N.H. Admin. Code § Ins 4702.07

Current through Register No. 50, December 12, 2024

Section Ins 4702.07 - Prohibited Policy Provisions, Exclusions and Limitations

(a) An individual accident and health travel insurance policy shall not contain provisions that:

(1) Guarantee policy renewal;

(2) Provide coverage for a trip that exceeds 12 months except as provided in this part;

(3) Apply preexisting condition exclusions or limitations;

(4) Charge deductibles or co-pays;

(5) Provide that coverage under the policy shall be excess coverage;

(6) Contain coordination of benefit language;

(7) Require a waiting or probationary period for coverage;

(8) Charge a penalty or administrative fee for trip cancellation or early termination by the policyholder, its affiliates, or the covered individual;

(9) Exclude recreational activities associated with travel and vacationing, except for high-risk sports or activities as set forth in Ins 4702.07(b)(4);

(10) Use words such as "violent," "external," "visible wounds" or similar words of description or characterization to describe accidental injury or accidental means and to limit coverage; or

(11) Define sickness to be more restrictive than the definition of sickness in this part; or

(12) Reduce coverage based on the age of the insured.

(b) An individual accident and health insurance travel policy that includes health insurance shall not limit or exclude coverage except when arising out of or related to any of the following:

(1) Mental illness;

(2) Operating a motor vehicle while intoxicated;

(3) Illness , treatment or medical condition arising out of:

a.War or act of war whether declared or undeclared, participation in a felony, riot or insurrections, service in the armed forces or units auxiliary to it;

b.Suicide, attempted suicide or intentionally self-inflicted injury, whether the insured is sane or insane; or

c.Aviation, except as a fare-paying passenger;

(4) Participation in high-risk sports or activities, including technical rock climbing, professional sports, aerial acrobatic sports, skydiving, caving, scuba diving at depth greater than 100 feet, or other extreme sports or activities;

(5) Financial loss for planned medical, dental, or cosmetic care or treatment when the purpose of the trip is to receive such medical, dental, or cosmetic care or treatment;

(6) Travel to or through a country that is, at the time of insurance purchase, under or subject to a travel warning, advisory, or restriction issued by the United States Department of State where the loss is directly or indirectly related to the conditions that caused the travel warning, advisory, or restriction to be issued; or

(7) A circumstance where the issuance of coverage or provision of payment of benefits would violate any applicable law, including without limitation any United States economic or trade sanctions.

N.H. Admin. Code § Ins 4702.07

Adopted byVolume XXXIV Number 41, Filed October 9, 2014, Proposed by #10681, Effective 11/3/2014, Expires 11/3/2024