What Do You Mean It's Not Covered: How the Policy Pays Claims

PAYMENT PERIOD AND MAXIMUM PAYMENT -- The payment period begins on the date that the deductible is satisfied. The payment period may not exceed five years of the payment of the maximum payment. The maximum payment which we will make for any one injury or sickness during a payment period is $500,000. Each injury or sickness is eligible for the maximum payment. When an insured person incurs less than $100 in insured expenses in any one 90 consecutive day period during the payment period, the payment period will cease at the end of the 90 day period.

The payment period begins on the date the deductible is first satisfied. This policy has a payment period of five years and a maximum payment of $500,000 for each injury or sickness. An example: You have a major medical policy with a $1,000 deductible. On March 1, you discover that you have a medical condition which requires treatment. Your expenses for doctor visits and medication for this condition do not exceed $1,000 until July 15, so your payment period begins on that date. If expenses for a given condition are less than $100 in a 90-day period, the payment period ends. Additional expenses related to the same condition would be treated as a new injury or sickness. An example: You've recovered from your condition to the point where medical expenses fall below $100 in a 90-day period, so your payment period ends. Two months later, you have a relapse and incur more expenses. This is a new sickness and will be subject to a new deductible and payment period.