The Pre-Existing Condition Limitation will apply to any added benefits or increases in benefits. This Limitation will not apply to a Covered Loss for which the Date of Diagnosis occurs after the Covered Person is insured under this Policy for at least 12 months after the Covered Person’s most recent effective date of coverage, and effective date of any added or increased amount of coverage. 6) Under the Claims Provisions section, the Time of Payment of Claim provision is replaced with the following: 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 . 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. 7) Under Administrative Provision section, the following Refund of Unearned Premium provision has been added: Refund of Unearned Premium If the Policyholder cancels this Policy for any reason, We shall refund the pro rata portion of the Unused Collected Premium to the beginning of the next monthly billing cycle. “Unused Collected Premium” as used herein means that portion of any premium collected which is not used, on a pro rata basis to the beginning of the next monthly billing cycle at the time of cancellation, by Us to insure against loss as there is no risk of loss from Covered Persons, or that portion of any collected premium which would have not been collected had the premium been paid monthly. 8) Under General Provisions section, the following Consumer Affairs contact information has been added: Contact Information for the Idaho Department of Insurance Idaho Department of Insurance Consumer Affairs 700 W. State Street, 3 rd Floor P.O. Box 83720 Boise, ID 83720-0043 1-800-721-3272 or 208-334-4250 or www.DOI.Idaho.gov 9) The following Rider form(s) is/are not available: HOSPITAL BENEFIT RIDER ACCIDENTAL DEATH AND DISMEMBERMENT RIDER ACCIDENTAL RIDER DISABILITY INCOME RIDER HEALTHY LIVING WELLNESS RIDER TERM LIFE INSURANCE RIDER Indiana residents: 1) Under the Claims Provisions , the Time of Payment of Claims is replaced with the following: Time of Payment of Claims We will pay benefits due under this Policy for any loss other than a loss for which this Policy provides any periodic payment immediately after receipt of due written or authorized electronic proof of such loss. 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. We shall pay or deny each Clean Claim as follows: (1) if the claim is filed electronically, within 30 days after the date We receive the claim; or (2) if the claim is filed on paper, within 45 days after the date We receive the claim.
42
Made with FlippingBook. PDF to flipbook with ease