{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-4306.1.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-4306.1.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-4306.1.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-4306.1.html"}],"law_id":73640,"edition_id":1,"section_id":73640,"structure_id":12833,"section_number":"38.2-4306.1","catch_line":"Interest on claim proceeds","history":"1992, c. 23; 1996, c. 75.","full_text":"A\n\nIf an action to recover the claim proceeds due under a health care plan results in a judgment against a health maintenance organization, interest on the judgment at the legal rate of interest shall be paid from the date of presentation to the health maintenance organization of proof of loss to the date judgment is entered.B\n\nIf no action is brought, interest upon the claim proceeds paid to the subscriber, claimant, or assignee entitled thereto shall be computed daily at the legal rate of interest from the date of thirty calendar days from the health maintenance organization’s receipt of proof of loss to the date of claim payment.C\n\nThis section shall not apply to individual contracts issued prior to July 1, 1990, but shall apply to any renewals or reissues of group contracts occurring after that date.D\n\nThis section shall not apply to claims for which payment has been or will be made directly to health care providers pursuant to a negotiated reimbursement arrangement requiring uniform or periodic interim payments to be applied against the health maintenance organization’s obligation on such claims.E\n\nFor purposes of this section, “proof of loss” means all necessary documentation reasonably required by the health maintenance organization to make a determination of benefit coverage.","order_by":null,"text":{"0":{"id":264844,"text":"If an action to recover the claim proceeds due under a health care plan results in a judgment against a health maintenance organization, interest on the judgment at the legal rate of interest shall be paid from the date of presentation to the health maintenance organization of proof of loss to the date judgment is entered.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":264845,"text":"If no action is brought, interest upon the claim proceeds paid to the subscriber, claimant, or assignee entitled thereto shall be computed daily at the legal rate of interest from the date of thirty calendar days from the health maintenance organization’s receipt of proof of loss to the date of claim payment.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"C"},"2":{"id":264846,"text":"This section shall not apply to individual contracts issued prior to July 1, 1990, but shall apply to any renewals or reissues of group contracts occurring after that date.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"D"},"3":{"id":264847,"text":"This section shall not apply to claims for which payment has been or will be made directly to health care providers pursuant to a negotiated reimbursement arrangement requiring uniform or periodic interim payments to be applied against the health maintenance organization’s obligation on such claims.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C","next_prefix":"E"},"4":{"id":264848,"text":"For purposes of this section, “proof of loss” means all necessary documentation reasonably required by the health maintenance organization to make a determination of benefit coverage.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D"}},"ancestry":[{"id":12833,"edition_id":1,"name":"Health Maintenance Organizations","identifier":"43","label":"chapter","depth":2,"order_by":1,"parent_id":12698,"metadata":{},"date_created":"2026-06-26 03:43:55","date_modified":"2026-06-26 03:43:55","permalink":{"id":216835,"object_type":"structure","relational_id":12833,"identifier":"43","token":"38.2\/43","url":"\/38.2\/43\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12698,"edition_id":1,"name":"Insurance","identifier":"38.2","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:49","date_modified":"2026-06-26 03:43:49","permalink":{"id":210661,"object_type":"structure","relational_id":12698,"identifier":"38.2","token":"38.2","url":"\/38.2\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":72005,"structure_id":12833,"section_number":"38.2-4300","catch_line":"Definitions","url":"\/38.2-4300\/","token":"38.2\/43\/38.2-4300","metadata":false},{"id":80882,"structure_id":12833,"section_number":"38.2-4301","catch_line":"Establishment of health maintenance organizations","url":"\/38.2-4301\/","token":"38.2\/43\/38.2-4301","metadata":false},{"id":64417,"structure_id":12833,"section_number":"38.2-4302","catch_line":"Issuance of license; fee; minimum net worth; impairment","url":"\/38.2-4302\/","token":"38.2\/43\/38.2-4302","metadata":false},{"id":73205,"structure_id":12833,"section_number":"38.2-4303","catch_line":"Powers","url":"\/38.2-4303\/","token":"38.2\/43\/38.2-4303","metadata":false},{"id":68216,"structure_id":12833,"section_number":"38.2-4304","catch_line":"Governing body","url":"\/38.2-4304\/","token":"38.2\/43\/38.2-4304","metadata":false},{"id":54130,"structure_id":12833,"section_number":"38.2-4305","catch_line":"Fiduciary responsibilities","url":"\/38.2-4305\/","token":"38.2\/43\/38.2-4305","metadata":false},{"id":81322,"structure_id":12833,"section_number":"38.2-4306","catch_line":"Evidence of coverage and charges for health care services","url":"\/38.2-4306\/","token":"38.2\/43\/38.2-4306","metadata":false},{"id":73640,"structure_id":12833,"section_number":"38.2-4306.1","catch_line":"Interest on claim 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assistance services or covered by the Family Access to Medical Insurance Security (FAMIS) Plan","url":"\/38.2-4320.1\/","token":"38.2\/43\/38.2-4320.1","metadata":false},{"id":74331,"structure_id":12833,"section_number":"38.2-4321","catch_line":"Health maintenance organization affected by chapter","url":"\/38.2-4321\/","token":"38.2\/43\/38.2-4321","metadata":false},{"id":63129,"structure_id":12833,"section_number":"38.2-4322","catch_line":"Affiliation period","url":"\/38.2-4322\/","token":"38.2\/43\/38.2-4322","metadata":false},{"id":67176,"structure_id":12833,"section_number":"38.2-4323","catch_line":"Alternative methods","url":"\/38.2-4323\/","token":"38.2\/43\/38.2-4323","metadata":false}],"previous_section":{"id":81322,"structure_id":12833,"section_number":"38.2-4306","catch_line":"Evidence of coverage and charges for health care services","url":"\/38.2-4306\/","token":"38.2\/43\/38.2-4306","metadata":false},"next_section":{"id":65829,"structure_id":12833,"section_number":"38.2-4307","catch_line":"Annual statement","url":"\/38.2-4307\/","token":"38.2\/43\/38.2-4307","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-4306.1\/","history_text":"

This law was first created in 1992. The record of its establishment is cataloged in chapter 23 of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. Unfortunately, the 1992 \u201cActs\u201d aren\u2019t available online. It has been modified 1 time. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. That modification is as follows: in 1996, chapter 75<\/a>.<\/p>","references":[{"id":71060,"section_number":"38.2-3407.15","catch_line":"Ethics and fairness in carrier business practices","order_by":null,"url":"\/38.2-3407.15\/"}],"refers_to":false,"permalink":{"id":216865,"object_type":"law","relational_id":73640,"identifier":"38.2-4306.1","token":"38.2\/43\/38.2-4306.1","url":"\/38.2-4306.1\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-4306.1\/","token":"38.2\/43\/38.2-4306.1","dublin_core":{"Title":"Interest on claim proceeds","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-4306.1","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> If an action to recover the claim proceeds due under a health care plan<\/span> results in a judgment<\/span> against a health maintenance organization<\/span>, interest on the judgment<\/span> at the legal rate<\/span> of interest shall be paid from the date of presentation to the health maintenance organization<\/span> of proof of loss<\/span> to the date judgment<\/span> is entered. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> If no action is brought, interest upon the claim proceeds paid to the subscriber<\/span>, claimant, or assignee entitled thereto shall be computed daily at the legal rate<\/span> of interest from the date of thirty calendar days from the health maintenance organization<\/span>’s receipt of proof of loss<\/span> to the date of claim payment. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> This section shall not apply to individual contracts<\/span> issued prior to July 1, 1990, but shall apply to any renewals or reissues of group contracts<\/span> occurring after that date. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> This section shall not apply to claims for which payment has been or will be made directly to health care providers<\/span> pursuant to a negotiated reimbursement arrangement requiring uniform or periodic interim payments to be applied against the health maintenance organization<\/span>’s obligation on such claims. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> For purposes of this section, “proof of loss<\/span>” means all necessary documentation reasonably required by the health maintenance organization<\/span> to make a determination of benefit coverage. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nINTEREST ON CLAIM PROCEEDS (\u00a7 38.2-4306.1)\n\nA. If an action to recover the claim proceeds due under a health care plan\nresults in a judgment against a health maintenance organization, interest on the\njudgment at the legal rate of interest shall be paid from the date of\npresentation to the health maintenance organization of proof of loss to the date\njudgment is entered.\n\nB. If no action is brought, interest upon the claim proceeds paid to the\nsubscriber, claimant, or assignee entitled thereto shall be computed daily at\nthe legal rate of interest from the date of thirty calendar days from the health\nmaintenance organization’s receipt of proof of loss to the date of claim\npayment.\n\nC. This section shall not apply to individual contracts issued prior to July 1,\n1990, but shall apply to any renewals or reissues of group contracts occurring\nafter that date.\n\nD. This section shall not apply to claims for which payment has been or will be\nmade directly to health care providers pursuant to a negotiated reimbursement\narrangement requiring uniform or periodic interim payments to be applied against\nthe health maintenance organization’s obligation on such claims.\n\nE. For purposes of this section, “proof of loss” means all necessary\ndocumentation reasonably required by the health maintenance organization to make\na determination of benefit coverage.\n\nHISTORY: 1992, c. 23; 1996, c. 75.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}