State Codes and Statutes

State Codes and Statutes

Statutes > Nebraska > Chapter44 > 44-761

44-761. Group sicknessand accident insurance; required provisions.Eachgroup policy of sickness and accident insurance shall contain in substancethe following provisions:(1) A provision that the policy, the application of the policyholderif such application or copy thereof is attached to such policy, and the individualapplications, if any, submitted in connection with such policy by the employeesor members, shall constitute the entire contract between the parties, thatall statements, in the absence of fraud, made by any applicant or applicantsshall be deemed representations and not warranties, and that no such statementshall avoid the insurance or reduce benefits thereunder unless contained ina written application of which a copy is attached to the policy;(2) A provision that the insurer will furnish to the policyholder,for delivery to each employee or member of the insured group, an individualcertificate setting forth in summary form a statement of the essential featuresof the insurance coverage of such employee or member and to whom benefitsthereunder are payable. If dependents are included in the coverage, only onecertificate need be issued for each family unit;(3) A provision that to the group originally insured may beadded from time to time eligible new employees or members or dependents, asthe case may be, in accordance with the terms of the policy; and(4) A provision that the insurance coverage of the employeeor member may include, originally or by subsequent amendment, upon the applicationof the employee or member, any two or more eligible members of his or herfamily, including husband, wife, dependent children, any children enrolledon a full-time basis in any college, university, or trade school, or any childrenunder a specified age which shall not exceed thirty years,and any other person dependent upon the policyholder. Any policy which providesthat coverage of an unmarried dependent child shall terminate upon the attainmentof the limiting age for unmarried dependent children specified in the policyshall also provide that attainment of such limiting age shall not operateto terminate the coverage of such child during the continuance of the insurancecoverage of the employee or member under such policy and while such childis and continues to be (a) incapable of self-sustaining employment by reasonof mental or physical handicap and (b) chiefly dependent upon the policyholderfor support and maintenance, if proof of such incapacity and dependency isfurnished to the insurer by the policyholder within thirty-one days of suchchild's attainment of the limiting age and subsequently as may be requiredby the insurer but not more frequently than annually after the two-year periodfollowing such child's attainment of the limiting age. The insurer may chargean additional premium for and with respect to any such continuation of coveragebeyond the limiting age of the policy, which premium shall be determined bythe insurer on the basis of the class of risks applicable to such child. Theprovisions of this subdivision shall be contained in all new policies of groupsickness and accident insurance delivered or issued for delivery to any personin this state. No group policy of sickness and accident insurance shall containany provisions which are in conflict with sections 44-3,144 to 44-3,150. SourceLaws 1947, c. 164, § 16(2), p. 469; Laws 1976, LB 649, § 1; Laws 1989, LB 92, § 153; Laws 1994, LB 1224, § 79; Laws 2009, LB551, § 2.AnnotationsGroup accident policy may insure eligible members of family including wife. Simmons v. Continental Cas. Co., 410 F.2d 881 (8th Cir. 1969).