c) The definition of Spouse is replaced as follows: The Employee’s current lawful Spouse. Except for purposes of determining initial eligibility, the term includes a Spouse who is widowed or divorced or legally separated from an Employee. The term includes a common-law Spouse who is recognized as a common-law Spouse under the laws of the jurisdiction where the common-law marriage was formed. 2) Under the Description of Coverages and Benefits section, the following is added to the Initial Critical Illness Benefit as an additional Benefit Condition if there is no separation period between Dates of Diagnosis:
a) the Heart Attack the Covered Person has an Inpatient admission.
3) Under the Eligibility section, the first paragraph of the Rehabilitation During a Period of Disability the following sentence has been removed: We have the sole discretion to approve the Employee's participation in a Rehabilitation Plan and to approve a program as a Rehabilitation Plan.
4) The Claim Provisions section, the following changes are made: a) The Time of Payment of Claims is been modified as follows:
We will pay benefits due under this Policy for any loss other than a loss for which this Policy provides any periodic payment not more than 30 days upon Our receipt of due written or authorized electronic proof of such loss. If additional information is required to process the claim, the claim must be paid within 15 days after receiving said information. Due proof of loss means all essential information needed to make a determination on the claim. Subject to due written or authorized electronic proof of loss, all accrued benefits for loss for which this Policy provides periodic payment will be paid monthly unless otherwise specified in the benefits descriptions and any balance remaining unpaid at the termination of liability will be paid immediately upon receipt of proof satisfactory to Us. Failure to pay a claim in accordance with the time periods stated in this provision will require the payment of interest at a rate not to exceed 15% per annum on all benefits due and unpaid. b) The Recovery of Overpayment provision is modified as follows: If benefits are overpaid, We have, within 90 days of the date an overpayment is made, the right to recover the amount overpaid by either of the following methods. We will provide 30 days’ notice before seeking recovery of an overpayment. 1. A request for lump sum payment of the overpaid amount. 2. A reduction of any amounts payable under this Policy. If there is an overpayment due when the Covered Person dies, We may recover the overpayment from the Covered Person’s estate. 5) Under the Administrative Provisions section of the Policy, the Change in Premium Rates provision is modified to require at least 45 days advance written notice. 6) The General Provisions section, the following changes were made: a) The Entire Contract: Changes is modified as follows: This Policy, including the endorsements, amendments, Certificate and any attached papers constitutes the entire contract of insurance. No change in this Policy or Certificate will be valid until approved by one of Our executive officers and endorsed on or attached to this Policy. No agent has authority to change this Policy or Certificate or to waive any of its provisions.
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