Uniform Individual Accident and Sickness Policy Provision Law (UPPL)

What this document is

Uniform Individual Accident and Sickness Policy Provision Law (UPPL) is a naic model law published by National Association of Insurance Commissioners (NAIC). It is one of the documents that insurance license exam questions are written from, including life & health practice questions. This page summarizes it and points to the official version, which is the text to rely on.

Sections cited in practice questions

Each practice answer shows the exact passage it comes from. These are sections of this document that questions cite, with a short excerpt from the source text.

• NAIC Model #180: Section 3 (Optional Provisions: Change of Occupation)

  “the insurer will pay only such portion of the indemnities provided in this policy as the premium paid would have purchased at the rates and within the limits fixed by the insurer for the more hazardous occupation.”

• NAIC Model #180: Section 3 (Optional Provisions: Illegal Occupation)

  “The insurer shall not be liable for any loss to which a contributing cause was the insured's commission of or attempt to commit a felony or to which a contributing cause was the insured’s being engaged in an illegal occupation.”

• NAIC Model #180: Section 3 (Conformity with State Statutes)

  “Any provision of this policy which, on its effective date, is in conflict with the statutes of the state in which the insured resides on such date is hereby amended to conform to the minimum requirements of such statutes.”

• NAIC Model #180: Section 3 (Reinstatement)

  “The reinstated policy shall cover only loss resulting from such accidental injury as may be sustained after the date of reinstatement and loss due to such sickness as may begin more than ten (10) days after that date.”

• NAIC Model NAIC 180: Section 3A(13) (Change of Beneficiary)

  “Unless the insured makes an irrevocable designation of beneficiary, the right to change of beneficiary is reserved to the insured and the consent of the beneficiary or beneficiaries shall not be requisite to surrender or assignment of this policy or to any change of beneficiary or beneficiaries, or...”

• NAIC Model NAIC 180: Section 3A(7) (Claim Forms)

  “If forms are not furnished within fifteen (15) days after the giving of notice the claimant shall be deemed to have complied with the requirements of this policy as to proof of loss upon submitting, within the time fixed in the policy for filing proofs of loss, written proof covering the...”

• NAIC Model NAIC 180: Section 3A(12) (Legal Actions)

  “No action at law or in equity shall be brought to recover on this policy prior to the expiration of sixty (60) days after written proof of loss has been furnished in accordance with the requirements of this policy.”

• NAIC Model NAIC 180: Section 3A(13) (Required Provisions: Change of Beneficiary)

  “the right to change of beneficiary is reserved to the insured and the consent of the beneficiary or beneficiaries shall not be requisite to surrender or assignment of this policy or to any change of beneficiary or beneficiaries, or to any other changes in this policy.”

• NAIC Model NAIC 180: Section 3A(10) (Payment of Claims)

  “Indemnity for loss of life will be payable in accordance with the beneficiary designation and the provisions respecting such payment which may be prescribed herein and effective at the time of payment. If no such designation or provision is then effective, the indemnity shall be payable to the estate of the insured.”

• NAIC Model NAIC 180: Section 3A(11) (Physical Examinations and Autopsy)

  “The insurer at its own expense shall have the right and opportunity to examine the person of the insured when and as often as it may reasonably require during the pendency of a claim hereunder and to make an autopsy in case of death where it is not forbidden by law.”

• NAIC Uniform Individual Accident and Sickness Policy Provision Law § 3.B(4), optional overinsurance provision, insurance with other insurers

  “In the event that this insurer pays benefits to the insured, his assignee or his beneficiary, in excess of the amount which would have been payable if the existence of other valid coverage had been disclosed, this insurer shall have a right of action against the insured, his assignee or his...”

• NAIC Uniform Individual Accident and Sickness Policy Provision Law § 3.B(3), optional overinsurance provision, other insurance in this insurer

  “Insurance effective at any one time on the insured under this policy and a like policy or policies in this insurer is limited to the one policy elected by the insured, his beneficiary or his estate, as the case may be, and the insurer will return all premiums paid for all other such policies.”

Practice this material

Questions about this source

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