{"data":{"id":"us-ri/r.i.-gen.-laws-27-20-66","jurisdiction":"us-ri","citation":"R.I. Gen. Laws § 27-20-66","heading":"Discretionary clauses.","body":"(a) No new or existing policy or certificate may contain any provision:\n(1) Purporting to reserve sole discretion to the insurer or healthcare entity to determine eligibility for benefits or interpret the terms of a policy or certificate; or\n(2) Specifying or affecting a standard of review upon which a court may review denial of a claim or any other decision made by an insurance company with respect to a policyholder or certificate holder.\n(b) Any such clause or language included in a contract, policy, or certificate issued to or covering a resident of this state that is contrary to or inconsistent with the provisions of this section is void and unenforceable.\n(c) Nothing in this section prohibits an insurer from including a provision in a contract that informs an insured that as part of its routine operations the insurer applies the terms of its contracts for making decisions, including making determinations regarding eligibility; receipt of benefits and claims; or explaining policies, procedures, and processes, so long as the provision could not give rise to a deferential standard of review by any reviewing court.","path":["Title 27 Insurance","Chapter 20 Nonprofit Medical Service Corporations"],"source_url":"https://webserver.rilegislature.gov/Statutes/TITLE27/27-20/27-20-66.htm","current_through":"site files published 2025-08-13","vintage":"","retrieved_at":"2026-09-05T19:57:34Z","sha256":"c530109a123437370d97bf562da63f2640b9c41975c76feeab2e1ba91efd5c6a","source_id":"us-ri","stale":true,"prev":"us-ri/r.i.-gen.-laws-27-20-65","next":"us-ri/r.i.-gen.-laws-27-20-67"},"notice":"GroundRules: Original legal text. Not legal advice."}