The following general terms apply to the policy/certificate and riders as approved in most states. Terms may vary by state. For a list of all terms, refer to the actual policy/certificate.
Right to Examine
The primary insured person may cancel the certificate within 30 days of receiving it by returning the certificate to Assurity’s administrative office. As soon as this certificate is received by Assurity, it is treated as if it was never issued. Premium payment will be refunded when Assurity receives the certificate.
Right to Cancel
After the 30-day period specified in the Right to Examine section, the primary insured person may cancel the certificate by notifying Assurity in writing that they wish to do so. The certificate will be canceled effective as of the end of the period for which premiums have been paid unless notice specifies a later date. Cancellation of the certificate will be without prejudice to any claim made prior to termination.
Renewal
Coverage will terminate and no benefits will be payable under the policy, any certificate or any attached riders when either the policyholder or Assurity cancels this policy upon giving at least 61 days’written notice to the other. Assurity will not cancel the policy prior to the end of the first year following the policy effective date.
Termination
Coverage will terminate and no benefits will be payable under the certificate or any attached riders on the earliest of the following:
•the date the policy terminates;
•when any premium due for the certificate is not paid before the end of the grace period;
•the date the primary insured person no longer meet the definition of employee, unless coverage is continued as described in the Portability section;
•the date the primary insured’s class is no longer eligible;
•the date Assurity receives from the employee or the policyholder written notice to terminate this certificate unless the notice specifies a later date; or
•upon the primary insured person’s death.
Coverage may continue when the primary insured person is no longer an employee of an eligible class and coverage would otherwise end. A written request and first premium payment for the portable coverage must be received by Assurity within 90 days of the certificate termination date.
Exclusion
Assurity will not pay benefits for losses caused by or as the result of any insured persons:
•operating, learning to operate, or serving as a crew member of any aircraft;
•engaging in hang-gliding, hot air ballooning, bungee jumping, parachuting, scuba diving, sail gliding, parasailing, parakiting, mountain or rock climbing, B.A.S.E. jumping, sky diving or cave diving;
•riding in or driving any motor-driven vehicle in an organized race, stunt show or speed test;
•officiating, coaching, practicing for or participating in any semi-professional or professional competitive athletic contest for which any type of compensation or remuneration is received;
•having a sickness independent of the covered accident, including physical or mental infirmity (sickness means any illness, infection, disease or any other abnormal physical condition which is not caused by an Injury);
•being exposed to war or any act of war, declared or undeclared;
•actively serving in any of the armed forces, or units auxiliary thereto, including the National Guard or Army Reserve, except during active duty training of less than 60 days;
•suffering from a mental and nervous disorder (except for post-traumatic stress disorder as described in this certificate);
•being addicted to drugs or suffering from alcoholism;
•being intoxicated (as determined by the laws governing the operation of motor vehicles in the jurisdiction where loss occurs) or under the influence of an illegal substance or a narcotic (except for narcotics used as prescribed to the insured person by a physician);
•having cosmetic surgery or other elective procedures that are not medically necessary;
•committing or attempting to commit a felony;
•being incarcerated in a penal institution or government detention facility;
•participating in a riot, insurrection or rebellion;
•driving any taxi for wage, compensation or profit;
•engaging in an illegal occupation;
•intentionally self-inflicting an injury; or
•committing or attempting to commit suicide, while sane or insane.
No benefits, except the Initial Accident Treatment benefit, will be payable for services provided outside of the United States.
In addition to these exclusions, Assurity will also not pay Hospital Sickness Rider benefits for losses caused by or as the result of any insured persons:
•suffering from a mental and nervous disorder;
•having cosmetic surgery (except when the Hospital Confinement is due to medically necessary reconstructive surgery);
•having a hernia;
•having an injury;
•having elective procedures that are not medically necessary (including but not limited to organ donation and elective sterilization);
•voluntarily inhaling gas;
•being confined primarily for rest care, convalescent care or for rehabilitation;
•having a covered sickness covered under Workers’ Compensation, an Employer’s Liability law or similar law;
•being born, unless the loss is the result of a Covered Sickness;
•being pregnant, experiencing pregnancy-related conditions (other than a complication of pregnancy), giving birth or otherwise terminating pregnancy during the 10-month period immediately following the Issue Date; or
•having dental treatment.