Exclusion: means for the purposes of accident and health insurance that an insurer does not provide insurance coverage, for whatever reason, for one of the following:
(a)
a specific physical condition;
(b)
a specific medical procedure;
(c)
a specific disease or disorder; or
(d)
a specific prescription drug or class of prescription drugs. See Utah Code 31A-1-301
Insurance: includes :
(i)
a risk distributing arrangement providing for compensation or replacement for damages or loss through the provision of a service or a benefit in kind;
(ii)
a contract of guaranty or suretyship entered into by the guarantor or surety as a business and not as merely incidental to a business transaction; and
(iii)
a plan in which the risk does not rest upon the person who makes an arrangement, but with a class of persons who have agreed to share the risk. See Utah Code 31A-1-301
Insured: means a person to whom or for whose benefit an insurer makes a promise in an insurance policy and includes:
State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
(2)
(a)
Except as provided in Subsection (3), a life insurancepolicy is incontestable after the policy has been in force for a period of two years from the policy’s date of issue:
(i)
during the lifetime of the insured; or
(ii)
for a survivorship life insurance policy, during the lifetime of the surviving insured.
(b)
A life insurance policy shall state that the life insurance policy is incontestable after the time period described in Subsection (2)(a).
(3)
(a)
A life insurance policy described in Subsection (2) may be contested for nonpayment of premiums.
(b)
A life insurance policy described in Subsection (2) may be contested as to:
(i)
provisions relating to accident and health benefits allowed under Section 31A-22-609; and
(ii)
additional benefits in the event of death by accident.
(c)
If a life insurance policy described in Subsection (2) allows the insured, after the policy’s issuance and for an additional premium, to obtain a death benefit that is larger than when the policy was originally issued, the payment of the additional increment of benefit is contestable:
(i)
until two years after the incremental increase of benefits; and
(ii)
based only on a ground that may arise in connection with the incremental increase.
(4)
(a)
A reinstated life insurance policy may be contested:
(i)
for two years following reinstatement on the same basis as at original issuance; and
(ii)
only as to matters arising in connection with the reinstatement.
(b)
Any grounds for contest available at original issuance continue to be available for contest until the policy has been in force for a total of two years:
(i)
during the lifetime of the insured; and
(ii)
for a survivorship life insurance policy, during the lifetime of the surviving insured.
(5)
(a)
The limitations on incontestability under this section:
(i)
preclude only a contest of the validity of the policy; and
(ii)
do not preclude the good faith assertion at any time of defenses based upon provisions in the policy that exclude or qualify coverage, whether or not those qualifications or exclusions are specifically excepted in the policy’s incontestability clause.
(b)
A provision on which the contestable period would normally run may not be reformulated as a coverage exclusion or restriction to take advantage of this Subsection (5).
