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(C) 7. Affirmative proof of loss must be furnished to the insurer at its said office in case of claim for loss of time from disability within ninety days after the termination of the period for which the insurer is liable, and in case of claim for any other loss, within ninety days after the date of such loss. (8) A standard provision relative to examination of the person of the insured and relative to autopsy which shall be in the following form: 8. The insurer shall have the right and opportunity to examine the person of the insured when and so often as it may reasonably require during the pendency of claim hereunder, and also the right and oppor..". to make an autopsy in case of death where it is not forbidden y law. (9) A standard provision relative to the time within which payments other than those for loss of time on account of disability shall be made, which provision may be in either of the following two forms and which may be omitted from any policy providing only indemnity for loss of time on account of disability. The insurer shall insert in the blank space either the word “immediately” or appropriate language to designate such period of time, not more than sixty days, as it may . desire; Form (A) to be used in policies which do not provide indemnity for loss of time on account of disability and Form (B) to be used in policies which do so provide. (A) 9. All indemnities provided in this policy will be paid...... y after receipt of due proof. (B) 9. All indemnities provided in this policy for loss other than that of time on account of disability, will be paid. . . . . . . . . . . . . . . . . . y after receipt of due proof. (10) A standard provision relative to periodical payments of indemnity for loss of time on account of disability, which provision shall be in the following form, and which may be omitted from any policy not providing for such indemnity. The insurer shall insert in the first blank space of the form, appropriate language to designate the proportion of accrued indemnity it may desire to pay, which proportion may be all or any part not less than one-half, and in the second blank space shall insert any period of time not exceeding sixty days. 10. Upon request of the insured and subject to due proof of loss - - - - - - - - - - - - accrued indemnity for loss of time on account of disability will be paid at the expiration of each. . . . . . . . . . . during the . continuance of the period for which the insurer is liable, and any balance remaining unpaid at the termination of such period will be paid immediately upon receipt of due proof. (11) A standard provision relative to indemnity payments which may be in either of the two following forms: Form (A) to be used in policies which designate a beneficiary and Form (B) to be used in policies which do not designate any beneficiary other than the insured: (A) 11. Indemnity for loss of life of the insured is payable to the beneficiary if surviving the insured, and otherwise to the estate of the insured. All other indemnities of this policy are payable to the insured. (B) 11. All the indemnities of this policy are payable to the insured.

(12) A standard provision providing for cancellation of the policy at the instance of the insured, which shall be in the following form: 12. If the insured shall at any time change his occupation to one classified by the insurer as less hazardous than that stated in the policy, the insurer, upon written request of the insured, and surrender of the policy, will cancel the same and will return to the insured the unearned premium. (13) A standard provision relative to the rights of the beneficiary under the policy which shall be in the following form and which may be omitted from any policy not designating a beneficiary. 13. Consent of the beneficiary shall not be requisite to surrender or assignment of this policy, or to change of beneficiary, or to any other changes in the policy. (14) A standard provision limiting the time within which suit may be brought upon the policy as follows: 14. No action at law or in equity shall be brought to recover on this policy prior to the expiration of sixty days after proof of loss has been filed in accordance with the requirements of this policy, nor shall such action be brought at all unless brought within two years from the expiration of the time within which proof of loss is required by the policy. (15) A standard provision relative to time limitations of the policy as follows: 15. If any time limitation of this policy with respect to giving notice of claim or furnishing proof of loss is less than that permitted by the law of the state in which the insured resides at the time this policy is issued, such limitation is hereby extended to agree with the minimum period permitted by such law. § 4. No such policy shall be so issued or delivered which contains any provision (1) relative to cancellation at the instance of the insurer; or (2) limiting the amount of indemnity to a sum less than the amount stated in the policy and for which the premium has been paid; or (3) providing for the deduction of any premium from the amount paid in settlement of claim; or, (4) relative to other insurance by the same insurer; or, (5) relative to the age limits of the policy; unless such provisions which are hereby designated as optional standard provisions, shall be in the words and in the order in which they are hereinafter set forth, but the insurer may at its option omit from the policy any such optional standard provision. Such optional standard provisions if inserted in the policy shall immediately succeed the standard provisions named in section three of this Act. (1) An optional standard provision relative to cancellation of the policy at the instance of the insurer as follows: 16. The insurer may cancel this policy at any time by written notice delivered to the insured or mailed to his last address as shown by the records of the insurer, together with cash or the insurer's check for the unearned portion of premiums actually paid by the insured, and such cancellation shall be without prejudice to any claim originating prior thereto.

(2) An optional standard provision relative to reduction of the amount of indemnity to a sum less than that stated in the policy as follows: 17. If the insured shall carry with another company, corporation, association or society other insurance covering the same loss without giving written notice to the insurer, then in that case the insurer shall be liable only for such portion of the indemnity promised as the said indemnity bears to the total amount of like indemnity in all policies covering such loss, and for the return of such part of the premium paid as shall exceed the pro rata for the indemnity thus determined. (3) An optional standard provision relative to deduction of premium upon settlement of claims as follows: 18. Upon the payment of claim hereunder any premium then due and unpaid or covered by any note or written order may be deducted therefrom. . (4) An optional standard provision relative to other insurance by the same insurer which shall be in such one of the following forms as may be appropriate to the indemnities provided, and in the blank spaces of which the insurer shall insert such upward limits of indemnity as are specified by the insurer's classification of risks, filed as required by this Act. (a) 19. If a like policy or policies, previously issued by the insurer to the insured be in force concurrently herewith, making the aggregate indemnity in excess of $. . . . . . . . , the excess insurance shall be void and all premiums paid for such excess shall be returned to the insured. (B) 19. If a like policy or policies, previously issued by the insurer to the insured be in force concurrently herewith, making the aggregate indemnity for loss of time on account of disability in excess of $. . . . . . weekly, the excess insurance shall be void and all premiums paid for such excess shall be returned to the insured. (C) 19. If a like policy or policies, previously issued by the insurer to the insured be in force concurrently herewith, making the aggregate indemnity for loss other than that of time on account of disability in excess of $. . . . . . . . . , or the aggregate indemnity for loss of time on account of disability in excess of $... . . . . . . weekly, the excess insurance of either kind shall be void and all premiums paid for such excess shall be returned to the insured. (5) An optional standard provision relative to the age limits of the policy which shall be in the following form and in the blank spaces of which the insurer shall insert such number of years as it may elect: 20. The insurance under this policy shall not cover any person under the age of....years nor over the age of....years. Any premium paid to the insurer for any period not covered by this policy will be returned upon request. § 5. No such policy shall be so issued or delivered if it contains any provision contradictory, in whole or part, of any of the provisions hereinbefore in this Act designated as “standard provisions” or as “optional standard provisions”; nor shall any endorsement or attached papers vary, alter, extend, be used as a substitute for, or in any way conflict with any of the said “standard provisions” or the said “optional standard provisions”; nor shall such policy be so issued or delivered

if it contains any provision purporting to make any portion of the charter, constitution or by-laws of the insurer a part of the policy unless such portion of the charter, constitution or by-laws shall be set forth in full in the policy, but this prohibition shall not be deemed to apply to any statement of rates or classification of risks filed with the Insurance Superintendent in accordance with the provisions of this Act. § 6. No policy of insurance provided for by this Act shall be issued, except upon the signed application of the person or persons sought to be insured. Any information or statement of the applicant shall plainly appear upon such application in the form of Interrogatories by the insurer, and Answers by the applicant. A correct and complete copy of the application shall be attached to or endorsed on the policy when delivered, and unless so attached, or endorsed, the contents of such application, or any part thereof, shall not be admitted in evidence on behalf of the insurer for any purpose whatsoever. § 7. The acknowledgment by any insurer of the receipt of notice given under any policy covered by this Act, or the furnishing of forms for filing proofs of loss or the acceptance of such proofs or the investigation of any claim thereunder shall not operate as a waiver of any of the rights of the insurer in defense of any claim arising under such policy. § 8. No alteration of any written application for insurance by erasure, insertion or otherwise, shall be made by any person other than the applicant without his written consent, and the making of any such alteration without the consent of the applicant shall be a misdemeanor. If such alteration shall be made by any officer of the insurer, or by any employee of the insurer with the insurer's knowledge or consent, then such act shall be deemed to have been performed by the insurer thereafter issuing the policy upon such altered application. § 9. A policy issued in violation of this Act shall be held valid but shall be construed as provided in this Act, and when any provision in such a policy is in conflict with any provision of this Act the rights, duties and obligation of the insurer, the policyholder and beneficiary shall be governed by the provisions of this Act. § 10. The policies of insurance against accidental bodily injury or sickness issued by an insurer not organized under the laws of the State may contain, when issued in this State, any provision which the law of the State, territory or district of the United States under which the insurer is organized, prescribes for insertion in such policies, and the policies of insurance against accidental bodily injury or sickness issued by an insurer organized under the laws of this State may contain, when issued or delivered in any other state, territory district or country, any provision required by the laws of the state, territory, district, or country in which the same are issued, anything in this Act to the contrary notwithstanding. § 11. Discrimination between individuals of the same class in the amount of premiums or rates charged for any policy of insurance covered by this Act, or in the benefits payable thereon, or in any of the terms or on. of such policy, or in any other manner whatsoever is prohibited.

§ 12. (1) Nothing in this Act, however, shall apply to or affect any policy of liability or workmen's compensation insurance or any policy of insurance on which the premiums are payable weekly, or any general or blanket policy of insurance issued to any municipal corporation or department thereof, or to any corporation, co-partnership, association of individual employer, police or fire department, underwriter's corps, salvage bureau, or like associations or organizations, where the officers, members or employers or classes or departments thereof are insured for their individual benefit against specified accidental bodily injuries or sickness while exposed to the hazards of the occupation or otherwise in consideration of a premium intended to cover the risks of all the persons insured under such policy. (2) Nothing in this Act shall apply to or in any way affect contracts supplemental to contracts of life or endowment insurance where such supplemental contracts contain no provisions except such as operate to safeguard such insurance against lapse or to provide a special surrender value therefor in the event that the insured shall be totally and permanently disabled by reason of accidental bodily injury or by sickness: Provided, that no such supplemental contract shall be issued or delivered to any person in this State unless and until a copy of the form thereof has been submitted to and approved by the Insurance Superintendent, under such reasonable rules and regulations as he shall make concerning the provisions in such contracts and their submission to and approval by him. (3) Nothing in this Act shall apply to or in any way affect fraternal benefit societies. (4) The provisions of this Act contained in clause five of section two and clauses two, three, eight and twelve of section three may be omitted from railroad ticket policies sold only at railroad stations, or at railroad ticket offices by railroad employees. § 13. Any company, corporation, association, society or other insurer or any officer or agent thereof, which or who issues or delivers to any person in this State any policy in wilful violation of the provisions of this Act shall be punished by a fine of not more than five hundred dollars for each offense, and the Insurance Superintendent may revoke the license of any company, corporation, association, society or other insurer of another state or country, or of the agent thereof, which or who wilfully violates any provision of this Act. § 14. All Acts or parts of Acts inconsistent with this Act are hereby repealed. § 15. This Act shall take effect on the first day of January in the year nineteen hundred and sixteen. Any policy covered by this Act, the form of which has received the approval of the Insurance Superintendent, may be issued or delivered in this State on and after the said date. APPROVED June 29th, 1915.

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