Group Critical Illness Insurance Certificate

5) Under the Claim Provisions section, the following changes are made:

a) Under the Notice of Claim provision, the first sentence is replaced with the following:

Written or authorized electronic/telephonic notice of claim must be given to Us within 20 days after a Covered Loss occurs or begins or as soon as is reasonably possible.

b) Under the Claim Forms provision, the first sentence is replaced with the following:

When We receive notice of a claim, We will send claim forms to claimant of to the Policyholder for delivery to the claimant, with written instructions for filing proof of loss.

c) The Claimant Cooperation Provision is replaced with the following:

Failure of a claimant to reasonably cooperate with Us in the administration of the claim may result in termination of the claim. Such cooperation includes, but is not limited to, providing any information or documents needed to determine whether benefits are payable or the actual benefit amount due.

d) Under the Time of Payment of Claims provision, the first sentence 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 60 days after Our receipt of due written or authorized electronic proof of such loss and right of the claimant to the Policy proceeds.

e) Under the Payment of Claims provision, the second sentence is replaced with the following:

All benefits payable under the Policy are payable to the Covered Person or the Covered Person’s assignee, if living, except if the Covered Person is a Dependent Child, then the benefits will be payable to the Employee.

f) Under the Payment of Claims provision, the following sentence is removed:

Any payment made by Us in good faith pursuant to this provision will fully discharge Us, and release Us from all liability, to the extent of such payment.

g) The following provisions are added: Payment to Texas Health and Human Services Commission Upon Our receipt of written notice at Our Home Office, benefits payable on behalf of a Dependent Child must be paid to the Texas Health and Human Services Commission if: 1. the Employee is required to pay child support by a court order or court-approved agreement and: a. is a possessory conservator of the child under a court order issued in this state; or b. is not entitled to possession of or access to the child; 2. the Texas Health and Human Services Commission is paying benefits on behalf of the child under Chapter 31 or 32, Human Resources Code; and 3. the written notice specifies that the benefits must be paid directly to the Texas Health and Human Services Commission.

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