CHAPTER 452

An Act to amend and reenact § $8.1-349 of the Code of Virginia, which
was enacted as § 38-349, which section relates to required provisions
of accident and sickness insurance policies so as to require the inclu-
sion of an additional provision relating to certain airtrip insurance.

[H 545]
Approved March 29, 1958

Be it enacted by the General Assembly of Virginia:

1. That § 38.1-349 of the Code of Virginia, which was enacted as § 88-349,
be amended and reenacted as follows:

§ 38.1-349. Required accident and sickness policy provisions.—
Except as provided in § 38.1-851 of this article, each such policy delivered
or issued for delivery to any person in this State shall contain the provi-
sions specified in this section in the words in which the same appear in
this section; provided, however, that the insurer may, at its option, substi-
tute for one or more of such provisions corresponding provisions of differ-
ent wording approved by the Commission which are in each instance not
less favorable in any respect to the insured or the beneficiary. Such provi-
sions shall be preceded individually by the caption “REQUIRED PROVI-
SIONS” or, at the option of the insurer, by such appropriate individual or
group captions or subcaptions as the Commission may approve.

(1) A provision as follows:

ENTIRE CONTRACT; CHANGES: This policy, including the
endorsements and the attached papers, if any, constitutes the
entire contract of insurance. No change in this policy shall be
valid until approved by an executive officer of the insurer and
unless such approwal be endorsed hereon or attached hereto. No
agent has authority to change this policy or to waive any of its
provisions.

(2) A provision as follows:

TIME LIMIT ON CERTAIN DEFENSES: (a) After three
years from the date of issue of this policy no misstatements,
except fraudulent misstatements, made by the applicant in the
application for such 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 such three-year

period.

(The foregoing policy provision shall not be so construed as to affect
any legal requirement for avoidance of a policy or denial of a claim during
such initial three-year period, nor to limit the application of paragraphs
(1), (2), (3), (4) and (5) of § 38.1-350 in the event of misstatement with
respect to age or occupation or other insurance.)

(A policy which the insured has the right to continue in force subject
to its terms by the timely payment of premium (1) until at least age 50
or, (2) in the case of a policy issued after age 44, for at least five years
from its date of issue, may contain in lieu of the foregoing the following
provision (from which the clause in parentheses may be omitted at the
insurer’s option) under the caption “INCONTESTABLE”:

wim ine wna lke ee ee A i te ee Me Bs is cis
(3

—_—

which the insured is disabled), it shall become incontestable as
to the statements contained in the application.) .

(b) No claim for loss incurred or disability (as defined in the
policy) commencing after three years from the date of issue
disease or physical condition not excluded from coverage by
name or specific description effective on the date of loss had
of this policy shall be reduced or denied on the ground that a
existed prior to the effective date of coverage of this policy.

A provision as follows:

GRACE PERIOD: A grace period of..................- (insert a number
not less than “7” for weekly premium policies, “10” for monthly
premium policies and “31” for all other policies) days will be
granted for the payment of each premium falling due after the
~ premium, during which grace period the policy shall continue
in force.

(A policy which contains a cancellation provision may add, at the end
of the above provision,

subject to the right of the insurer to cancel in accordance with
the cancellation provision hereof.

A policy in which the insurer reserves the right to refuse any renewal
shall have, at the beginning of the above provision,

(4)

Unless not less than five days prior to the premium due date
the insurer has delivered to the insured or has mailed to his last
address as shown by the records of the insurer written notice of
its intention not to renew this policy beyond the period for which
the premium has been accepted,).

A provision as follows:

REINSTATEMENT: If any renewal premium be not paid
within the time granted the insured for payment, a subsequent
acceptance of premium by the insurer or by any agent duly
authorized by the insurer to accept such premium, .without
requiring in connection therewith an application for reinstate-
ment, shall reinstate the policy; provided, however, that if the
insurer or such agent requires an application for reinstatement
and issues a conditional receipt for the premium tendered, the
policy will be reinstated upon approval of such application by
the insurer or, lacking such approval, upon the forty-fifth day
following the date of such conditional receipt unless the insurer
has previously notified the insured in writing of its disapproval
of such application. The reinstated policy shall cover only loss
resulting from such accidental injury as may be sustained after
the date of reinstatement and loss due to such sickness as may
begin more than ten days after such date. In all other respects
the insured and insurer shall have the same rights thereunder
as they had under the policy immediately before the due date
of the defaulted premium, subject to any provisions endorsed
hereon or attached hereto in connection with the reinstatement.
Any premium accepted in connection with a reinstatement shall
be applied to a period for which premium has not been previously
paid, but not to any period more than sixty days prior to the date
of reinstatement.

(The last sentence of the above provision may be omitted from any
policy which the insured has the right to continue in force subject to its
terms by the timely payment of premiums (1) until at least age 50, or,
(2) in the case of a policy issued after age 44, for at least five years from
its date of issue.)

(5)

A provision as follows:
NOTICE OF CLAIM: Written notice of claim must be given
to the insurer within twenty days after the occurrence or com-
mencement of any loss covered by the policy, or as soon there-
after as is reasonably possible. Notice given by or on behalf of
the insured or the beneficiary to the insurer at........—--------_-—---==

(insert the location of such office as the insurer may designate
for the purpose), or to any authorized agent of the insurer, with
information sufficient to identify the insured, shall be deemed
notice to the insurer.

a policy providing a loss-of-time benefit which may be payable for
two years, an insurer may at its option insert the following between
and second sentences of the above provision: _ .

Subject to the qualifications set forth below, if the insured suf-
fers loss of time on account of disability for which indemnity
may be payable for at least two years, he shall, at least once in
every six months after having given notice of claim, give to the
insurer notice of continuance of said disability, except in the event
of legal incapacity. The period of six months following any filing
of proof by the insured or any payment by the insurer on account
of such claim or any denial of liability in whole or in part by the
insurer shall be excluded in applying this provision. Delay in the
giving of such notice shall not impair tthe insured’s right to any
indemnity which would otherwise have accrued during the period
of six ynonths preceding the date on which such notice is actually
given.

A provision as follows:

CLAIM FORMS: The insurer, upon receipt of a notice of claim,
will furnish to the claimant such forms as are usually furnished
by it for filing proofs of loss. If such forms are not furnished
within fifteen days after the giving of such notice the claimant
shall be deemed to have complied with the requirements of this
policy as to proof of loss upon submitting, within the time fixed
in the policy for filing proofs of loss, written proof covering the
occurrence, the character and the extent of the loss for which
claim is made.

A provision as follows:

PROOFS OF LOSS: Written proof of loss must be furnished
to the insurer at its said office in case of claim for loss for
which this policy provides any periodic payment contingent upon
continuing loss within ninety days after the termination of the
period for which the insurer is liable and in case of claim for
any other loss within ninety days after the date of such loss.
Failure to furnish such proof within the time required shall not
invalidate nor reduce any claim if it was not reasonably possible
to give proof within such time, provided such proof is furnished
as soon as reasonably possible and in no event, except in the
absence of legal capacity, later than one year from the time proof
is otherwise required.

A provision as follows:

TIME OF PAYMENT OF CLAIMS: Indemnities payable under
this policy for any loss other than loss for which this policy
provides any periodic payment will be paid immediately upon
receipt of due written proof of such loss. Subject to due written
proof of loss, all accrued indemnities for loss for which this

tion of liability will be paid immediately upon receipt of due
written proof.
A provision as follows: . ‘
PAYMENT OF CLAIMS: indemnnnty for loss of life will be
payable in accordance with the beneficiary designation and the
provisions respecting such payment which may be prescri
erein and effective at the time of payment. If no such designa-
tion or provision is then effective, such indemnity shall be pay-
able to the estate of the insured. Any other accrued indemnities
unpaid at the insured’s death may, at the option of the insurer,
be paid either to such beneficiary or to such estate. All other
indemnities will be payable to the insured.
e following provisions, or either of them, may be included with
roing provision at the option of the insurer:
If any indemnity of this policy shall be payable to the estate
of the insured, or to an insured or beneficiary who is a minor
or otherwise not competent to give a valid release, the in-
surer may pay such indemnity, up to an amount not exceeding
aneenensmnnnnneeee (insert an amount which shall not exceed $1,000),
to any relative by blood or connection by marriage of the insured
or beneficiary who is deemed by the insurer to be equitab
entitled thereto. Any payment made by the insurer in good fait:
pursuant to this provision shall fully discharge the insurer to
the extent of such payment. ;
Subject to any written direction of the insured in the applica-
tion or otherwise all or a portion of any indemnities provided
by this policy on account of hospital, nursing, medical, or surgical
services may, at the insurer’s option and unless the insured re-
quests otherwise in writing not later than the time of filing proofs
of such loss, be paid directly to the hospital or person rendering
such services; but it is not required that the service be rendered
by a particular hospital or person.)
A provision as follows:
PHYSICAL EXAMINATIONS AND AUTOPSY: The insurer at
its own expense shall have the right and opportunity to examine
the person of the insured when and as often as it may reasonably
require during the pendency of a claim hereunder and to make
an autopsy in case of death where it is not forbidden by law.
A provision as follows:
LEGAL ACTIONS: No action at law or in equity shall be brought
to recover on this policy prior to the expiration of sixty days
after written proof of loss been furnished in accordance with
the requirements of this policy. No such action shall be brought
after the expiration of three years after the time written proof
of loss is required to be furnished.
A provision as follows:
CHANGE OF BENEFICIARY: Unless the insured makes an
irrevocable designation of beneficiary, the right to change of
beneficiary is reserved to the insured and the consent of the bene-
ficiary or beneficiaries shall not be requisite to surrender or
assignment of this policy or to any change of beneficiary or bene-
ficiaries, or to any other changes in this policy.
e first clause of this provision, relating to the irrevocable designa-
eneficiary, may be omitted at the insurer’s option.)
A provision as follows:
REQUIRED COVERAGE ON CONNECTING OR RETURNING
PLANES: In every airtrip accident policy, issued in this state
through a mechanical vending machine, or otherwise, the coverage
thereof, according to its terms and provisions, shall extend to an
accident on a connecting or returning plane on which the insured’s
initial airtrip ticket entitles him to ride, if it be shown that
the insured would be entitled to recover under such policy had the
accident occurred while insured was riding on the initial plane
designated on such ticket.