Merritt Personal Lines Manual: Other Major Medical Coverage Matters
EXTENSION OF COVERAGE
When coverage is terminated, we will extend coverage only for a continuous injury or sickness for which an insured person is then being treated. We will extend the coverage to the earliest of: (a) the date on which treatment is no longer required; (b) the date on which the maximum payment is incurred; (c) the date on which the payment period for that injury or sickness would end; and (d) the date on which a 90 consecutive day period ends in which the insured person incurs less than $100 in insured expenses.
When the policy terminates, the insurance company will extend coverage if an insured is being treated for a continuous injury or sickness that began while coverage was in force. Coverage will continue for that person until the earliest date on which treatment is no longer required, the maximum benefit has been paid, the payment period ends, or less than $100 of expenses are incurred in a 90-day period.
POLICY NOTICE
Your policy may not apply when you have a claim! Please read! Your policy was issued based on the information entered in your application, a copy of which is attached to the policy. If, to the best of your knowledge and belief, there is any misstatement in your application or if any information concerning the medical history of any insured person has been omitted, you should advise the Company immediately regarding the incorrect or omitted information; otherwise, your policy may not be a valid contract.
As in the basic policy, this is a warning to the insured to check the information given in the application. Under the general provisions, certain misstatements in the application could void the insurance or be used to deny a claim during the first two years of coverage. If a mistake has been made, the insurance company should be notified of the correct information, or else coverage may not apply.
RIGHT TO RETURN POLICY WITHIN 10 DAYS
If for any reason you are not satisfied with your policy, you may return it to the Company within ten days of the date you received it and the premium you paid will be promptly refunded.
As in the basic policy, a policyholder has a right which is known as a 10-day free look. The same conditions and caveats apply.
