Cal. Code Regs. tit. 10 § 2232.25

Current through Register 2024 Notice Reg. No. 45, November 8, 2024

Section 2232.25 - Payment of Claims

Indemnity for loss of life will be payable in accordance with the beneficiary designation and the provisions respecting such payment which may be prescribed herein and effective at the time of payment. If no such designation or provision is then effective, such indemnity shall be payable to the estate of the insured employee. Any other accrued indemnities unpaid at the insured employee's 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 employee.

If any indemnity of this policy shall be payable to the estate of the insured employee, or to an insured employee 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 $___ to any relative by blood or connection by marriage of the insured employee or beneficiary who is deemed by the insurer to be equitably entitled thereto. Any payment made by the insurer in good faith pursuant to this provision shall fully discharge the insurer to the extent of such payment.

Subject to any written direction of the insured employee in an application or otherwise all or a portion of any indemnities provided by this policy on account of hospital, nursing, medical or surgical service may, at the insurer's option, and unless the insured employee requests otherwise in writing not later than the time for filing proof 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.

Instructions

1. The insurer shall use the first paragraph of this provision in any policy which provides a benefit for accidental death.

2. The insurer may omit the first paragraph if the policy does not include a benefit for accidental death and no provision is made for a beneficiary, in which case the phrase "to the insured employee" shall be used in the uniform provision captioned "Time of Payment of Claims."

3. The insurer may, at its option, use either or both of the second two paragraphs of this provision, or may omit them both, irrespective of whether the first paragraph is used or not.

4. If the insurer uses the second paragraph, there shall be inserted in the blank an amount not exceeding $1,000.

5. If the second paragraph is used and the policy makes no provision for the appointment of a beneficiary, the insurer shall omit from said second paragraph all references to payments to a beneficiary.

6. The insurer may substitute for the words "an application" in the second line of the third paragraph other words consistent with the policy terminology. (Ins. C. 10350.9)

Cal. Code Regs. Tit. 10, § 2232.25