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A BILL
TO BE ENTITLED
AN ACT To ANEND CRAPTER 6N2, FLORIDA STATUTE,
PETATINO To ACCIDENT AND SICKNESS INSURANCE, DI
ADDING TNERETO A NEW SECTION TO BE DESIGNATED
SECTION 61:2.031, IN SUBSTITUTION m2 PRESENT
SECTION 6h2.03, FLORIDA STATUTES, REIA TINO To
THE Tom AND CONTENT OP ACCIDan' AND SIcaunSS
POLICIIS, AND IN SUBSTITUTION NOR SUDSECTION
619.0141), FIORIDA STATUTES, REIATINO TO FAIIILY
GROUP ACCIDENT AND SICKNESS INSURANCE, SAID NEW
SECTION PROVIDING EOR INDIVIDUAL ACCIDINT AND
SICKNESS INSURANCE, PORN OP POLICIES, POLch
PROVISIONS AND mLANATIONS THEREOF, TNE RIDERS
OR ENDORSIIIINTs TO BE ATTACHED TRERETO OR APPIXED
TNEREON, TRE APPLICATIONS TO BE USED TRl-mmm,
AND THE POWERS, DUTIES AND OBLIGATIONS OR THE
COtD:ISSIONER RITE RESPECT To APPROVAL mEREOF;
PIXINC THE EPPECTINE DATE OF TRIS ACT; CONTINUING
IN EFFECT CERTAIN PROVISIONS OP SAID SECTION
6h2.o3 AND SAID SUESECTION 6h2.oh( 1) UNDER STATED
CONDITIONS DURINO TEE WREEdeEAR PERIOD Imam-TEL!
SUESE'JUENT T0 SAID EPPECTIVE DATE, ND REPEALINC
SAgg SECTION AND SAID SUDSDCTION ON OCTOBER 1,
19 .
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF FLORIDA:
Section 1. That Chapter 6h2, Florida Statutes, is
amended by adding thereto a new section to be designated
Section 6h2.031, Florida Statutes, nhich new section is
as follows:
"6&2.031 Individual Accident and Sickness
Insurance.--The form and content of individual accident
end sickness policies shell confbrn to the following:
"A. Form of Policy.
No policy of accident and sickness
insurance shall be delivered or issued for delivery to
any person in this state unless:
"(1) The entire money and other
considerations therefor are expressed therein; and
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"If any indemnity of this policy shall
be payable to the estate of the insured, or to an insured
or beneficiary who is a minor or otherwise not competent to
give a valid release, the insurer may pay such indemnity, up
to an amount not exceeding 6. . . . . (insert an
amount shich shall not exceed 91000), to any relative by
blood or connection by marriage of the insured or bene-
ficiary who is deemed by the insurer to be equitably en-
titled thereto. Any payment made by the insurer in good
faith pursuant to this provision shall fully discharge the
insurer to the extent of such payloht."
"Subject to any written direction of
the insured in the application or otherwise all or a por
tion or any indemnities provided by this policy on account
of hospital, nursing, medical, or surrical services may,
at the insurer's option and unless the insured requests
otherwise in writing not later than the tins of filing
proofs of such loss, be paid directly to the hospital or
person rendering such services; but it is not required
that the service be rendered by a particular hospital or
person.")
"(10) A provision es follows:
"Physical Examinations and Autopsy:
The insurer at its own expense shall have the right and op-
portunity to examine the person or the insured then and
as often as it may reasonably require during the pendency
of e clain hereunder and to make an autopsy in case of
death where it is not forbidden by law.
"(11) A provision as follows:
"Legal Actions: No action at law or
in equity shall be brought to recover on this policy prior
to the expiration of sixty days after written proof of
loss has been furnished in accordance with the requirements
of this policy. "0 such action shall be brought after the
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expriation of three years after the time written proof of
loss is required to be furnished.
"(12) A provision as follows:
"Change of Beneficiary: Unless the
insured makes an irrevocable designation of beneficiary, the
right to change of beneficiary is reserved to the insured
and the consent of the beneficiaryor beneficiaries shall
not be requisite to surrender or assignment of this policy
or to any change of beneficiary or beneficiaries, or to
any other changes in this policy.
"(The first clause of this provision,
relating to the irrevocable designation of beneficiary,
may be omitted at the insurer's option.)
"B. Other Provisions:
"Except as provided in sub-section F of
this section, no such policy delivered or issued for delivery
to any person in this state shall contain provisions respect-
ing the matters set forth below unless such provisions are
in the words in which the same appear in this section; provided,
however, that the insurer may, at its option, use in lieu
of any such provision a corresponding provision of different
wording approved by the insurance commissioner which is not
less favorable in any respect to the insured or the benefic-
iary. Any such provision contained in the policy shall be
preceded individually by the appropriate caption appearing
in this subsection or, at the option of the insurer, by
such appropriate individual or group captions or subcap-
tions as the insurance comissioner may approve.
"(1) A provision as follows:
"Change of Occupation: If the insured
be injured or contract sickness after having changed his
occupation to one classified by the insurer as more hazard-
ous than that stated in this policy or while doing for
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compensation anything pertaining to an occupation so
classified, the insurer will pay only such portion of
the indemnities provided in this policy as the prenium
paid would have purchased at the rates and within the
limits fixed by the insurer for such were hazardous oc-
cupation. If the insured changes his occupation to one
classified by the insurer as less hazardous than that
stated in this policy, the insurer, upon receipt of proof
of such change of occupation, will reduce the premium
rate accordingly, and will return the excess pro-rats un-
earned premium frcn the date of change of occupation or
from the policy anniversary date immediately preceding
receipt of such proof, whichever is the more recent. In
applyinr this provision, the classification of occupa-
tional risk and the premium rates shall be such as have
been last filed by the insurer prior to the occurrence of
the loss forttdch the insurer is liable or prior to date
of proof of change in occupation with the state official
having supervision of insurance in the state where the
insured resided at the time this policy was issued; but
if such filing was not required, then the classification
of occupational risk and the premium rates shall be those
last made effectivs by the insurer in such state prior to
the occurrence of the loss or prior to the date of proof
of change in occupation.
'(2) A provision as follows:
"His-statement of Age: If the age of
the insured has been sis-stated, all amounts payable under
this policy shall be such as the premium paid would have
purchased at the correct age.
"(3) A prevision as follows:
"other Insurance in this Insurer: if
an accident or sickness or accident and sickness policy
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or policies previously issued by the insurer to the in-
sured be in force conCurrently herewith, making the aggre-
gate indemnity for . . . . . (insert type of
coverage or coverages) in excess of 8... . . (insert
maximum limit of indemnity or indemnities) the excess in-
surance shall be void and all premiums paid for such ex-
case shall be returned to the insured or to his estate, or,
in lieu thereof:
"Insurance effective at any one time
on the insured under a like policy or policies in this in
surer is limited to one such policy elected by the in-
sured, his beneficiary or his estate, as the case may be,
and the insurer will return all premiums paid for all other
such policies.
"(h) A provision as follows:
"Insurance with Other Insurers: If
there be other valid coverage, not with this insurer, pro-
viding benefits for the sane loss on a provision of service
basis or on an expense incurred basis and of which this in-
surer has not been given written notice prior to the oc-
currence or commencement of loss, the only liability under
any expense incurred coverage of this policy shall be for
such proportion of the loss as the amount which would
otherwise have been payable hereunder plus the total of the
like amounts under all such other valid coverages for the
same loss of which this insurer had notice bears to the
total like amounts under all valid coverages {or such loss,
and for the return of such portion of the premiums paid
as shall exceed the pro-rats portion for the amount so
determined. For the purpose of applying this provision
when other coverage is on a provision of service basis,
the "like amount" of such other coverage shall be taken
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as the amount which the services rendered would have cost
in the absence of such coverage.
"(If the foregoing policy provision is
included in a policy which also contains the next following
policy provision there shall be added to the caption of
the foregoing provision, the phrase "-Expense Incurred
unnuw Memmmrmmatuawum,mdweMtMs
provision a definition of I'other valid coverage," approved
as to for: by the Insurance Commissioner, nhich definition
shall be limited in subject matter to coverage provided
by organizations subject to regulation by insurance law or
by insurance authorities of this or any other state of
the United States or any province or Canada, and by hos-
pital or medical service organizations, and to any other
coverage the inclusion of vhich may be approved by the
Insurance Commissioner. In the absence of such definition
such term shall not include group insurance, automobile
medical payments insurance, or coverage provided by hos-
pital or medical service organizations or by union sel-
fare plans or employer or employee benefit organizations.
For the purpose of applying the foregoing policy provis-
ion with respect to any insured, any amount of benefit
provided for such insured pursuant to any compulsory bene-
fit statute (including any workmens compensation or an-
ployer's liability statute) whether provided by a govern-
mental agency or otherwise shall in all cases be deemed
to be "other valid coverage" of which the insurer has had
notice. In applying the foregoing policy provision no
third party liability coverage shall be included as "other
valid coverage.")
"(5) A provision as follows:
"Insurance uith other Insurers: If
there be other valid coverage, not with this insurer, pro-
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viding benefits for the same loss on other than an expense
incurred basis and of which this insurer has not been given
written notice prior to the occurrence or commencement of
loss, the only liability for such benefits under this
policy shall be for such proportion of the indemnities
otherwise provided hereunder for such loss as the like in-
demnities of which the insurer had notice (including the
indemnities under this policy) bear to the total amount of
all like indemnities for such loss, and for the return of
such portion of the premium paid as shall exceed the pro-
rata portion for the indemnities thus determined.
"(If the foregoing policy provision
is included in a policy which also contains the next pre-
ceding policy provision there shall be added to the caption
of the foregoing provision the phrase "-Other Benefits."
The insurer may at its option, include in this provision
a definition of "other valid coverage," approved as to
form by the Insurance Comissioner, which definition shall
be limited in subject matter to coverage provided by or-
ganizations subject to regulation by insurance law or by
insurance authorities of this or any other state of the
United States or any province of Canada, and to any other
coverage the inclusion of uhich may be approved by the
Insurance Commissioner. In the absence of such definition
such term shall not include group insurance, or benefits
provided by union welfare plans or by employer or employee
benefit organizations. For the purpose of applying the
foregoing policy provision with respect to any insured, any
amount of benefit provided for such insured pursuant to any
compulsory benefit statute (including any workmen's com-
pensation or employer's liability statute) whether pro-
vided by a governmental agency or otherwise shall in all
cases be deemed to be "other valid coverage" of which the
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insurer has hsd notice. In applying the foregoing policy
provision no third party liability coverage shell be in-
cluded as "other valid coverege.")
I'(6) A provision as follows:
I'Relation of Earnian to Insurance: If
the total monthly amount of loss of time benefits promised
for the same loss under all valid loss of tine coverage
upon the insured, whether payable on a weekly or nontth
basis, shell exceed the monthly earnings of the insured
at the time disability commenced or his average monthly
eaminga for a period of two years immediately preceding
a disability for which claim is made, whichever is the
greater, the insurer will be liable only for such propor-
tionate amount of such benefits under this policy as the
-ouht of such monthly earrdngs or such average lonthly
earnings of the insured bears to the total amount of
monthly benefits for the one loss under all such coverage
upon the insured at the time such disability ounences and
for the return of such part of the premium paid during
such two years as shall exceed the pro-rate amount of the
premiums for the benefits actually paid hereunder; but
this shall not operate to reduce the total monthly amount
of benefits payable under all such coverage upon the in-
sured below the sun of tee hundred dollars or the sum of
the monthly bemfits specified in such coverages, which-
ever is the lesser, ncs' shall it operate to reduce bene-
fits other than those pmble for loss of time.
"(The foregoing policy provision nay
be inserted only in a policy which the insured has the
right to continue in force subject to its tens by the
timely payment of premiums, (1) until at least age 50 or,
(2) in the ease of a policy issued after age hh, for at
least five years from its date of issue. The insurer nay,
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at its option, include in this provision a definition of
"valid loss of time coverage," approved as to form by the
Insurance Commissioner, which definition shall be limited in
subject matter to coverage provided by governmental agencies
or by orcanisations subject to regulation by insurance
law or by insurance authorities of this or any other state
of the United States or any province of Canada, or to any
other coverage the inclusion of which may be approved by
the Insurance Commissioner or any combination of such
coverages. In the absence of such definition such term
shall not include any coverage provided for such insured
pursuant to any compulsory benefit statute (including any
workmen's compensation or employer's liability statute),
or benefits provided by union welfare plans or by employer
or employee benefit organizations).
"(7) A provision as follows:
"Unpaid Premium: Upon the payment of
a claim under this policy, any premium then due and unpaid
or covered by any note or written order may be deducted
therefrom.
"(8) A provision as follows:
"Cancellation: The insurer may can-
cel this policy at any time by written notice delivered
to the insured, or mailed to his last address as shown
by the records of the insurer, stating when, not less than
five days thereafter, such cancellation shall be effective;
and after the policy has been continued beyond its original
term the insured may cancel this policy at any time by
written notice delivered or mailed to the insurer, effective
upon receipt or on such later date as may be specified in
such notice. In the event of cancellation, the insurer
will return promptly the unearned portion of any premium
paid. If the insured cancels, the earned premium shall be
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computed by the use of the short-rats table last filed
with the state official having supervision of insurance
in the state where the insured resided when the policy
was issued. If the insurer cancels, the earned premium
shall be computed pro-rats. Cancellation shall be with-
out prejudice to any claim originating prior to the
effective date of cancellation.
"(9) A provision as follows:
"Conformity with State Statutes:
Any provision of this policy which, on its effective date,
is in conflict with the statutes of the state in which
the insured resides on such date is hereby amended to con-
form to the minimum requirements of such statutes.
"(10) A provision as follows:
"Illegal Occupation: The insurer
shall not be liable for any loss to which a contributing
cause was the insured's commission of or attempt to commit
a felony or to which a contributing cause was the insured's
being engaged in an illegal occupation.
"(11) A provision as follows:
"Intoxicants and Narcotics: The insurer
shall not be liable for any loss sustained or contracted
in consequence of the insured's being intoxicated or under
the influence of any narcotic unless administered on the ad-
vice of a physician.
"F. Inapplicable or Inconsistent Provis-
ions:
"If any provision of this section is
in whole or in part inapplicable to or inconsistent with
the coverage provided by a particular form of policy the
insurer, with the approval of the Insurance Commissioner,
shall omit from such policy any inapplicable provision or
part of a provision, and shall modify any inconsistent
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provision or prt of the provision in such manner as to make
the provision as contained in the policy consistent with the
coverage provided by the policy.
"G. Order of Certain Policy Provisions.
"The provisions which are the subject
of subsections D and E of this section, or any corresponding
provisions which are used in lieu thereof in accordance with
such subsections, shall be printed in the consecutive order
of the provisions in such subsections or, at the option of
the insurer, any such provision may appear as a unit in any
part of the policy, with other provisions to which it may
be logically related, provided the resulting policy shall
not be in whole or in part unintelligible, uncertain, am-
biguous, abstruse, or likely to mislead a person to whom
the policy is offered, delivered or issued.
"H. Third Party Ownership.
"The word "insured" as used in this
act, shall not be construed as preventing a person other
than the insured with a proper insurable interest from
making application for and owning a policy covering the
insured or from being entitled under such a policy to any
indemnities, benefits and rights provided therein.
"I. Requirements of Other Jurisdictions.
"(1) Any policy of a foreign or alien
insurer, when delivered or issu-d for delivery to any
person in this state, may contain any provision which is
not less favorable to the insured or the beneficiary than
the provisions of this Act and which is prescribed or re-
quired by the law of the state under mich the insurer is
organi zed.
"(2) Any policy of a domestic insurer
may, when issued for delivery in any other state or country,
contain any provision peruitted or required by the lows of
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"(2) The tine at shich the insur-
ance takes effect and termdnatee is expressed therein;
end
"(3) It purports to insure only
one person, except that a policy may insure, originally
or by subsequent anendment, upon the application of an
adult member of a family Iho shall be deemed the policy-
holder, any two or more eligible members of that family,
including husband, wife, dependent children or any children
under a specified age mich shall not exceed nineteen years
and any other person dependent upon the policyholder; and
'(h) The style, arrange-ant and over
all appearqnce of the policy give no undue prominence to
any portion of the text, and unless every printed portion
of the text of the policy and of any endorsement: or
attached papers is plainly printed in light-faced type of
a style in general use, the size of which shall be unifona
and not less then ten-point with a lower case unepsced
alphsbet length not less than one hundred and twentybpoint
(the'text"shall include all printed matter except the
name and address of the insurer, name or title of the policy,
the brief description if any, and captions and subcaptions);
and
'(5) The exceptions and reductions
of indemnity are set forth in the policy and, except those
Ihich are set forth in sub-section D and E of this act,
are printed, at the insurer's option, either included with
the benefit provisions to which they apply, or under an
appropriate caption such as 'EXCZPTIOKS, OR FEXCCPTIOIS
AND REDUCTIONS", provided that if an exception or reduction
specifically applies only to a particular benefit of the
policy, a statement of such exception or reduction shall be
included with the benefit provision to which it applies; and
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such other state or country.
"J. Filing Procedure.
"The Insurance Comissioner may make
such reasonable rules and regulations concerning the pro-
cedure for the filing or submission of policies subject to
this Act as are necessary, proper or advisable to the ad-
ministration of this Act. This provision shall not abridge
any other authority granted the Insurance Commissioner by law.
"X. Other Policy Provisions.
"No policy provision which is not sub-
Ject to sub-section D and E of this Act shall make a policy,
or any portion thereof, less favorable in any respect to
the insured or the beneficiary than the provisions there
of which are subject to this Act.
"L. APPLICATION.
"(1) The insured shall not be bound
by any statement made in an application for a policy un-
less a copy of such application is attached to or en-
dorsed on the policy when issued as a part thereof. If
any such policy delivered or issued for delivery to any
person in this state shall be reinstated or renewed, and
the insured or the beneficiary or assignee of such policy
shall make written request to the insurer for a copy of
the application, if any, for such r-instatement or renewal,
the insurer shall within fifteen rwvr after the receipt
of such request at its home 0'11? n. any branch office
of the insurer, deliver or mail to the person making such
request, a copy of such application. If such copy shall
not be so delivered or mailed, the insurer shall be pre-
cluded from introducing such application as evidence in
any action or proceeding based upon or involving such
policy or its reinstatement or renewal.
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"(2). No alteration of any written
application for any such policy shall be made by any
person other than the applicant without his written
consent, except that insertions may be made by the in-
surer for administrative purposes only, in such manner
as to indicate clearly that such insertions are not to
be ascribed to the applicant.
"(3). The falsity or any statement
in the application for any policy covered by this Act
may not bar the right to recovery thereunder unless
such false statement materially affected either the
acceptance of the risk or the hazard assumed by the
insurer.
"15. NOTICE, sum.
"The acknowledgment by any insurer
of the receipt of notice given under any policy covered
by this Act, or the furnishing of fbrms for filing proofs
of loss, or the acceptance of such proofs, or the investi-
gation of any claim thereunder shall not operate as a
waiver of any of the rights of the insurer in defense of
any claim arising under such policy.
"N. AGE LIMIT.
"If any such rsl2y contains a pro-
vision establishing, as an age lic.' or otherwise, a
date after which the coverare ; "- v the policy
will not be effective, and if :;" -~ 34118 within a
period for which premium is accepted a; the insurer or
if the insurer aCCepts a premium artcr such date, the
coverage provided by the policy will continue in force
subject to any right of cancellation until the end of
the period for which premium has been accepted. In the
chnt the age of the insured has been min-stated and if,
according to the correct age of the insured, the coverage
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provided by the policy would not have become effective,
or would have ceased prior to the acceptance of such
premium or premiums, then the liability of the insurer
shall be limited to the refund, upon request, of all pro-
miums paid for the period not covered by the policy."
Section 2. This act shall take effect on October 1,
1953, provided any policy, rider or endorsement which
could have been lawfully issued c~ delivered or issued
for delivery to any person in this state imediatelu
before the effective date of this act, may be issued
or delivered or issued for delivery during three years
after the effective date, provided such policy is en-
dorsed so as to comply with paragraphs (2), (3), (h),
(5) and (7) of subsection D and paragraph (3) of sub-
section B, of above Section 6h2.031, when applicable.
It is provided that whereas the uniform provisions set
forth in said new Section 6h2.031 are in substitution
of the provisions of said Section 6h2.03 and said sub.
section 6h2.0h(l), effective at the time and as con-
ditioned herein, that where in other parts of Chapter
6&2, Florida Statutes, reference is made to the standard
provisions set forth in said Section 6h2.03 it shall be
understood that such reference shall also include the
unifonn provisions of said new Section 6h2.03l, under
the conditions and circumstances as contemplated by
the provisions of this act.
Section 3. Section 6&2.03 and subsection 6h2.0h(l)
shall remain effective during the tree-year period im-
mediately fallening the effective date of this act, sub-
Ject to the conditions and requirements set forth in
preceding Section 2 hereof, and Section 6h2.03 and sub-
section 6h2.0h(1) shall stand repealed on October 1, 1956.
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Section 1;. Should my part of this act or w
proviso therein or paragraph thereof, be declared to
be unconstitutional, inoperative or void such fact
shall in no W186 affect the validity of tho remaining
portions of this act
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"(6) Each such fonm, including riders
and endorsements, shall be identified by a form number in
the lower left-hand corner of the first page thereof; and
"(7) It contains no provision purport-
ing to make any portion of the charter, rules, constitution,
or by-laws of the insurer a part of the policy unless such
portion is set forth in full in the policy, except in the
case of the incorporation of, or reference to, a statement
of rates or classification of risks, or short-rate table
filed with the insurance commissioner.
"(8) Approved by the insurance com-
missioner. The insurance commissioner may, in addition
to the aforementioned requirements, impose other require-
ments as may be reasonable and consistent with the law
and the public interest.
"B. Any such policy may contain a pro-
vision for paying a benefit for death from any cause in
an amount not exceeding two hundred and fifty dollars,
which benefit shall not relieve such policy from the re-
quirements of this Act and all the provisions herein shall
apply to such policy.
"C. If any policy is issued by an insurer
domiciled in this state for delivery to a person residing
in another state, and if the official having responsibility
for the administration of the inSurance laws of such other
state shall have advised the insurance commissioner that
any such policy is not subject to approval or disapproval
by such official, the insurance commissioner may by ruling
require that such policy meet the standards set forth in
sub-sections A, D, and E of this section.
"D. Required Provisions.
"Except as provided in sub-section F of
this section each such policy delivered or issued for de-
livery to any person in this state shall contain the pro-
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visions specified in this subsection in the words in which
the same appear in this section; provided, however, that
the insurer may, at its option, substitute for one or more
of such provisions corresponding provisions of different
wording approved by the Insurance Commissioner which are
in each instance not less favorable in any respect to the
insured or the beneficiary. Such provisions shall be pre-
ceded individually by the caption appearing in this sub-
section or, at the option of the insurer by such appropriate
individual or group captions or subcaptions as the Insure
ance Commissioner may approve.
n(l) A provision as follows:
"Entire Contract; Changes: This policy,
including the endorsements rod t.c attached papers, if any,
constitutes the entire contract or insurance. No change
in this policy shall be valid until approved by an execu-
tive officer of the insurer and unless such approval be
endorsed hereon or attached hereto. No agent has authority
to change this policy or to no? ve any of its provisions.
"(2) A provision as follows:
"Time Limit on Certain Defenses: (a)
After three years from the date of issue of this policy no
min-statements, except fraudulent mic-statements, made by the
applicant in the application for such policy shall be used
to void the policy or to deny a c1331 for loss incurred
or disability (as defined in the pcliry) commencing after
the expiration of such three year period.
"(The Dre-:91" :alicy provision shall
not be so construed as to affect any legal requirement for
avoidance of a policy or a denial of a claim during such
initial three year period, nor to Jtait the application of
sub-section E (l), (2), (3), (h), and (S) in the event of
.1.
mis-statement with respect to age or occupation or other
insurance).
"(A policy which the insured has
the right to continue in force subject to its terms by
the timely payment of premium, (1) until at least age 50
or, (2) in the case of a policy issued after age hh, for
at least five years from its date of issue, may contain
in lieu of the foregoing the following provision (from
which the clause in parentheses may be omitted at the
insurer's option) under the caption "INCONTESTABLE":
"After this policy has been in force
for a period of three years during the lifetime of the
insured (excluding any period during which the insured
is disabled), it shall become incontestable as to the
statements contained in the application).
"(b) No claim for loss incurred
or disability (as defined in the policy) commencing after
three years from the date of issue of this policy shall
be reduced or denied on the ground that a disease or
physical condition not excluded from coverage by name or
specific description effective on the date of loss had
existed prior to the effective date of coverage of this
policy.
"(For the purpose of'permitting in-
surers to use a uniform policy in several states, the
insurer is permitted to print in the policy form in re-
quired provisions (2) (a) and (2) (b) above the term 'three
years'. Nevertheless, the provisions of the contract and
text of the statute to the contrary notwithstanding, the
time limits for said defenses under any contract delivered
or issued for delivery to any person in this state shall
not exceed two years.)
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"(3) A provision as follows:
"Grace Period: A grace period of
. . . . (insert a number not less than "7" for
weekly premium policies, "10" for monthly premium poli-
cies and "31" for all other policies) days will be granted
for the payment of each premium falling due after the first
premium, during which grace period the policy shall continue
in force.
"(A policy which contains a cancella-
tion provision may add, at the end of the above provis-
ion: "subject to the right of the insurer to cancel in ac
cordance with the cancellation provisian hereof."
"A policy in which the insurer reserves
the right to refuse any renewal shall have, at the beginning
of the above provision: "Unless not less than five days
prior to the premium due date the insurer has delivered to
the insured or has mailed to his last address as shown by
the records of the insurer written notice of its intention
not to renew this policy beyond the period for which the
premium has been acoepted").
"(h) A provision as follows:
"Reinstatement: If any renewal pre-
mium be not paid within the time granted the insured for
payment, a subsequent acceptance of premium by the insurer
or by any agent duly authorized by the insurer to accept
such premium, without requiring in connection therewith an
application for reinstatement, shall reinstate the policy;
provided, however, that if the insurer or such agent requires
an application for reinstatement and issues a conditional
receipt for the premium tendered, the policy will be re-
instated upon approval of such application by the insurer
or, lacking such approval, upon the forty-fifth day follow-
ine the date of such conditional receipt unless the insurer
.6-
has previously notified the insured in writing of its dis-
approval of such application. The reinstated policy shall
cover only loss resulting from such accidental injury as
may be sustained after the date of reinstatement and loss
due to such sickness as may begin more than ten days after
such date. In all other respects the insured and insurer
shall have the same rights thereunder as they had under the
policy imediately before the due date of the defaulted
premium, subject to any provisions endorsed hereon or
attached hereto in connection with the reinstatement. Any
premium accepted in connection with a reinstatement shall
be applied to a period for which premium has not been previous-
ly paid, but not to any period more than sixty days prior to
the date of reinstatement.
"(The last sentence of the above pro-
vision may be omitted from any policy which the insured
has the right to continue in force subject to its terms by
the timely payment of premiums (1) until at least age 50, or,
(2) in the case of a policy issued after age hh, for at
least five years from its date of issue.)
"(5) A provision as follows:
"Notice of Claim: written notice of
claim must be given to the insurer within twenty days after
the occurrence or commencement of any loss covered by the
policy, or as soon thereafter as is reasonably possible.
Notice given by or on behalf of the insured or the benefic-
iary to the insurer at . . . . (insert the loca-
tion of such office as the insurer may designate for the
purpose), or to any authorized agent of the insurer, with
information sufficient to identify the insured, shall be
deemed notice to the insurer.
"(In a policy providing a loss-of-time
benefit which may be payable for at least two years, an
-7-
insurer may at its option insert the following between
the first and second sentence: of the above provision:
"Subject to the qualifications set forth below, if the
insured suffers lose of time on account of disability for
which indemnity may be payable for at least two years, he
shall, at least once in every six months after having given
notice of claim, give to the insurer notice of continuance
of said disability, except in the event of legal incapacity.
The period of six months follouing any filing of proof by
the insured or any payment by the insurer on account of
such claim or any denial of liability in whole or in part
by the insurer shall be excluded in applying this pro-
vision. Delay in giving of such notice shall not in-
pair the insured'e right to any indemnity which would
other1dse have accrued during the period of six months pre-
ceding the date on which such notice is actually Riven.")
"(6) A provision as follows:
"Claim loans: The insurer, upon re-
ceipt of a notice of claim, will furnish to the claimant
such form: as are usually furnished by it for filing proofs
of loss. If such forms are not furnished within fifteen
days after the giving of such notice the claimant shall be
deemed to have complied with the requirements of this policy
as to proof of loss upon submitting, within the time fixed
in the policy for filing proofs of lose, written proof
covering the occurrence, the character and the extent of
the loss for which claim is made.
"(7) A provision as follows:
"Proofs of Loss: Written proof of loss
must be furnished to the insurer at its said office in case
of clean for loss for which this policy provides any periodic
payment contingent upon continuing loss within ninety days
after the termination of the period for which the insurer
is liable and in case of claim for any other loss within
.3-
ninety days after the date of such loss. Failure to
furnish such proof within the time required shall not in
validate nor reduce any claim if it was not reasonably
possible to give proof within such time, provided such
proof is furnished as soon as reasonably possible and in
no event, except in the absence of legal capacity, later
than one year from the time proof is otherwise required.
"(8) A provision as follows:
"Time of Payment of Claims: Indemni-
ties payable under this policy for any loss other than
loss for which this policy provides any periodic payment
will be paid immediately upon receipt of due written proof
of such loss. Subject to due written proof of loss, all
accrued indemnities for loss for which this policy provides
periodic payment will be paid. . . ... . (insert period
for payment which must not be less frequently than monthly)
and any balance remaining unpaid upon the terudnation of
liability will be paid immediately upon receipt of due
written proof.
"(9) A provision as follows:
"Payment of Claims: Indemnity for loss
of life will be payable in accordance with the beneficiary
desirnation and the provisions respecting such payment
which may be prescribed herein and effective at the time
of payment. If no such designation cr provision is then
effective, such indemnity shall be payable to the estate
of the insured. Any other accrued indennities unpaid at
the insured'e death may, at the option of the insurer, be
paid either to such beneficiary or to such estate. All
other indemnities will be payable to the insured.
"(The following provisions, or either
of them, may be included with the foregoing provision at
the option of the insurer:
PAGE 1
A IL .. ... E. ...TL ...
PAGE 2
..t n.. ...e.d.. .. ..,, (ne
PAGE 3
expiaton f treeyeas aterthetilte riten roo o .... .. rqi dt b rn hd... "( I Ay pr 1, na olos
PAGE 4
co:ger.satien anything ,artaininr to an occupati on so clanified, the inmarer will ay or-ly such portion of the i unr.1 t les provided is: this poli cy as the are:1tum pai.] would have pu--chased at the rates and within the li::::t!; "ixed by the insurer for such .ore hazardous occupatier:. If t.:e insured changes his occupation to one cla205 Red by --he --:1'iurer as le:Is hazanlous than that stated in this pol-.cy, the insurer, upon receipt of proof of Euch chanre af occupatiers will reduce the pre:uium rate accordincly, ar.d will returr: the excess pre-rata unearr.ed ;.reari-im froo the date of change of occuj-ation or from the policy anniversary ate jmediately preceding receipt af si:ch proof, whichever is the more recent. In apply:nr this provision, the classificatier. of ace:ga-tioral risk arid the premium rates shall be mich as have heer liist filed by the insurer prj.or to the occurrence of the ~Ms for '.tica the inaurer is liable or prior to date of goof of charly in occupation -dith the state offj.cial havir., supervisia:1 af ir:surance in the state olare -1.3 ir.suru resided at Oc tirse this colicy wra W:aad; but if s:c: !-ilir.g was not requireda then C r c".;:::::i;:a:ttior, of pu:1:rition...l r1G, and 11-.e 7:rc --12 m. r s r"...l'. N t i-.oce last a!.;-.de e f fective by t!-:C i ns.3:-er ir. Esb state pri or to the accurra:ice of the loss or prior to the date c:0 ;.rcof of che et in occupation, hf6 li provistor. 46 follriwa : is--statseent of Age: If the age of C;c i7Irr-r' trie la-en mis-stated, all a--lo.mts payab~.ai under this 131 !cy shall he such its the prert~r pai. Trould have purclase at the currect age. '(3) ji provision an follows: "Other Insurar.co ir. this insurer: If an acci.-lent or sickness or ac.eldent aur1 sickness policy -12-
PAGE 5
.i y f r ..........
PAGE 6
"(ftefrgigp ly .ro.....n..
PAGE 7
-os h ny 1iab1lty -sc bnfit ndrIp l. .h11l -e -.n pr rin f d e ,tb-~ ~ ..-. 1 1 -Ilk -I'II I l f14If1 1 1I1I1 PI-111-11 1 -1d I fuhprino th pe i ..id as pp-ecd th y o T,(IfD th e --egin pof c -h oi -h are a t -3gpIr.,, in-ud -, ,hspovs b, d -lnfio 1" -he vai ovr ," -p1-ve a t formor o~e scase Cmisione, wi chdefni Mon hal
PAGE 8
.n.... .. .... ....... .... .plig h orrigpl prcy..mr: ~ ~ ~ .. 51tidprylaiiy oeaesalb n
PAGE 9
at ~ ~ ~ ~ ~ .1.1. ts opton -rlud inti rviinadfiiino "-j-i loy oftm ovr-, apoe a ofr -b -rh-t-~c Iamsinryahdfinto shal -e y i insuact tertocvesg roiddbygoenmA tlagnce cr y rraiztio~ssubec tore -a il b nua -a rIInu Fnc auh1,te o.ths r nyoters (7) de: tdSae r Apr ineo a do ay -tr o lag h n-o -Y rihma eaprvdb the ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ .1-.,ne1'msinrcr n oaiato fsc covera ~ ~ ~ ~ ~ ~ ~~7 .es .....bec f uhdfiiinsuhtr shlireircldean cvea -toided b-.sd isue pursnre ~ ~ -, ., yn o~laybnftsaue(nldn n 11,men do~rstoo mlye' ibl ttt) or ~ ~ ~ ~ ~ ~ b benefit ir.ddb ro efrepaso yepoe
PAGE 10
co-p-td ,y the us f -. 1-r-rt -al atfld Aae .A inu-1 balt e "(9) A ArvIsin A I.oll s "tn -ty ...I tbh t t-tts Any b. r frso -fti o y hi, n -t ffcie a A th th e Is.. d, o.f -h -tA I. ..it the ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~h inue.esdso sc a. .hrby .edd ocn "(10PAA A Aoi.io As fll s 11llegal Thu.io: Te nue thal pt-dt belalefry los -r ... c .1 cn bting i,ae ,'.b the Inue' C.-s-,o rateptt cm (--1 -A ,rAvlAiA as p...As: pnr cecqcf h -n--, d' b.,y i xia d ... -nder
PAGE 11
pr-irin o 'at of the Prov-o in -u1, 1.ne as ..-k t --r,"io s otand in -h '-lc ---"sen -it the covcrage-. -rv e thy the plicy "G Ode o crtinP -i y --gsin "T1 e b. vsin tih aete uj. p,,,, 1-setin th e;.itd t iosc t oder ofp rvs-'si uhr,,d tion -r, P-th ,ptono thr --Jyi ofee, !-terd --ssud. -B -'i d htyine hp tha. heinurd it apr te in -rbl inee t r inertebenefin rg pr,.;ded th.rein. 1o 6,s tah, l tf the tnsre thtbeeiiayta "() Ay poliy of .domi tc-ru my whni-.ed I.,r dtlier in .y othr stat .r ct ry, -riay -r=ii pemte trrqie y the -tw tf
PAGE 12
"(2) The time at which the insurtakes effect and terr.inates is expressed thereini "(3) It purports to ins-.ire only --F rs:..n, except that a pol icy may incure originally susegunnt amer.dment, upcn the application of an t E.e-lher --f a fa.TJ.1y to shall be dee:lled the policyar, any tra or mere eligible merhers of that falnily, 1-ig husband, wife, dependent children or og children r a specified age mich shall not exceed nineteer years any c*.her person rieper;der:t upon the policyholder; and "(O The style, arrangement arad over a marance of the poney give no undue prominence to i ..li~ypi .te ..... ..--ae ..y .....
PAGE 13
-I ~ -1 IP -. Other -y Provi -i.n s. "(I T po iy prviio -h d i tsb -scto Uan o ti At hllmP ea olY .or terefe s fvorbl i .1 -ny res .ct ortebnfcayth h poiinste
PAGE 14
(3). Elo alC rtir o ay ri, e
PAGE 15
.r-:'' y .....i -.r..l -... ..e L c m e f c i or ~ ~ ~ ~ ~ ~ ~~~() wer) Weca~ ro ote cetrc fs. prri-.o ruurr ~sn th, -l -11-. 1-tei ~ue
PAGE 16
Eectir 4. Should any part of this act or any provis:: t::ereir. or paragraph tharsof, be declared to be ut.ex.rst.itutior.al, ir.eperative er void such fact shal~a ir, ac -:lis-.affect '.he va'-idity of the remaining pcrtions -yi l.hiu act -23-
PAGE 17
"(6) E yah su l-, u n dn r t, h.11 b, Identified by i. th, 1-1 1 t--d e f the tst ; ythe of; a "(7) ttayntan proisonpuy ot 'at tktyttaaafhyy~ait~hia by-l-, f the inur a pa t fh ay t.p-, p-rti, t frh i futh. --y, -x-pt i. the tt rayes atr a i yicato tf risk, ta hot-a ate tyb fil.d .ihhe in ncan "() Approved lb, h insuanc comto, -h ,at-y a -n f t x d d i t -tc .l beeihlno -d .ppy p.-uc -oiy by t. -f ny ah pa ay 'tataptfrdeath f-o -ny J.sei audred a fda-, live -uh ,l-y froh e ta 'p a.i.a. tatt --a al' -r diaa aiava ..c rmisinrmy bymin ettesad ds etf-rth in thi, .-tin ah suhp.liy 1-eytoaypesni thi ts
PAGE 18
vison spciiedinths sbsctin n he ors i wiy
PAGE 19
"(A PI-y Inich the insured ha the ri,. boootinue -h t it f c ubje -t ts t-s by tily pyet of .peu., (1) Intil t est ae 51 ( i ob poly iss I-! fage -, for t 11st fiv yrfro itsdte of is-ue, 1a cntai 000 of the -oregobng th fclloeing provision (fo hc h cas nperatheces -ny bo oitote tthe nsuro'I ption) nd theocapti o TAoLo : ".Aftthis policy -ee bee. in orI foe-od of th-ec yoaos d-ring the lieti-e of the insr (elrdiny peid drig -h the inIred i disabld), it -ol beoe ntesbl -to the cstt .ortooInd in tho spplicatoo) "(b) II clots fot incrrgd r abilityy (s defined in the poliy) eoeiog aitr thre par fo the d t o bssue of this policy halt bse iedced oo r l d onied bo eo on htt disser ph or.onotxludd fropsovr by e o.r pecifIc deoeetoe effebies on thoe dote of loos hd .p tP the erfectos dtf oosoege oof ti polio., "(Fo tho promee of I-ttinc toueropposeanioropoIey in oseoe1 st.es, the instopr-er erotted to prit i the oliy ftein requircpoisons (2) (a) -nd (2) (b) ebote the test 'tree yr'. erhles-, the poiios of the ontct od teot If t-o tt the on-r-y owithstendipg, the tie liot tsorsd tetootos ude yotrt-It dli..orod otor r dtto -o tn ptsopin bois ottoothall
PAGE 20
)A p r.. ii fs f.-1-: i A pr1 period of Ieet -ubrntls t-a "T' -o ic-e, "1"f., .onthly pr-ium pl-all .th-r bolci) da-il 1. grat -ahpeimfalling d-"te the first i ga Perid the poli-y -1al co-ind r hvi Pio.r -1d, It -he PP P io: "ujc -tt th lpit .tP p-i. -Pplp p If, 'I P t prpiti-prtep e bF,, r ... t .-?u tfr~ pea halh, a .h-1.,rd te i urer .wri.e not-ed ierd t. Imby ith th therith -n i su-:ppptr l ute at p--, PPdtin te ,-t-liy; .rsuh .-etrqur
PAGE 21
:ove -nly loss r ul i r-~ -uc -c-d-a injur as --ue to -uc likesa a egin -1r than -e d-y --te 11c dat. ta...e repcsteisrd nd in u... shl hv he sa ilhts thereunder bs thy -a underth 4-lcyimedatly 'If-r th -u baof the ---ute >rcasbe t, .. y pr--ii-n end-d h.... o ,ttaihd heeoin -oncio h the entaeet Any .y ti, u , -oa~ perio --r than -ity daspirt. -a ergh ocnill1,n I.rsbject to it em by ,hethol pymnt f reius l)untl t eat ge50, -r "(5) A Proviina follo1-1-T 9r 1e ient t e -nur1 rit-I t-ety dlys -11e .olc:, r a sonthreate a isres--by p-, itle yr oteisrra -, .-.l t( -sr t.... lc bf-rnt-1n ui.ient tl id-nify -h --urd, sa b .e n e t, the n rr
PAGE 22
.--------.-::. -ri ---.| -. : .r. .-.-; --
PAGE 23
..r.e d.y .. te .... e fsel os ai et .ur s .r p.so .ih t ....~i .euie .h l .o
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