Section 2236.3 - Provisions Required(a) The Uniform Provisions for group disability insurance and the Instructions for their use, and the definition of words set forth in Sections 2232.1 to 2232.41, inclusive, of Article 2a of Title 10, insofar as applicable, shall be required and shall apply to disability policies; except that insofar as applicable to blanket disability policies such Uniform Provisions and Instructions for their use are hereby amended in the following respects:(1) In a tuition refund policy in place of using the Uniform Provision captioned "Payment of Claims" the insurer may use one of the following provisions: Form A. Payment of Claims
All benefits provided in this policy will be paid to the school hereby insured immediately after receipt of due proof of loss in repayment for the return of, or in payment of, tuition, fees, or charges of the school for the period of attendance of the pupil lost by reason of disability covered by this policy.
Form B. Payment of Claims.
All benefits provided in this policy will be paid immediately after receipt of due proof of loss, to the person paying tuition charges for the pupil suffering disability covered by this policy.
(2) In blanket disability policies issued to provide accidental death benefits, the insurer, in place of using the first paragraph of the Uniform Provision captioned "Payment of Claims," may use the following provisions, in which case no provision may be included in the policy whereby the individual insured may appoint a beneficiary: Payment of Claims.
Indemnity for loss of life of a minor insured will be payable to the minor insured's parents or guardians, if surviving the insured, otherwise to the estate of the insured. Indemnity for loss of life of any other insured will be payable to the estate of the insured. Any other accrued indemnities unpaid at the insured's death may, at the option of the insurer, be paid either to the parents guardians or estate of the insured. All other indemnities, will be payable to insured.
The instructions for the use of said Uniform Provision in group disability policies are also applicable to the above form. In such blanket disability policies, the insurer shall omit the Uniform Provision captioned "Change of Beneficiary" if the last above form of alternative Uniform Provision captioned "Payment of Claims" is used.
(3)(i) In blanket disability policies issued to provide hospital, medical or surgical benefits resulting from accidents or sickness, in lieu of the first paragraph of the Uniform Provision captioned "Payment of Claims," the insurer may the following paragraph: All indemnities of this policy shall be payable to the insured and any accrued indemnities unpaid at the death of the insured (*) may be paid to the estate of the deceased (*).
(3)(ii) In lieu of the second and third paragraphs of said Uniform Provision captioned "Payment of Claims," the insurer may use the following paragraphs: If any indemnity of this policy shall be payable to the estate of any insured (*), or to an insured (*) who is a minor or in the judgment of the insurer otherwise not competent to give valid release, the insurer may pay such indemnity to the person responsible for the insured's (**) support. Any payments made by the insurer in good faith pursuant to this provision shall fully discharge the insurer to the extent of such payment. All or a portion of any indemnities provided by this policy on account of hospital, nursing, medical or surgical services may, at the insurer's option, and unless a person to whom benefits might otherwise be payable thereunder requests otherwise in writing not later than the time for filing proof of such loss, be paid directly to the hospital or person rendering such services; but it is not required that the services be rendered by a particular hospital or person.
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* Insurer shall insert the proper word or words to describe the individual or individuals insured.
** Insurer shall insert in blank space the proper word or words to describe the individual or individuals insured.
Cal. Code Regs. Tit. 10, § 2236.3
1. Change without regulatory effect amending subsection (a)(2) filed 7-14-2021 pursuant to section 100, title 1, California Code of Regulations (Register 2021, No. 29). Filing deadline specified in Government Code section 11349.3(a) extended 60 calendar days pursuant to Executive Order N-40-20.1. Change without regulatory effect amending subsection (a)(2) filed 7-14-2021 pursuant to section 100, title 1, California Code of Regulations (Register 2021, No. 29). Filing deadline specified in Government Code section 11349.3(a) extended 60 calendar days pursuant to Executive Order N-40-20.