50 Ill. Adm. Code 2001.3
Discretionary Clauses Prohibited
Section 2001.3 Discretionary Clauses Prohibited
No policy, contract, certificate, endorsement, rider
application or agreement offered or issued in this State, by a health carrier,
to provide, deliver, arrange for, pay for or reimburse any of the costs of
health care services or of a disability may contain a provision purporting to
reserve discretion to the health carrier to interpret the terms of the
contract, or to provide standards of interpretation or review that are
inconsistent with the laws of this State.