We, at Our own expense, have the right and opportunity to examine the Covered Person when and as often as We may reasonably require while a claim is pending, and to have an autopsy performed at Our expense, in case of death where it is not forbidden by law. The autopsy must be performed in South Carolina.
b) The Legal Action provision as is replaced with the following:
No action at law or in equity may be brought to recover under this Policy less than 60 days after written or authorized electronic proof of loss has been furnished as required by this Policy. No such action will be brought at all unless brought within six years after the time such written proof of loss is required to be furnished.
3) Under the General Provisions section, the following changes are made:
a) The Entire Contract; Changes provision is replaced with the following:
This Policy, including the endorsements, amendments, group applications and any attached papers constitutes the entire contract of coverage. No change in this Policy 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 to waive any of its provisions.
b) The Policy Termination provision is amended to include the following as last paragraph:
However, if the premium is to be collected in weekly, monthly, or other periodic installments by authority of a payroll deduction order executed by the Employee and delivered to Us or the Employer authorizing the deduction of premium installments from the Employee’s salary or wages, We may not, during the period for which the Policy is issued and while the Employee remains employed by the authorized Employer, declare forfeited or lapsed the Policy until and unless a written or printed notice of the failure of the Employer to remit the premium or installment thereof, stating the amount or portion thereof due on the Policy and to whom it must be paid, has been duly addressed and mailed to the Employee who is insured under the Policy at least fifteen days before the Policy is terminated or lapsed.
South Dakota residents:
1) Under the Description of Coverage and Benefits section under the Hospital Intensive Care Unit ICU Stay Benefit, the Benefit Condition stating the person must be admitted on an Inpatient basis is removed.
2) Under the General Definitions section the following changes are made:
a) The Inpatient definition is revised as follows: A Covered Person who is formally admitted and confined to a Hospital or facility under a Physician’s order.
b) The Physician definition is revised as follows:
A licensed health care provider practicing within the scope of his license and rendering care and treatment to a Covered Person that is appropriate for the condition and locality and who is not:
1. employed or retained by the Policyholder; 2. living in the Covered Person’s household; or 3. a parent, sibling, spouse or child of the Covered Person.
The exclusion of treatment by family members does not apply in those areas in which the family member is the only Physician in the area and is acting within their scope of practice.
3) Under the Common Exclusions and Limitations section, the following changes are made:
a) The following exclusions are removed:
• voluntary ingestion of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
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