUDE ATTORNEY'S FEES, IF ALLOWED BY STATE LAW, AND MAY
BE ENTERED AS A JUDGMENT IN ANY COURT OF PROPER JURISDICTION.
(b) The statement described in Subsection
(5)(a) shall be disclosed prior to the execution of the insurance contract
between the insurer and the policyholder and shall be contained in the
certificate of insurance or other disclosure of benefits.
(6) A voluntary binding arbitration provision
may not preclude a dispute from being resolved through any small claims court
having jurisdiction.
(7) Any
arbitration provision contained in an insurance policy shall comply with Title
78B, Chapter 11, Utah Uniform Arbitration Act.
(8) An agreement for arbitration may not
obligate an insured to pay for the arbitration as part of the voluntary appeal
in accordance with
29 CFR
2560.503-1(c)(3)(v).
(9) An arbitration provision may not require
that arbitration be held at a place further from the residence of the insured
than the nearest location of a State Court of General Jurisdiction.
