376.776. Hospital and medical expense provisions extended for certain handicapped and dependent children past normal coverage age.
Hospital and medical expense provisions extended for certainhandicapped and dependent children past normal coverage age.
376.776. 1. This section applies to the hospital and medical expenseprovisions of an accident or sickness insurance policy.
2. If a policy provides that coverage of a dependent child terminatesupon attainment of the limiting age for dependent children specified in thepolicy, such policy so long as it remains in force shall be deemed toprovide that attainment of such limiting age does not operate to terminatethe hospital and medical coverage of such child while the child is andcontinues to be both incapable of self-sustaining employment by reason ofmental or physical handicap and chiefly dependent upon the policyholder forsupport and maintenance. Proof of such incapacity and dependency must befurnished to the insurer by the policyholder at least thirty-one days afterthe child's attainment of the limiting age. The insurer may require atreasonable intervals during the two years following the child's attainmentof the limiting age subsequent proof of the child's disability anddependency. After such two-year period, the insurer may require subsequentproof not more than once each year.
3. If a policy provides that coverage of a dependent child terminatesupon attainment of the limiting age for dependent children specified in thepolicy, such policy, so long as it remains in force until the dependentchild attains the limiting age, shall remain in force at the option of thepolicyholder. The policyholder's election for continued coverage underthis section shall be furnished by the policyholder to the insurer withinthirty-one days after the child's attainment of the limiting age. As usedin this subsection, a dependent child is a person who:
(1) Is a resident of this state;
(2) Is unmarried and no more than twenty-five years of age; and
(3) Not provided coverage as a named subscriber, insured, enrollee,or covered person under any group or individual health benefit plan, orentitled to benefits under Title XVIII of the Social Security Act, P.L.89-97, 42 U.S.C. Section 1395, et seq.
4. This section applies only to policies delivered or issued fordelivery in this state more than one hundred twenty days after October 13,1967.
(L. 1967 p. 577, A.L. 2007 H.B. 818)Effective 1-01-08