627.657 Provisions of group
health insurance policies. ---
(1) Each group health insurance policy shall contain
in substance the following provisions:
(a) A provision that, in the absence of fraud, all
statements made by applicants or the policyholder or by an insured
person shall be deemed representations and not warranties and that
no statement made for the purpose of effecting insurance shall
avoid such insurance or reduce benefits unless contained in a
written instrument signed by the policyholder or the insured
person, a copy of which has been furnished to such policyholder or
to such person or his beneficiary.
(b) A provision that the insurer will furnish to the
policyholder, for delivery to each employee or member of the
insured group, a certificate containing the group number and
setting forth the essential features of the insurance coverage of
such employee or member and those to whom benefits are payable. If
dependents are included in the coverage, only one certificate need
be issued for each family unit.
(c) A provision that eligible new employees or members or
dependents may be added to the group, in accordance with the terms
of the policy.
(2) Unless stated otherwise in this part, the
provisions of part VI of this chapter do not apply to group health
insurance policies, but no such policy shall contain any provision
relative to notice or proof of loss, to the time for paying
benefits, or to the time within which suit may be brought on the
policy, which provision is less favorable to the individuals
insured than would be permitted by the comparable provision
required for individual health insurance
policies.
History: s. 589, ch. 59-205; s. 3, ch. 76-168; s. 1, ch. 77-457; ss.
2, 3, ch. 81-318; ss. 504, 523, 809(2nd), ch. 82-243; s. 79, ch.
82-386; s. 114, ch. 92-318.
