Maximum of six surfaces per for permanent anterior teeth; and Two occlusal restorations for the upper molars on teeth one, two, three, 14, 15 and 16. Subrogation Thiringer v. If the policy includes a subrogation provision, it must: American Make clear that the issuer is entitled only to excess after the enrollee Motors Ins., is fully compensated 91 WN 2d 215, Inform enrollee that legal expenses will be apportioned equitably 588 P.2d 191 The policy may not: (1978); Great West Have any provision which would inappropriately require full Life Annuity Ins v. reimbursement for all medical expenses Knudson The contract cannot unreasonably restrict or delay the payment of benefits. Delays are not justified because the expenses incurred, or the services received, resulted from an act or omission of a third party Unfair and False RCW 48.30.040 The forms may not contain any false, deceptive, or misleading Discriminatory representation or advertising relative to the business of a Disability Practices insurer or to any person engaged therein. Advertising Unfair and RCW 48.30.090 The may not contain any misrepresentation of the terms of any Discriminatory of contract, or the benefits or advantages promised thereby, or use the Practices Contract name or title of any contract or class of contract misrepresenting the (Cont’d) Terms nature thereof. No RCW 48.30.100 Contract must not guarantee or to the payment of future dividends guarantee of or future refunds of unused charges or savings. future payments
Maximum of six surfaces per for permanent anterior teeth; and Two occlusal restorations for the upper molars on teeth one, two, three, 14, 15 and 16. Subrogation Thiringer v. American Motors Ins., 91 WN 2d 215, 588 P.2d 191 (1978); Great West Life Annuity Ins v. Knudson If the policy includes a subrogation provision, it must: Make clear that the issuer is entitled only to excess after the enrollee is fully compensated Inform enrollee that legal expenses will be apportioned equitably The policy may not: Have any provision which would inappropriately require full reimbursement for all medical expenses The contract cannot unreasonably restrict or delay the payment of benefits. Delays are not justified because the expenses incurred, or the services received, resulted from an act or omission of a third party Unfair and Discriminatory Practices Unfair and Discriminatory Practices (Cont’d) False Advertising RCW 48.30.040 The forms may not contain any false, deceptive, or misleading representation or advertising relative to the business of a Disability insurer or to any person engaged therein. of Contract Terms RCW 48.30.090 The may not contain any misrepresentation of the terms of any contract, or the benefits or advantages promised thereby, or use the name or title of any contract or class of contract misrepresenting the nature thereof. No guarantee of future payments RCW 48.30.100 Contract must not guarantee or to the payment of future dividends or future refunds of unused charges or savings.
cklist-forms-18-disability-ind-s-a-dental-w-pediatric-ehbs.docx