41-2106. TIME LIMIT ON CERTAIN DEFENSES. (1) There shall be a provision as follows:
"Time Limit on Certain Defenses:
(a) After two (2) years from the date of issue of this policy, no misstatements, except fraudulent misstatements, made by the applicant in the application for such policy shall be used to void the policy or to deny a claim for loss incurred or disability, as defined in the policy, commencing after the expiration of such two (2) year period.
(b) No claim for loss incurred or disability, as defined in the policy, commencing after two (2) years from the date of issue of this policy shall be reduced or denied on the ground that a disease or physical condition not excluded from coverage by name or specific description effective on the date of loss had existed prior to the effective date of coverage of this policy."
(2) The policy provision of (1)(a) above shall not be so construed as to affect any legal requirement for avoidance of a policy or denial of a claim during such initial two (2) year period, nor to limit the application of sections 41-2118 through 41-2122, Idaho Code, in the event of misstatement with respect to age or occupation or other insurance.
(3) Notwithstanding the provisions of section 41-2106(2), Idaho Code, if an insurer elects to use a simplified application form, with or without a question as to the applicant’s health at the time of application, but without any questions concerning the insured’s health history or medical treatment history, the policy must cover any loss occurring after twelve (12) months from any preexisting condition not specifically excluded from coverage by terms of the policy, and, except as so provided, the policy or contract shall not include wording that would permit a defense based upon preexisting conditions.
(4) A policy which the insured has the right to continue in force subject to its terms by the timely payment of premium (a) until at least age fifty (50) or, (b) in the case of a policy issued after age forty-four (44), for at least five (5) years from its date of issue, may contain in lieu of the foregoing, the following provision, from which the clause in parentheses may be omitted at the insurer’s option, under the caption, "Incontestable":
"After this policy has been in force for a period of two (2) years during the lifetime of the insured (excluding any period during which the insured is disabled), it shall become incontestable as to any statements, other than fraudulent statements, contained in the application."
History:
[41-2106, added 1961, ch. 330, sec. 495, p. 645; am. 1976, ch. 135, sec. 1, p. 507.]
Structure Idaho Code
Chapter 21 - DISABILITY INSURANCE POLICIES
Section 41-2101 - SCOPE OF CHAPTER.
Section 41-2102 - SHORT TITLE.
Section 41-2103 - SCOPE AND FORMAT OF POLICY.
Section 41-2104 - REQUIRED PROVISIONS — CAPTIONS — OMISSIONS — SUBSTITUTIONS.
Section 41-2105 - ENTIRE CONTRACT — CHANGES.
Section 41-2106 - TIME LIMIT ON CERTAIN DEFENSES.
Section 41-2107 - GRACE PERIOD.
Section 41-2108 - REINSTATEMENT.
Section 41-2109 - NOTICE OF CLAIM.
Section 41-2110 - CLAIM FORMS.
Section 41-2111 - PROOFS OF LOSS.
Section 41-2112 - TIME OF PAYMENT OF CLAIMS.
Section 41-2113 - PAYMENT OF CLAIMS.
Section 41-2114 - PHYSICAL EXAMINATION — AUTOPSY.
Section 41-2115 - LEGAL ACTIONS.
Section 41-2116 - CHANGE OF BENEFICIARY.
Section 41-2117 - OPTIONAL POLICY PROVISIONS.
Section 41-2118 - CHANGE OF OCCUPATION.
Section 41-2119 - MISSTATEMENT OF AGE.
Section 41-2123 - RELATION OF EARNINGS TO INSURANCE.
Section 41-2124 - UNPAID PREMIUMS.
Section 41-2125 - CONFORMITY WITH STATE STATUTES.
Section 41-2126 - ILLEGAL OCCUPATION.
Section 41-2127 - INTOXICANTS AND NARCOTICS.
Section 41-2128 - RENEWABILITY.
Section 41-2129 - ORDER OF CERTAIN PROVISIONS.
Section 41-2130 - THIRD PARTY OWNERSHIP.
Section 41-2131 - REQUIREMENTS OF OTHER JURISDICTIONS.
Section 41-2132 - POLICIES ISSUED FOR DELIVERY IN ANOTHER STATE.
Section 41-2133 - CONFORMING TO STATUTE.
Section 41-2135 - PROHIBITED POLICY PLANS — PROVISIONS.
Section 41-2136 - FILING OF RATES.
Section 41-2137 - FRANCHISE DISABILITY INSURANCE LAW.
Section 41-2138 - HEALTH INSURANCE — TEN-DAY FREE EXAMINATION.
Section 41-2139 - REQUIRED PROVISIONS — COVERAGE OF DEPENDENT CHILD.
Section 41-2140 - REQUIRED PROVISIONS.
Section 41-2141 - COORDINATION OF BENEFITS — COORDINATION WITH SOCIAL SECURITY BENEFITS.
Section 41-2142 - LIMITATION OF BENEFITS FOR ELECTIVE ABORTIONS.
Section 41-2143 - SERVICES PROVIDED BY GOVERNMENTAL ENTITIES.
Section 41-2144 - MAMMOGRAPHY COVERAGE.
Section 41-2146 - COVERAGE PROVIDED TO PERSONS HAVING INSURANCE.