If the Covered Person incurs eligible expenses as the direct result of a covered injury and independent of all other causes, the Company will pay the charges incurred for such expense within 365 days, beginning on the date of accident. Payment will be made for eligible expenses in excess of the applicable Deductible Amount, not to exceed the Maximum Medical Benefit. The first such expense must be incurred within 90 days after the date of the accident. “Eligible expense” means charges for the following necessary treatment and service, not to exceed the usual and customary charges in the area where provided.
Excess coverage: This plan does not cover treatment or service for which benefits are payable or service is available
under any other insurance or medical service plan available to the Covered Person.
Abuse or molestation, aircraft, all acts of terrorism, asbestos liability, assault and battery, collapse of temporary structure, owner auto coverage, employment related practices, fungi and bacteria, hepatitis, HIV, HTVL, AIDS, transmissible spongiform encephalopathy, lead poisoning, medical payments, nuclear energy liability, professional liability, pyrotechnics activity, total pollution, war liability, and liability for occurrences prior to the effective date of coverage. All of the above are subject to the terms and conditions of the policy.
Note: There is no liability coverage for claims arising out of any of the following activities: All motor sports, ballooning, bungee jumping, cheerleading pyramids, gymnastics, inflatables, luge, mountain climbing, parachuting, polo, rock climbing, rodeo or any equestrian-related sports, sale/manufacture or distribution of any athletic equipment, skin diving, SCUBA diving, snow skiing, squash, tobogganing, use of saunas, white water rafting, water craft, or any saddle animal exposures.
"Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowinglypresents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison."
VIRGINIA, TENNESSEE, MAINE
"It is a crime to knowingly provide false, incomplete or misleading information to an insurancecompany for the purpose of defrauding the company. Penalties may include imprisonment, fines or denial of insurance benefits."
"It is unlawful to knowingly provide false, incomplete, or misleading facts or information to aninsurance company for the purpose of defrauding or attempting to defraud the company.Penalties may include imprisonment, fines, denial of insurance and civil damages.Any insurance company or agent of an insurance company who knowingly provides false, incomplete,or misleading facts or information to a policyholder or claimant for the purpose of defrauding orattempting to defraud the policyholder or claimant with regard to a settlement or award payable frominsurance proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies."
"WARNING: It is a crime to provide false or misleading information to aninsurer for the purpose of defrauding the insurer or any other person. Penalties include imprisonment and/or fines.In addition, an insurer may deny insurance benefits if false information materially related to a claim was provided by the applicant."
"Any person who knowingly and with intent to injure, defraud, or deceive any insurerfiles a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree."
"Any person who knowingly and with intent to defraud any insurance company or otherperson files an application for insurance containing any materially false information or conceals,for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime."
Insurance applications must contain this statement:
"Any person who includesany false or misleading information on an application for an insurance policy is subject to criminal and civil penalties."
"ANY PERSON WHO KNOWINGLY PRESENTS A FALSE OR FRAUDULENTCLAIM FOR PAYMENT OF A LOSS OR BENEFIT OR KNOWINGLY PRESENTSFALSE INFORMATION IN AN APPLICATION FOR INSURANCE IS GUILTY OF ACRIME AND MAY BE SUBJECT TO CIVIL FINES AND CRIMINAL PENALTIES."
"Any person who knowingly and with intent to defraud any insurance companyor other person files an application for insurance or a statement of claimcontaining any materially false information concerning any fact material thereto, commits afraudulent insurance act, which is a crime, and shall also be subject to a civilpenalty not to exceed five thousand dollars and the stated value of the claim for each such violation."
"Any person who, with intent to defraud or knowing that he is facilitating a fraudagainst an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud."
"WARNING: Any person who knowingly, and with intent to injure, defraud ordeceive any insurer, makes any claim for the proceeds of an insurance policycontaining any false, incomplete or misleading information is guilty of a felony."
Purpose of misleading "Any person who knowingly and with intent to defraudany insurance company or other person files an application for insurance orstatement of claim containing any materially false information or conceals forthe information concerning any fact material thereto commits afraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties."