§ 44-761 — Group sickness and accident insurance; required provisions

Nebraska § 44-761

• Jurisdiction: Nebraska
• Ch. 44: Insurance

Text

Each
group policy of sickness and accident insurance shall contain in substance
the following provisions:
(1) A provision that the policy, the application of the policyholder
if such application or copy thereof is attached to such policy, and the individual
applications, if any, submitted in connection with such policy by the employees
or members, shall constitute the entire contract between the parties, that
all statements, in the absence of fraud, made by any applicant or applicants
shall be deemed representations and not warranties, and that no such statement
shall avoid the insurance or reduce benefits thereunder unless contained in
a written application of which a copy is attached to the policy;
(2) A provision that the insurer will furnish to the policyholder,
for delivery to each employee or member of the insured group, an individual
certificate setting forth in summary form a statement of the essential features
of the insurance coverage of such employee or member and to whom benefits
thereunder are payable. If dependents are included in the coverage, only one
certificate need be issued for each family unit;
(3) A provision that to the group originally insured may be
added from time to time eligible new employees or members or dependents, as
the case may be, in accordance with the terms of the policy; and
(4) A provision that the insurance coverage of the employee
or member may include, originally or by subsequent amendment, upon the application
of the employee or member, any two or more eligible members of his or her
family, including husband, wife, dependent children, any children enrolled
on a full-time basis in any college, university, or trade school, or any children
under a specified age which shall not exceed thirty years,
and any other person dependent upon the policyholder. Any policy which provides
that coverage of an unmarried dependent child shall terminate upon the attainment
of the limiting age for unmarried dependent children specified in the policy
shall also provide that attainment of such limiting age shall not operate
to terminate the coverage of such child during the continuance of the insurance
coverage of the employee or member under such policy and while such child
is and continues to be (a) incapable of self-sustaining employment by reason
of mental or physical handicap and (b) chiefly dependent upon the policyholder
for support and maintenance, if proof of such incapacity and dependency is
furnished to the insurer by the policyholder within thirty-one days of such
child's attainment of the limiting age and subsequently as may be required
by the insurer but not more frequently than annually after the two-year period
following such child's attainment of the limiting age. The insurer may charge
an additional premium for and with respect to any such continuation of coverage
beyond the limiting age of the policy, which premium shall be determined by
the insurer on the basis of the class of risks applicable to such child. The
provisions of this subdivision shall be contained in all new policies of group
sickness and accident insurance delivered or issued for delivery to any person
in this state. No group policy of sickness and accident insurance shall contain
any provisions which are in conflict with sections 44-3,144 to 44-3,150 .

Legislative History

Source: Laws 1947, c. 164, § 16(2), p. 469; Laws 1976, LB 649, § 1; Laws 1989, LB 92, § 153; Laws 1994, LB 1224, § 79; Laws 2009, LB551, § 2. Annotations: Group accident policy may insure eligible members of family including wife. Simmons v. Continental Cas. Co., 410 F.2d 881 (8th Cir. 1969).