California Insurance Code

§ 10192.5

INS § 10192.5 Effective Jan 1, 2006Div. 2 · Part 2 · Ch. 1 · Art. 6

Statute text

A policy or certificate shall not be advertised, solicited, or issued for delivery as a Medicare supplement policy or certificate unless the policy or certificate contains definitions or terms that conform to the requirements of this section.

(a)(1) “Accident,” “accidental injury,” or “accidental means” shall be defined to employ “result” language and shall not include words that establish an accidental means test or use words such as “external, violent, visible wounds” or other similar words of description or characterization.

(2)The definition shall not be more restrictive than the following: “injury or injuries for which benefits are provided means accidental bodily injury sustained by the insured person that is the direct result of an accident, independent of disease or bodily infirmity or any other cause, and occurs while insurance coverage is in force.”

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Legislative history

Amended by Stats. 2005, Ch. 206, Sec. 18. Effective January 1, 2006.