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Incontestability of Coverage
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Evidence of Coverage  PDF (552K)
Table of Contents   Evidence of Coverage
CERTIFICATE OF GROUP HEALTH CARE COVERAGE
  1. RULES GOVERNING ELIGIBILITY.
  2. GROUP HEALTH CARE COVERAGE.
  3. RIGHT OF SUBROGATION AND REIMBURSEMENT UNDER THE GROUP HEALTH CARE COVERAGE.
  4. RULES FOR COORDINATION OF BENEFITS OF THE GROUP CONTRACT WITH OTHER BENEFITS.
  5. EFFECT OF MEDICARE ON THE GROUP HEALTH CARE COVERAGE.
  6. CLAIM RULES.
  7. INCONTESTABILITY OF COVERAGE.
  8. GENERAL INFORMATION.
  9. DEFINITIONS

This section limits Community First’s use of Your statements in contesting Your Coverage under the Group Health Care Coverage.  These are statements made to persuade Community First to effect that coverage, and all such statements are considered representations and not warranties.  They will be considered to be made to the best of Your knowledge and belief. These rules apply to each statement:

 
  1. It will not be used in a contest to void Your coverage or reduce benefits under the Coverage unless:

    1. It is in a written application signed by You; and
       
    2. A copy of that application is or has been furnished to You, or in the event of Your death or incapacity, to Your personal representative.
       

  2. Your coverage can be voided only in the event of a fraudulent misrepresentation of material fact on the enrollment application.
 
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