rnative percentage described at the end of the first sentence of this provision) bears to (b) the total amount of loss-of-time benefits payable for such month under this policy and all other valid loss-of-time coverage on the insured (without giving effect to the “overinsurance provision” in this or any other coverage) less in both (a) and (b) any amount of loss-of-time benefits payable under other valid loss-of-time coverage which does not contain an “overinsurance provision.” In making such computation, all benefits and earnings shall be converted to a consistent (insert “weekly” if the loss-of-time benefit of this policy is payable weekly, “monthly” if such benefit is payable monthly, etc.) basis. If the numerator of the foregoing ratio is zero or is negative, no benefit shall be payable under this policy. In no event shall this provision (1) operate to reduce the total combined amount of loss-of-time benefits for such month payable under this policy and all other valid loss-of-time coverage below the lesser of $300 and the total combined amount of loss-of-time benefits determined without giving effect to any “coordination of benefits provision,” nor (2) operate to increase the amount of benefits payable under this policy above the amount which would have been paid in the absence of this provision, nor (3) take into account or operate to reduce any benefit other than the loss-of-time benefit. For purposes of this provision: (A) “Earned income,” except where otherwise specified, means the greater of the monthly earnings of the insured at the time disability commences and his average monthly earnings for a period of 2 years immediately preceding the commencement of such disability, and shall not include any investment income or any other income not derived from the insured’s vocational activities. (B) “Coordination of benefits provision” includes this provision and any other provision with respect to any loss-of-time coverage which may have the effect of reducing an insurer’s liability if the total amount of loss-of-time benefits under all coverage exceeds a stated relationship to the insured’s earnings. 2. If the policy provision stated in subsection 1 is included in a policy which also contains the policy provision stated in NRS 689A.230, there shall be added to the caption of the provision stated in subsection 1 the phrase “loss-of-time benefits.” 3. The foregoing provision may be included only in a policy which provides a loss-of-time benefit which may be payable for at least 52 weeks, which is issued on the basis of selective underwriting of each individual application, and for which the application includes a question designed to elicit information necessary either to determine the ratio of the total loss-of-time benefits of the insured to the insured’s earned income or to determine that such ratio does not exceed the percentage of earnings, not less than 60 percent selected by the insurer and inserted in lieu of the blank factor above. The insurer may require, as part of the proof of claim, the information necessary to administer this provision. If the application indicates that other loss-of-time coverage is to be discontinued, the amount of such other coverage shall be excluded in computing the alternative percentage in the first sentence of the overinsurance provision. The policy shall include a definition of “valid loss-of-time coverage,” approved as to form by the Commissioner, which definition shall not include group insurance, benefits provided by union welfare plans, employer or employee benefit plans, workmen’s compensation or employer’s liability statute or third party liability. The insurer shall not include a subrogation clause in the policy. 4. If by application of any of the foregoing provisions the insurer effects a material reduction of benefits otherwise payable under the policy, the insurer shall refund to the insured any premium unearned on the policy by reason of such reduction of coverage during the policy year current and that next preceding at the time the loss commenced, subject to the insurer’s right to provide in the policy that no such reduction of benefits or refund will be made unless the unearned premium to be so refunded amounts to $5 or such larger sum as the insurer may so specify. (Added to NRS by 1971, 1761) NRS 689A.250 Unpaid premiums. There may be a provision as follows: Unpaid Premium: Upon the payment of a claim under this policy, any premium then due and unpaid or covered by any note or written order may be deducted therefrom. (Added to NRS by 1971, 1763) NRS 689A.260 Conformity with state statutes. There may be a provision as follows: 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. (Added to NRS by 1971, 1763) NRS 689A.270 Illegal occupation. There may be a provision as follows: 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. (Added to NRS by 1971, 1763) NRS 689A.280 Intoxicants and narcotics. [Effective through June 30, 2006.] 1. There may be a provision as follows: Intoxicants and Narcotics: The insurer is not liable for any loss sustained or contracted in consequence of the insured’s being intoxicated or under the influence of any narcotic unless administered on the advice of a physician. 2. If the insurer includes the provision set forth in subsection 1, he shall also provide that such provision in no way affects benefits payable for the treatment of alcohol or drug abuse, as required by subsection 9 of NRS 689A.030. (Added to NRS by 1971, 1763; A 1975, 1849; R 2005, 2348, effective July 1, 2006) NRS 689A.290 Renewability. Health insurance policies, other than accident insurance only policies, in which the insurer reserves the right to refuse renewal on an individual basis, shall provide in substance in a provision thereof or in an endorsement thereon or rider attached thereto that subject to the right to terminate the policy upon nonpayment of premium when due, such right to refuse renewal may not be exercised so as to take effect before the renewal date occurring on, or after and nearest, each policy anniversary (or in the case of lapse and reinstatement, at the renewal date occurring on, or after and nearest, each anniversary of the last reinstatement), and that any refusal of renewal shall be without prejudice to any claim originating while the policy is in force. (The parenthetic reference to lapse and reinstatement may be omitted at the insurer’s option.) (Added to NRS by 1971, 1764) NRS 689A.300 Order of certain provisions. The provisions which are the subject of NRS 689A.050 to 689A.290, inclusive, or any corresponding provisions which are used in lieu thereof in accordance with such sections shall be printed in the consecutive order of the provisions in such sections or, at the option of the insurer, any such provision may appear as a unit in any part of the policy, with other provisions to which it may be logically related, provided that the resulting policy shall not be in whole or in part unintelligible, uncertain, ambiguous, abstruse or likely to mislead a person to whom the policy is offered, delivered or issued. (Added to NRS by 1971, 1764) NRS 689A.310 Ownership of policy by person other than insured. The word “insured,” as used in this chapter, shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under such a policy to any indemnitie

Vegas Law