California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 2 - Policy Forms and Other Documents › Article 2a - Group Disability Policies › Subarticle 2 - Compulsory Uniform Provisions › Section 2232.17 - Entire Contract; Changes

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Form A.
This policy and the application of the employer
						constitute the entire contract between the parties, and any statement made by
						the employer shall, in the absence or fraud, be deemed a representation and not
						a warranty. No statement made by any employee whose eligibility has been
						accepted by the insurer shall (avoid the insurance or reduce the benefits under
						this policy or) be used in defense to a claim hereunder.
Form B.
This policy constitutes the entire contract between the
						parties, and no statement made by the employer or by any employee whose
						eligibility has been accepted by the insurer shall (avoid the insurance or
						reduce the benefits under this policy or) be used in defense to a claim
						hereunder.
No change in this policy shall be valid unless approved
						by an executive officer of the insurer and unless such approval be endorsed
						hereon or attached hereto. No agent has authority to change this policy or to
						waive any of its provisions.
Form C.
This policy (the application of the employer, if any, and
						the individual applications, if any, of the employees) constitute(s) the entire
						contract between the parties, and any statement made by the employer or by any
						employee shall, in the absence of fraud, be deemed a representation and not a
						warranty. No such statement shall (avoid the insurance or reduce the benefits
						under this policy or) be used in defense to a claim hereunder unless it is
						contained in a written application, nor shall any such statement of the
						employer, except a fraudulent misstatement, be used at all to void this policy
						after it has been in force for three years from the date of its issue, nor
						shall any such statement of any employee eligible for coverage under the
						policy, except a fraudulent misstatement, be used at all in defense to a claim
						for loss incurred or disability (as defined in the policy) commencing after the
						insurance coverage with respect to which claim is made has been in effect for
						three years from the date it became effective.
No change in this policy shall be valid unless approved
						by an executive officer of the insurer and unless such approval be endorsed
						herein or attached hereto. No agent has authority to change this policy or
						waive any of its provisions.
Instructions
1. The insurer may, at its option, use either
					 Form A, Form B, or Form C.
2. If
					 the insurer uses Form A, it shall use paragraph (a), or paragraph (b) of the
					 "Time Limit on Certain Defenses" uniform provision as is required or permitted
					 by the instructions for their use, but revised to eliminate all reference to
					 the statements and applications of employees. Paragraph (c) of said uniform
					 provision shall be used or omitted in accordance with the instructions for its
					 use.
3. If the insurer uses Form B,
					 it shall use neither paragraph (a) nor paragraph (b) of the "Time Limit on
					 Certain Defenses" uniform provision, and it shall use or omit paragraph (c) of
					 said uniform provision as required in accordance with the instructions for its
					 use.
4. If the insurer uses Form C,
					 it may, at its option, omit therefrom at the place indicated by parentheses in
					 the first sentence reference to the applications of employees or the
					 application of the employer, or both if it does not desire to make the
					 application or applications, reference to which is omitted, a part of the
					 policy. In such case proper connective words shall be used and the verb
					 "constitute" made singular or plural to agree with the option selected by the
					 insurer.
5. The insurer may, at its
					 option, include or omit the words in parentheses in the first paragraph of Form
					 A and Form B and in the second sentence of Form C reading, "avoid the insurance
					 or reduce the benefits under this policy or."
6. The insurer may, at its option, substitute
					 for the words "and unless such approval be endorsed hereon or attached hereto"
					 at the end of the first sentence of the second paragraph of Form A, Form B, or
					 Form C the words "and evidenced by endorsement hereon, or by amendment hereto
					 signed by the employer and by an executive officer of the insurer."
7. The insurer may omit the portion of the
					 first paragraph of Form C following the phrase "unless it is contained in a
					 written application" if the insurer uses paragraph (a) or (b) of the uniform
					 provision captioned "Time Limit on Certain Defenses" in accordance with the
					 instructions for their use. (Ins. C. 10270.6 (a), 10350. 1.)
1.
						Amendment of Form A filed 5-6-77 as procedural and organizational; effective
						upon filing (Register 77, No. 19).
Note: Authority cited: Section
						  10270.94,
						  Insurance Code. Reference: Sections
						  10350 and
						  10351,
						  Insurance Code.