Merritt Personal Lines Manual: How Individuals Are Terminated from the Policy
TERMINATION OF AN INSURED PERSON
An adult insured person's insurance will terminate in the month after the first of these events happens:
(1) the person attains age 65, or
(2) the person becomes eligible for Medicare.
The day of termination is that day of the month which coincides with the policy date.
A dependent child's insurance will terminate on the premium due date after the first of these events happens:
(1) the child attains age 25
(2) the child marries, or
(3) the child is no longer dependent on you.
A dependent child's insurance will not terminate for the above reasons while the child:
(1) is incapable of self-support due to mental retardation or physical handicap
(2) is chiefly dependent on you for support and maintenance and
(3) is not eligible for Medicare.
To continue the handicapped dependent child's insurance, you must submit proof of the child's incapacity and dependency. The proof must be given to us within 31 days of the child's attainment of the limiting age.
We reserve the right to require proof of the handicapped dependent child's continued incapacity and dependency. However, we will not require proof more than once a year after the dependent child attains age 27.
An adult person's insurance may be continued only until reaching age 65 or becoming eligible for Medicare, whichever occurs first. Coverage ends during the month that the event occurs on the day that coincides with the policy date.
An example: Your 65th birthday will occur on August 20 and you would become eligible for Medicare on September 10. Even though your policy date is January 15, your coverage ends on August 15 (the day that matches the policy date during the month of your birthday).
A dependent child's insurance will terminate on the premium due date after the first of these events happens:
(1) the child attains age 25
(2) the child marries, or
(3) the child is no longer dependent on you.
Insurance for a dependent child normally ends when the child reaches age 25 (though some policies will use other ages), gets married, or is no longer dependent on an insured adult.
But coverage for a child will not end if the child is mentally or physically handicapped, remains dependent on an insured and is not eligible for Medicare. Proof of incapacity and dependency must be given to the insurance company within 31 days of the child's 25th birthday. The insurance company may require additional proof, but not more than once each year after the child reaches age 27.
When the insurance is terminated due to any of the reasons stated in this "Termination of an Insured Person" provision, we will:
(1) continue that person's insurance for any term for which we accept the premium
(2) consider any claim for which an expense was incurred before the insurance terminated
(3) allow that person a conversion policy as set forth in the "Conversion Privilege"
(4) extend the insurance for a limited time, as provided below, for a continuous loss that is due to an injury or sickness which began while the insurance was in force.
Whenever insurance is terminated due to reaching a limiting age, eligibility for Medicare, or loss of dependency, coverage will continue for any period for which a premium has been accepted and claims for expenses incurred prior to termination will still be covered.
Additionally, the insurance company will offer a converted policy to a person whose coverage terminates and will extend coverage for a limited time for any continuous loss which began prior to termination.
