Sample Long Term Care Insurance Policy, Page 24
SAMPLE LONG TERM CARE INSURANCE POLICY
PART 6 - GENERAL PROVISIONS
This part explains some of the important provisions that affect Your rights and Our rights
under this Policy.
Entire Contract and Changes
This Policy is a legal binding contract between You and Us. This entire contract is made up of:
• the Policy;
• the application; and
• any riders, amendments and endorsements.
No change to this Policy will be valid until approved by Our President or Secretary. To be valid, such approval must also be endorsed on or attached to this Policy. No agent may change this Policy or waive any of its provisions. If We change Our address or Our toll-free telephone number, We will notify You.
Time Limit on Certain Defenses/Misrepresentation
If this Policy has been in effect for less than six months We may rescind it or deny an otherwise valid claim if the application contained a misrepresentation that is material to the acceptance of Your application. If this Policy has been in effect for at least six months but less than two years, We may rescind it or deny an otherwise valid claim if the application contained a misrepresentation that:
• was material to the acceptance of Your application; and
• pertains to the condition for which the claim is made.
After this Policy has been in effect for two years, it is incontestable except for relevant facts relating to Your health that You knowingly and intentionally misrepresented or failed to disclose.
In the event this Policy is rescinded after We have paid benefits, We may not recover the payments already made.
Conformity with State Laws
Any part of this Policy which is in conflict with the laws of the state in which You reside on the
Effective Date of Coverage is amended to conform to the minimum requirements of such laws.
SAMPLE LONG TERM CARE INSURANCE POLICY
Right to Recovery
If We make payments with respect to benefits in a total amount which is, at any time, in excess of the benefits payable under the provisions of this Policy, We will have the right to recover such excess from:
• any persons to, or for, or with respect to whom, such payments were made; and
• any organization which should have made such payments.
Policy Termination
This Policy will terminate at 12:01 a.m. on the earliest occurrence of one of the following events:
• You have exhausted Your Policy Limit.
• You do not pay Your premium when due (see the provision captioned “Grace Period”);
• You cancel Your Policy; or
• The date of Your death.
SAMPLE LONG TERM CARE INSURANCE POLICY
COPY OF APPLICATION
NOTE: Examine this copy carefully. If You find any error or omission, write or contact Our LTC
Administrative Office immediately. Please explain fully the error or omission and give Us Your policy number.
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