What Do You Mean It's Not Covered: What Coverage the Base Policy Offers

INSURING CLAUSE: When we receive proof of a covered injury or sickness, and subject to the provisions of this policy, we will provide benefits for expense: (1) Which is incurred while the person's insurance coverage is in force; (2) Less any deductible and copayment amount; and (3) Up to any maximum payment that may be specified.

This is simply an overall insuring agreement (more specific agreements are found in the individual coverage sections which follow). Subject to all applicable policy provisions, the insurance company agrees that when it receives proof of a covered injury or sickness, it will provide benefits for covered expenses incurred while the insurance is in force. Benefits may be subject to deductibles and copayments (which will be subtracted) and maximum benefit amounts (which is the most the insurer will pay).

TEN DAY RIGHT TO EXAMINE THIS POLICY: This policy may be returned within ten days after it is received. Return it to our home office or to the agent from whom it was purchased. We will void this policy and return any premium you have paid.

Each policyholder has a right to what is known as a 10-day free look. You may examine the policy, return it within 10 days if not satisfied for any reason, and receive a full refund of any premiums paid. A caveat: Pay attention to the date you receive the policy if you're thinking about exercising your free look. Most disputes over this issue involve policyholders who keep the thing for several weeks and then try to back out.