California Code of Regulations
Title 10 - Investment
Chapter 5 - Insurance Commissioner
Subchapter 2 - Policy Forms and Other Documents
Article 2a - Group Disability Policies
Subarticle 1 - General Instructions and Rules
Section 2232.7 - Alternative Permissible Order

Universal Citation: 10 CA Code of Regs 2232.7

Current through Register 2024 Notice Reg. No. 38, September 20, 2024

Alternative permissible orders, groupings and captions for the uniform provisions prescribed by this article without obtaining the prior approval of the commissioner as provided in Section 2232.5 are as hereinafter set forth in this section. If, in accordance with any of the alternatives hereinafter set forth in this section, more than one of the uniform provisions are grouped together under a principal caption, such uniform provisions shall nevertheless be set forth in the policy in their relative orders as set forth in this article, unless any such variation in order is noted, explained and approved by the commissioner as is required for other variations in order. The alternatives hereinabove referred to are as follows:

(a) The uniform provisions captioned "Notice of Claim," "Claim Forms" and "Proofs of Loss" may be grouped together under a principal caption such as "Notice and Proof of Claim" or "Notice and Proof of Loss," but each uniform provision shall be preceded and identified by its individual caption or subcaption.

(b) The uniform provisions captioned "Time of Payment of Claim" and "Payment of Claims" may be grouped together under a principal caption "Payment of Claim," "Payment of Loss" or "Payment of Benefits," but each uniform provision shall be preceded and identified by its individual caption or subcaption. The uniform provision captioned "Payment of Claims" may be set forth with the short form of proof of claim in accordance with Section 2232.8 hereof.

(c) The uniform provisions covered in paragraphs (a) and (b) above may be grouped together under a principal caption identifying the provisions as relating to notice, proof and payment of claim appropriately combining a caption permitted by paragraph (a) with caption permitted by paragraph (b) but each individual uniform provision shall be preceded and identified by it's individual caption or subcaption.

(d) The uniform provision captioned "Physical Examination and Autopsy" may be included with the uniform provisions covered in paragraph (a) or in paragraph (c) hereof, and under one of the principal captions therein permitted, but each uniform provision shall be preceded and identified by its individual caption or subcaption.

(e) The insurer may set forth the optional uniform provision captioned "Reduced Hospital Benefits in Case of Coverage Under the California Unemployment Insurance Code" in the policy as a separate uniform provision under its proper caption, or the insurer may set forth the substance or effect of such provision in the policy as a part of the statement of the hospital benefits in conformity with the instructions for its use, in which case a separate caption or subcaption for the uniform provision is not required.

(f) The uniform provisions captioned "Entire Contract; Changes," "Time Limit on Certain Defenses," "Grace Period," "Legal Actions" and "Changes of Beneficiary" may be set forth in the policy separately under their individual captions, or they may be grouped in whole or in part under an appropriate principal caption, or may be set forth with other provisions of the policy with which they are logically related subject to the requirements of identical in Section 2232.5 hereof, but said provider provisions or the variations hereof.

(1) The uniform provision captioned "Entire Contract; Changes" may be set forth in the policy on the first page thereof with the insuring, consideration or execution clauses, in which case the separate caption for the uniform provision is not required; or said uniform provision may be set forth in the policy under some principal caption such as "Contract Provisions" along with the uniform provisions captioned "Time Limit on Certain Defenses" and "Legal Actions," but each uniform provision shall, in such case, be preceded and identified by its individual caption or subcaption.

(2) The uniform provision captioned "Time Limit on Certain Defenses" may be set forth in the policy on the first page thereof with the caption or subcaption with the uniform provisions covered by paragraph (b) hereof, or may be set forth with the uniform provision captioned "Legal Actions" under an appropriate principal caption such as "Time Limits on Legal Actions and Certain Defenses," in which case a separate caption or subcaption for the uniform provisions is not required.

(3) The uniform provision captioned "Grace Period" may be set forth in the policy with the provision thereof relative to payment of the premium by the employer, in which case a separate caption or subcaption for the uniform provision is not required if the caption for the combined provisions includes mention of a grace period.

(4) The uniform provision captioned "Change of Beneficiary" may be set forth in the policy along with the provisions thereof relative to the designation of beneficiary by the employee, in which case a separate caption or subcaption for the uniform provision is not required if the caption for the combined provisions includes mention of change of beneficiary. (Ins. C. 10327.)

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