LEGAL SERVICES PLANS

M.G.L. pt. Part I, tit. Title XXII, ch. c. 176H

in effect

M.G.L. c. 176H, § 1 Definitions

c. 176H, § 1. Definitions Section 1. In this chapter the following words shall have the following meanings:— ''Attorney'', an attorney at law who is a member of the bar of the commonwealth or any other state. ''Commissioner'', the commissioner of insurance. ''Covered dependents'', dependents of an insured for whom benefits for covered legal services are provided under an insured legal services plan, or dependents of a member for whom covered legal services are provided under a membership legal services plan. ''Covered legal services'', legal services for which benefits are provided under an insured legal services plan or which are provided under a membership legal services plan. ''Insurance certificate'', a contract entered into between an insurer and an insured under an insured legal services plan, or a statement of legal services provided by an insurer to an insured under a group insurance policy. ''Insured'', a person to whom an insurance certificate has been issued. ''Insured legal services plan'', a plan whereby benefits for legal services are provided to insureds and their covered dependents in accordance with the provisions of this chapter. ''Insurer'', a corporation which underwrites a legal services plan. ''Member'', a person to whom a membership certificate has been issued. ''Membership certificate'', a contract entered into between a sponsor and a member under a membership legal services plan. ''Membership legal services plan'', a plan whereby legal services are provided to members and their covered dependents in accordance with the provisions of this chapter. ''Participating attorney'', an attorney who agrees in writing with an insurer to provide legal services to an insured or insureds in accordance with the provisions of an insurance certificate under an insured legal services plan, or an attorney who agrees in writing with a sponsor to provide legal services to a member or members in accordance with the provisions of a membership certificate under a membership legal services plan. ''Sponsor'', any person, group of persons, or entity which establishes and operates a legal services plan in accordance with the provisions of this chapter.

M.G.L. c. 176H, § 2 Establishment and operation of insured legal services plan; types of plans

c. 176H, § 2. Establishment and operation of insured legal services plan; types of plans Section 2. Any sponsor may establish and operate an insured legal services plan underwritten in whole or in part by an insurer subject to the provisions of this chapter. An insured legal services plan may be either an indemnity plan or a service plan, or a combination of both. Under an indemnity plan, benefits for covered legal services shall be paid to the insured for the legal services of an attorney of the insured's choice. Under a service plan, benefits for covered legal services shall be paid to a participating attorney for the legal services of a participating attorney of the insured's choice, provided, however, that such benefits shall be paid to an attorney for his legal services, whether or not such attorney is a participating attorney, if the insured chooses such attorney and notifies the insurer in writing before such legal services are rendered.

M.G.L. c. 176H, § 3 Insurer of insured legal services plans

c. 176H, § 3. Insurer of insured legal services plans Section 3. Insurance corporations may be insurers of insured legal services plans, and such companies shall be subject to the insurance laws of the commonwealth except insofar as any provision of the insurance laws may be in conflict with applicable provisions of this chapter. An insurer may also be a sponsor of an insured legal services plan.

M.G.L. c. 176H, § 4 Insurance certificates; issuance; required provisions

c. 176H, § 4. Insurance certificates; issuance; required provisions Section 4. An insurance certificate shall be issued to each insured under an insured legal services plan. No insurance certificate shall be issued unless it contains the following provisions:— (a) A statement of covered legal services and the basis for payment for such legal services; (b) A statement of the duration of the legal services provided and of the terms and conditions upon which such services may be extended, renewed, amended, canceled or otherwise terminated; and (c) A statement of the period of grace which will be allowed for making any payment due to the insurer which in any event shall not be less than thirty days.

M.G.L. c. 176H, § 5 Group insurance policy or insurance certificate contract; filing copies; approval; hearing

c. 176H, § 5. Group insurance policy or insurance certificate contract; filing copies; approval; hearing Section 5. No insurer shall issue a group insurance policy providing benefits for legal services or an insurance certificate which is a contract, or any amendment to such group policy provisions or insurance certificate previously approved and issued without prior approval of the commissioner, and prior to such approval the insurer shall file a copy of the group insurance policy or the insured legal services plan and insurance certificate contract to be issued thereunder with the commissioner and shall provide copies thereof to the advisory committee on prepaid legal services. The advisory committee on prepaid legal services shall review the group insurance policy or the insured legal services plan and insurance certificate contract and advise the commissioner in writing whether such group policy provisions or plan and certificate are in conformity with rules of the supreme judicial court governing the practice of law. After the filing of any such plan, certificate, or group insurance policy provisions the commissioner shall either approve the plan in writing or hold a public hearing upon such plan, upon not less than fifteen days written notice to all interested parties, otherwise, after thirty days after such filing, the plan, certificate, or group insurance policy shall be deemed approved. The advisory committee on prepaid legal services shall be a party with respect to any plan, certificate or group policy filed under this section, shall have the right to participate in any hearing held hereunder, and shall receive notice of the approval by the commissioner of any plan, certificate or group policy under the provisions of this section. Any such plan, certificate or group policy shall be approved unless the commissioner finds that the plan, certificate or group policy contains a provision which is unfair, inequitable, misleading, or deceptive, or that the plan, certificate or group policy does not comply with the provisions of this chapter or any other applicable provision of law, or rule of the supreme judicial court.

M.G.L. c. 176H, § 6 Rates under insured legal services plan

c. 176H, § 6. Rates under insured legal services plan Section 6. The rates to be charged by an insurer for an insurance certificate contract under an insured legal services plan approved under the provisions of this chapter shall be filed and determined in accordance with the provisions of sections one to five, inclusive, and six to twenty, inclusive, of chapter one hundred and seventy-five A. The rates to be charged by an insurer under a group insurance policy for legal services benefits shall be filed and determined in accordance with such provisions of chapter one hundred and seventy-five A; provided, however, that such filing and determination procedure shall not apply to any insurer which maintains at all times an unassigned surplus of not less than twenty million dollars.

M.G.L. c. 176H, § 7 Membership legal services plan

c. 176H, § 7. Membership legal services plan Section 7. Any corporation formed under the provisions of chapter one hundred and eighty, any corporation formed under general or special law for any of the purposes set forth in section four of chapter one hundred and eighty, or any labor organization is authorized to establish and operate a membership legal services plan. Only such corporations or labor organizations may be sponsors of membership legal services plans. Under a membership legal services plan sponsored by a corporation whose primary purpose is other than the establishment and operation of a membership legal services plan, legal services may be provided only to bona fide members of the corporation and the dependents of such members; and any such member may elect not to participate in such plan. A sponsor of a membership legal services plan may contract on behalf of its members with a participating attorney or participating attorneys, including, at the option of the sponsor, an attorney or attorneys chosen by a member or members, to provide covered legal services to such members and dependents. A membership legal services plan shall not include any plan or legal services provided by a legal aid office or public defender office, a military legal assistance office, a lawyer referral service operated, sponsored or approved by a bar association representative of the general bar of the geographical area in which the association exists, or of any other nonprofit organization that recommends, furnishes or pays for legal services to its members or beneficiaries in a manner incidental and reasonably related to a primary purpose of such organization to promote a public interest, including, without limitation, defense of human and civil rights, elimination of prejudice and discrimination as to race, religion, sex and national origin, lessening neighborhood tensions, preservation of scenic beauty, combatting or preventing pollution, preservation of natural resources, protection of consumer interest, promotion of cultural, historical or other educational activities, and prevention of cruelty to animals.

M.G.L. c. 176H, § 8 Membership certificate; required provisions

c. 176H, § 8. Membership certificate; required provisions Section 8. A membership certificate shall be issued by a sponsor to each participating member under a membership legal services plan. No membership certificate shall be issued unless it contains the following provisions:— (a) A statement of covered legal services under the certificate and the basis for payment for such legal services; (b) A statement of the duration of the certificate and of the terms and conditions upon which it may be extended, renewed, amended, canceled or otherwise terminated; (c) A statement of the period of grace which will be allowed for making any payment due from the participant member under the certificate, which in any event shall not be less than thirty days; and (d) A description of the membership legal services plan's method for resolving member complaints.

M.G.L. c. 176H, § 9 Issuance of membership certificates; filing of copy of plan and certificate for commissioner's approval; hearing

c. 176H, § 9. Issuance of membership certificates; filing of copy of plan and certificate for commissioner's approval; hearing Section 9. No sponsor shall issue a membership certificate or any amendment to a membership certificate previously approved and issued without prior approval of the commissioner, and prior to such approval the sponsor shall file a copy of the membership legal services plan and membership certificate to be issued thereunder with the commissioner and copies thereof to the advisory committee on prepaid legal services. The advisory committee on prepaid legal services shall review the membership legal services plan and membership certificate and advise the commissioner in writing whether such plan and certificate are in conformity with rules of the supreme judicial court governing the practice of law. Within thirty days after the filing of any such plan or certificate the commissioner shall either approve the plan in writing or hold a public hearing on such plan, after not less than fifteen days written notice to all interested parties. The advisory committee on prepaid legal services shall be a party with respect to any plan or certificate filed under this section, shall have the right to participate in any hearing held hereunder, and shall receive notice of the approval by the commissioner of any plan or certificate under this section. Any such plan and certificate shall be approved unless the commissioner finds that the plan or certificate contains any provision which is unfair, inequitable, misleading or deceptive, or that the plan or certificate does not comply with the provisions of this chapter or any other applicable provision of law or rule of the supreme judicial court, or that the sponsor has failed to establish its ability to provide covered legal services to its members in accordance with the terms of the membership certificate. The commissioner may approve any such plan subject to such conditions as may be appropriate to assure the continuing ability of the sponsor to provide covered legal services to its members in accordance with the terms of the membership certificate.

M.G.L. c. 176H, § 10 Rates under membership legal services plan

c. 176H, § 10. Rates under membership legal services plan Section 10. The rates to be charged by a sponsor under a membership legal services plan approved under this chapter shall be filed and determined in accordance with the provisions of sections one through five and six through twenty of chapter one hundred and seventy-five A.

M.G.L. c. 176H, § 11 Hearing; determination to modify provisions or rescind prior approval

c. 176H, § 11. Hearing; determination to modify provisions or rescind prior approval Section 11. The commissioner may, upon not less than fifteen days' written notice to all interested parties, hold a public hearing upon an insured legal services plan or a membership legal services plan previously approved by him under section five or section nine of this chapter to determine whether modification of any provisions of such a plan or rescission of his prior approval may be necessary in order to protect the interests of the insureds, members or covered dependents of such a plan. The advisory committee on prepaid legal services shall be a party with respect to any plan which is the subject of a hearing under this section, shall have the right to participate in any hearing held hereunder, and shall receive notice of any order or decision of the commissioner issued thereon. After hearing, upon his finding that it is necessary in order to protect the interests of the insureds, members or covered dependents of a plan, the commissioner may modify any provisions of a plan or rescind his prior approval thereof. No insured legal services plan or membership legal services plan may be the subject of a hearing under this section except after three years from the date of approval of the plan by the commissioner under section five or section nine of this chapter or except after three years from the date of any order or decision of the commissioner after a hearing upon such a plan under this section.

M.G.L. c. 176H, § 12 Hearing; orders or decisions made without hearing; request; decisions to be in writing

c. 176H, § 12. Hearing; orders or decisions made without hearing; request; decisions to be in writing Section 12. Any insurer or sponsor or other interested party aggrieved by any order or decision of the commissioner made without a hearing, or the advisory committee on prepaid legal services may, within fifteen days after written notice of the order or decision, make written request to the commissioner for a hearing thereon. The commissioner or his designee shall hear such party or parties within thirty days after receipt of such request and shall give not less than fifteen days' written notice of the time and place of the hearing. Such hearing shall be an adjudicatory hearing as defined in chapter thirty A. Within thirty days after such hearing, the commissioner or his designee shall affirm, reverse or modify his previous order or decision specifying his reasons therefor in writing. Pending such hearing and decision thereon, the commissioner may suspend or postpone the effective date of his previous order or decision.

M.G.L. c. 176H, § 13 Examination of books, records, papers, officers and employees; costs and expenses; confidential matters exempt

c. 176H, § 13. Examination of books, records, papers, officers and employees; costs and expenses; confidential matters exempt Section 13. The commissioner, or any deputy examiner or any other person designated by the commissioner, shall, at least once in three years, and at other times the commissioner deems prudent, visit any sponsor, other than an employer or employee organization subject to the Employee Retirement Income Security Act of 1974, P.L. 93–406, and examine into its affairs. The commissioner shall have free access to all of the books, records and papers of the sponsor and may summon and examine under oath its officers, agents, employees and other persons in relation to its affairs and condition. The commissioner shall require every such sponsor to keep its books, records, accounts and vouchers in such manner that he or his authorized representatives may readily determine whether the sponsor has complied with the law. Said sponsor shall be liable for all costs incurred in such examinations, including expenses of the commissioner, deputy examiner, or any designee employed in such examinations. Files or records containing confidential matters of an insured, a member, or covered dependents, or attorney's client files and records shall be exempt from this section, except as otherwise may be ordered by court upon a complaint brought in the superior court by the commissioner.

M.G.L. c. 176H, § 13A Applicability of chapter 176V to legal service plans governed by this chapter

c. 176H, § 13A. Applicability of chapter 176V to legal service plans governed by this chapter Section 13A. Notwithstanding any general or special law to the contrary, chapter 176V shall apply to legal services plans governed by this chapter.

M.G.L. c. 176H, § 13B Applicability of chapter 176W to legal service plans governed by this chapter

c. 176H, § 13B. Applicability of chapter 176W to legal service plans governed by this chapter Section 13B. Notwithstanding any general or special law to the contrary, chapter 176W shall apply to legal services plans governed by this chapter.

M.G.L. c. 176H, § 14 Disputes or controversies; hearings

c. 176H, § 14. Disputes or controversies; hearings Section 14. Any dispute or controversy arising between an insurer or sponsor and any attorney, insured, or member, or any person whose insurance certificate contract or membership certificate has been canceled or to whom an insurer or sponsor has refused to issue an insurance certificate contract or membership certificate or between any attorney and an insured or member may within thirty days after such dispute or controversy arises make written request to the commissioner for a hearing thereon. The commissioner or his designee shall hear such party or parties within thirty days after receipt of such request and shall give not less than fifteen days written notice of the time and place of the hearing. Such hearing shall be an adjudicatory hearing as defined in chapter thirty A. Within thirty days after such hearing the commissioner or his designee shall issue a decision thereon.

M.G.L. c. 176H, § 15 Injunction

c. 176H, § 15. Injunction Section 15. Upon application to the superior court by the commissioner, injunctive relief may be granted if any sponsor of an insured legal services plan or a membership legal services plan has failed to comply with the provisions of this chapter; is operating fraudulently; is operating so as to render further operations contrary to the public interest; has exceeded its powers; has violated any provision of law; is financially unable to pay its claims in full; or is insolvent. The court may forthwith issue a temporary injunction restraining the transaction of any business, and it may, after a full hearing make the injunction permanent, and appoint one or more receivers to take possession of the books, papers, monies and other assets of the sponsor to settle its affairs, and distribute its funds to those entitled thereto, subject to such rules and orders as the court may prescribe, or may make such other order as it may deem appropriate.

M.G.L. c. 176H, § 16 Sale of legal services plan

c. 176H, § 16. Sale of legal services plan Section 16. It shall be unlawful for any person, group of persons, or entity except an insurer or sponsor of an insured legal services plan or a membership legal services plan, to establish, underwrite, operate or offer to sell a legal services plan, except in conformity with the provisions of this chapter; provided, however, that the provisions of this chapter shall not apply to a labor organization providing legal services to its members and their dependents nor to legal fee reimbursement services provided by an automobile club in conformity with the provisions of chapter one hundred and seventy-four B.

M.G.L. c. 176H, § 17 Rules and regulations

c. 176H, § 17. Rules and regulations Section 17. The commissioner may, after public hearing, promulgate appropriate rules and regulations for the execution of his duties under this chapter. The rules and regulations may include such provisions as the commissioner deems necessary to assure that legal services plans operate in the public interest, to enable insureds, members and their covered dependents to receive legal services at reasonable cost, and to restrain any inflation in the cost of legal services attributable to the operation of legal services plans.

M.G.L. c. 176H, § 18 Repealed, 1996, 58, Sec. 31

M.G.L. c. 176H, § 19 Enforcement of chapter

c. 176H, § 19. Enforcement of chapter Section 19. The provisions of this chapter may be enforced by a complaint brought in the superior court by the commissioner or the advisory committee on prepaid legal services.

Source: Massachusetts General Court (malegislature.gov)URL: https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXXII/Chapter176HFetched: 10/20/2026