An outline of coverage, in the form prescribed in this
section, shall be issued in connection with policies meeting the standards of
§
88.164 of this title (relating to
hospital confinement indemnity coverage). The items included in the outline
must appear in the sequence prescribed:
(COMPANY NAME) (HOME OFFICE ADDRESS)
HOSPITAL CONFINEMENT INDEMNITY COVERAGE REQUIRED
OUTLINE OF COVERAGE
(1)
Read Your Policy Carefully-This outline provides a very brief
description of the important features of your policy. 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
CAREFULLY!
(2)
Hospital
Confinement Indemnity Coverage-Policies of this category are 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. Such policies do
not provide any benefits other than the fixed daily indemnity
for hospital confinement. (*NOTE: Immediately preceding sentence may be
appropriately modified, if necessary, to reflect coverage provided.)
(3) (A brief
specific
description of the benefits contained in
this policy, in the
following order:
(a) Daily benefit payable
during hospital confinement; and
(b) Duration of benefit described in
(a).
(c) Any other benefits
provided by the policy.
*NOTE: The above description of benefits shall be stated
clearly and concisely, and shall include a description of benefit amounts,
durations or limits, elimination periods, inner limits, deductible or
co-payment provisions and any other items appropriate to the coverage
provided.)
(4) (A
description of the exceptions, reductions and limitations contained in the
policy or contract, including the pre-existing conditions provisions, if any,
and the circumstances under which any reduction becomes operative.)
(5) (A description of the terms and
conditions of renewability of the policy or contract, including any limitation
by age, time or event, rights to change premium, status requirements and any
other matters appropriate to the terms and conditions of renewability
(including any rights of cancellation reserved to the insured).)
