4) Under the Common Exclusions section, the following changes are made:
a) The exclusion related to voluntary ingestion is replaced with the following: voluntary ingestion of any narcotic, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
b) The exclusion related to operating a vehicle while under the influence of alcohol, or drugs is replaced with the following:
• operating any type of vehicle while under the influence of alcohol, narcotic or other intoxicant including any prescribed drug for which the Covered Person has been provided a written warning against operating a vehicle while taking it. Under the influence of alcohol, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Loss occurred.
5) Under the Claim Provisions section, the Time of Payment of Claims provision is replaced with the following:
All claims arising under the terms of the Policy shall be paid not more than 30 days from the date upon which written or authorized electronic notice and proof of claim, in the form required by the terms of the Policy, are furnished to Us unless reasonable grounds, such as would put a reasonable and prudent businessman on His guard, exist. Failure to comply with this provision shall subject Us to a penalty payable to the Covered Person of double the amount of the benefits due under the terms of the Policy during the period of delay, together with attorney’s fees to be determined by the court.
6) Under the Administrative Provision section, the Changes in Premium Rates provisions is replaced with the following:
The premium rates may be changed by the Insurance Company from time to time with at least 31 days advance written notice. However, the Insurance Company shall provide at least 45 days written notice for an increase in premium rates that equals or exceeds 20%. No change in rates will be made until 24 months after the Effective Date. An increase in rates will not be made more often than once in a 12 month period. However, the Insurance Company reserves the right to change the rates even during a period for which the rate is guaranteed, if any of the
following events take place: 1. The Policy terms change.
2. A division, subsidiary, eligible company, or class is added or deleted. 3. There is a change of more than 10% in the number of eligible Employees. 4. Federal or state laws or regulations affecting benefit obligations change. 5. Other changes occur in the nature of the risk that would affect the Insurance Company’s original risk assessment. 6. The Insurance Company determines the Employer fails to furnish necessary information.
If an increase or decrease in rates takes place on a date that is not a Premium Due Date, a pro rata adjustment will apply from the date of the change to the next Premium Due Date.
The Employer must, upon request, give the Insurance Company any information required to determine who is insured, the amount of insurance in force and any other information needed to administer the plan of insurance.
7) Under the General Provisions section, the first paragraph of the Policy Termination provision is replaced with the following:
We may terminate insurance on or after the first anniversary of the Policy Effective Date. The Policyholder or We may terminate insurance on any Premium Due Date. Written notice with the reason for such termination, by certified mail, must be given at least 60 days prior to such Premium Due Date. Failure by the Policyholder to pay premiums when due or within the Grace Period shall be deemed notice to Us to terminate insurance at the end of the period for which premium was paid.
Maryland residents:
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