5) Under the Eligibility section, following provision is added:
Newborn Child(ren ) Coverage for a newly born child shall be provided without notice for no less than 31 days after the date of birth.
6) Under the Termination of Insurance section, the following is added:
Extension of Benefits If the Policy terminates while a Covered Person is Totally Disabled as the result of a Covered Injury or Illness, We will continue to pay benefits for that Covered Person until the earliest of: 1. 90 days after the Policy terminates; or 2. the date the Covered Person is no longer Totally Disabled.
7) Under the Claim Provisions section, make the following changes:
a) The Claim Forms provision is replaced with the following:
When we receive notice of claim, We will send claim forms to the claimant or to the Policyholder for delivery to the claimant, with written instructions for filing proof of loss. If such forms are not sent within 15 days after We receive notice, the proof requirements will be met by submitting, within the time fixed in this Policy for filing proof of loss, written or authorized electronic proof of the nature and extent of the loss for which the claim is made.
b) 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.
c) The Time of Payment of Claims provisions are 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 the right of the claimant to the Policy proceeds. 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. If payment is delayed beyond the time period after receiving satisfactory proof of loss, We will be liable to pay the insured or the beneficiary making the claim under the policy, in addition to the amount of the claim, interest on the amount of the claim at the rate of 18 percent a year as damages, together with reasonable attorney's fees.
8) 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
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