Code of Maryland Regulations (Last Updated: April 6, 2021) |
Title 31. Maryland Insurance Administration |
Subtitle 10. HEALTH INSURANCE—GENERAL |
Chapter 31.10.25. Required Standard Provisions for Individual Nonprofit Health Service Plan Contracts |
Sec. 31.10.25.05. Limitations and Exclusions
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A. Crime.
(1) An individual contract may not include a limitation or exclusion for loss to which a contributing cause was the covered individual's commission of or attempt to commit a crime.
(2) An individual contract may not include a limitation or exclusion for loss for which a contributing cause was the commission of or the attempt to commit a crime by an individual other than the covered individual.
B. Illegal Occupation. An individual contract may not include a limitation or exclusion for loss to which a contributing cause was the covered individual's being engaged in an illegal occupation.
C. Intoxicants or Narcotics or Use of Intoxicants or Narcotics.
(1) An individual contract may not include a limitation or exclusion for loss sustained or contracted in consequence of the covered individual's being intoxicated or under the influence of any drug.
(2) An individual contract may not include a limitation or exclusion for loss due to:
(a) The use of alcohol;
(b) The use of drugs or narcotics; or
(c) Alcoholism or drug addiction.
D. Preexisting Condition. If an individual contract contains a preexisting condition limitation or exclusion, the limitation or exclusion may not apply to a condition which the applicant revealed in the application for the contract, unless the condition is excluded by means of a signed waiver rider attached to the contract.