Hospital Indemnity Insurance – Florida Consumer

THIS PRODUCT PROVIDES LIMITED BENEFITS. USAble Life’s HOSPITAL INDEMNITY INSURANCE IS HOSPITAL INDEMNITY - ONLY COVERAGE. THIS COVERAGE IS SUPPLEMENTAL AND IS NOT A SUBSTITUTE OR REPLACEMENT FOR COMPREHENSIVE HEALTH INSURANCE COVERAGE. IT IS NOT INTENDED TO COVER ALL MEDICAL EXPENSES. THIS PRODUCT DOES NOT PROVIDE COVERAGE FOR ILLNESS OR DISEASE.

This document provides a brief description of USAble Life’s Hospital Indemnity insurance. This is not an insurance policy. Limitations and exclusions may apply, and coverage may be reduced or terminated due to lack of eligibility. Please read the insurance policy carefully.

Please consult your policy and any attached riders, if applicable, for specific information about the benefits available, the benefit amounts payable, and the requirements that describe qualifying for payment of the benefits.

 

Renewability and continuation

The policy is guaranteed renewable during the covered person’s lifetime. USAble Life may change the premium rate, but only if the rate is changed for all policies in the covered person’s state. The policy will not be issued to anyone 65 years of age or over on the initial effective date. If you purchase the policy prior to your 65th birthday, you may continue coverage after age 65 as long as you continue to pay the premium rate by the due date or during the 31 days that follow. Children born while the policy is in force will be covered immediately from the moment of birth under the Individual and Family plans. If you wish to continue coverage on newborn children under the Individual or Individual/Spouse Plan, you must apply within 90 days of the child’s birth date. A covered person’s spouse’s coverage will terminate on the first renewal date following the covered persons death or at the time of divorce. A covered dependent who no longer meets eligibility requirements may convert to an individual policy without evidence of insurability.

 

Pre-existing conditions

Benefits will not be paid for pre-existing conditions during the first twelve months the coverage is in force. A “pre-existing condition” means a sickness or injury that was diagnosed or treated within 12 months before the effective date of coverage or a pregnancy existing on the effective date of coverage. After the coverage has been in force for 12 months, we will pay benefits for any pre-existing condition not specifically excluded.

 

Exceptions and limitations

The policy pays only for loss resulting from a covered sickness or accident as defined in the policy. It does not cover loss due to:

  1. War or any act of war, declared or undeclared.
  2. Intentional self-inflicted injury or attempting suicide.
  3. Being engaged in an illegal occupation or felony.
  4. Routine physicals.
  5. Custodial, intermediate care, or rehabilitative confinement.
  6. Mental, nervous, or emotional disorder without organic origin.
  7. Alcoholism or drug addiction.
  8. The use of alcohol or drugs, unless taken as prescribed by a physician.
  9. Dental, elective, or cosmetic surgery or treatment, except as a result of a covered injury or congenital defect of a newborn child.
  10. Hernia, tonsils, or adenoids during the first six months of coverage, unless treated on an emergency basis.
  11. Well baby care.
  12. Voluntarily acting as an organ donor.

 

For complete details of coverage, please refer to individual policy forms: HIP2 (2-13)