§ 26-18-106 — Time limit on certain defenses

Wyoming § 26-18-106

• Jurisdiction: Wyoming
• Title 26: Insurance Code
• Ch. 18: DISABILITY INSURANCE POLICIES

Text

(a) "Time Limit on Certain Defenses: After three (3) years
from the date of issue of this policy no misstatements, except
fraudulent misstatements, made by the applicant in the
application for the policy shall be used to void the policy or
to deny a claim for loss incurred or disability, as defined in
the policy, commencing after the expiration of the three (3)
year period."
(i) This time limit shall not be so construed as to
affect any legal requirement for avoidance of a policy or denial
of a claim during the initial three (3) year period, nor to
limit the application of W.S. 26-18-118 through 26-18-121 in
case of misstatement with respect to age or occupation or other
insurance;
(ii) A policy which the insured has the right to
continue in force subject to its terms by the timely payment of
premium until at least age fifty (50) or in the case of a policy
issued after age forty-four (44), for at least five (5) years
from its date of issue, may contain instead of the "time limit
on certain defenses" provision of this section the following
provision (from which paragraph (i) of this subsection may be
omitted at the insurer's option) under the caption
"Incontestable: After this policy is in force for a period of
three (3) years during the insured's lifetime, excluding any
period during which the insured is disabled, it is incontestable
as to the statements contained in the application."
(b) "Except for the preexisting condition provision stated
in this subsection, no claim for loss incurred or disability, as
defined in the policy, shall be reduced or denied due to a
preexisting condition not excluded from coverage by name or
specific description effective on the date of loss. This
preexisting condition provision shall not exclude coverage for a
period beyond twelve (12) months following the individual's
effective date of coverage and shall only relate to conditions
for which medical advice, diagnosis, care or treatment was
recommended or received during the six (6) months immediately
preceding the effective date of coverage or as to a pregnancy
existing on the effective date of coverage."
(c) In determining whether a preexisting condition
provision applies to an insured or dependent, all private or
public health benefit plans shall credit the time the person was
previously covered by a private or public health benefit plan if
the previous coverage was continuous to a date not more than
ninety (90) days prior to the effective date of the new
coverage. In the case of a preexisting conditions limitation
allowable in the succeeding carrier's plan, the level of
benefits applicable to preexisting conditions or persons
becoming covered by the succeeding carrier's plan during the
period of time this limitation applies under the new plan shall
be the lesser of:
(i) The benefits of the new plan determined without
application of the preexisting conditions limitation; or
(ii) The benefits of the prior plan.