N.H. Admin. Code § Ins 6202.06

Current through Register No. 49, December 5, 2024

Section Ins 6202.06 - Outline of Coverage

An outline of coverage, in the format prescribed below, shall be issued in connection with policies meeting the standards of this part. The items included in the outline of coverage shall appear in the following sequence:

(a) A brief specific description of the benefits shall be provided in the following order:

(1) Daily benefit payable during hospital confinement;

(2) Duration of benefit described in (1); and

(3) Any benefits provided in addition to the daily hospital benefit;

(b) A description of any policy provisions that exclude, eliminate, restrict, reduce, limit, delay, or in any other manner operate to qualify payment of the benefit described in paragraph (a) above shall be included;

(c) A description of policy provisions with respect to renewability or continuation of coverage, including age restrictions or any reservation of right to change premiums shall be included; and

(d) The notice required by paragraphs (a) - (c) above shall be in substantially the same form as follows:

[COMPANY NAME]

[HOSPITAL CONFINEMENT FIXED INDEMNITY COVERAGE]

[OTHER FIXED INDEMNITY COVERAGE]

THIS [POLICY] [CERTIFICATE] PROVIDES LIMITED BENEFITS

BENEFITS PROVIDED ARE NOT INTENDED TO COVER ALL MEDICAL EXPENSES

OUTLINE OF COVERAGE

Read Your [Policy] [Certificate] Carefully-this outline of coverage provides a very brief description of the important features of coverage. This is not the insurance contract and only the actual policy provisions will control. The policy itself sets forth in detail the rights and obligations of both you and your insurance company. It is, therefore, important that you READ YOUR [POLICY] [CERTIFICATE] CAREFULLY!

[Hospital confinement fixed indemnity coverage is designed to provide, to persons insured, coverage in the form of a fixed daily benefit during periods of hospitalization resulting from a covered accident or sickness, subject to any limitations set forth in the policy or certificate. Coverage is provided as described below:]

[Other fixed indemnity coverage is designed to provide, to persons insured, coverage in the form of a fixed dollar benefit for the covered event resulting from a covered accident or sickness, subject to any limitations set forth in the policy or certificate. Coverage is provided as described below:]

N.H. Admin. Code § Ins 6202.06

Derived From Volume XXXVIII Number 50, Filed December 13, 2018, Proposed by #12659, Effective 11/5/2018, Expires 11/5/2028.