Incontestable Claims Sample Clauses
The Incontestable Claims clause establishes that, after a specified period, certain claims or statements made in a contract or policy cannot be challenged or disputed by either party. Typically, this applies to insurance policies, where after a set timeframe—often two years—the insurer cannot void the policy or deny a claim based on misstatements or omissions, except in cases of fraud. This clause provides certainty and security to the policyholder by limiting the insurer’s ability to contest claims, thereby reducing the risk of unexpected denials and ensuring the enforceability of the agreement after the contestability period has passed.
Incontestable Claims. An “Incontestable Claim” is a claim for benefits that falls outside of the period of time during which the Ceding Company may challenge the validity of the Policy.
(i) Upon the Ceding Company’s request for payment of a domestic Incontestable Claim where Munich Re, U.S. (Life)’s share is less than $500,000, the Ceding Company shall provide Munich Re, U.S. (Life) with the death certificate, policy face amount, reinsured amount, retention amount, and other agreed upon information necessary for Munich Re, U.S. (Life) to reimburse the claim (“Claim Proofs”).
(ii) In addition, upon request for payment of a domestic Incontestable claim where Munich Re, U.S. (Life)’s share is greater than or equal to $500,000, the Ceding Company shall also provide Munich Re, U.S. (Life) with a claimant’s statement and proof of payment upon which Munich Re, U.S. (Life) should rely for reimbursement of the claim.
(iii) In addition, if the Incontestable Claim relates to a Policy for which Munich Re, U.S. (Life)’s share is greater than the Ceding Company’s share and the duration of the Policy is five (5) years or less, the Ceding Company shall promptly provide Munich Re, U.S. (Life) with all other documentation maintained by the Ceding Company related to the claim and issuance of the Policy including, but not limited to, the underwriting file, the claims investigation file and the Policy file.
(iv) If the death occurs outside of the United States or Canada, the Ceding Company will seek consultation with Munich Re, U.S. (Life) prior to communicating a decision to the beneficiary. If after the Ceding Company seeks consultation, Munich Re, U.S. (Life) fails to respond within five (5) business days, the Ceding Company may settle the claim without further consultation.
Incontestable Claims. An “Incontestable Claim” is a claim for benefits that falls outside of the period of time during which the Ceding Company may challenge the validity of the Policy for material misrepresentations made in the application for coverage as defined by the Policy.
(i) The Ceding Company will not be required to submit claim papers, claimant statements, proof of payment or death certificates to ▇▇▇▇ for claims where ▇▇▇▇’s share of the policy’s face amount on the life of the deceased is $[ * ] or less with the following exceptions:
(ii) Claims where the death of the insured occurred outside of the United States or its Territories
(iii) Claims where accidental death benefits are applicable.
(iv) Claims for accelerated death benefits.
(v) Claims occurring within the contestable period of the policy.
Incontestable Claims. An “Incontestable Claim” is a claim for benefits that falls outside of the period of time during which the Ceding Company may challenge the validity of the Policy.
(i) Upon the Ceding Company’s request for payment of a domestic Incontestable Claim where MARC’s share is less than [*], the Ceding Company shall provide MARC with the death certificate, Policy face amount, reinsured amount, retention amount, and other agreed upon information necessary for MARC to adjudicate the claim (“Claim Proofs”).
(ii) In addition, upon request for payment of a domestic Incontestable claim where Munch Re’s share is greater than or equal to [*], the Ceding Company shall also provide MARC with a claimant’s statement and proof of payment.
(iii) In addition, if the Incontestable Claim relates to a Policy for which MARC’s net amount at risk is equal to or exceeds $[*] and the duration of the Policy is [*]years or less, the Ceding Company shall promptly provide MARC with all other documentation maintained by the Ceding Company related to the claim and issuance of the Policy including, but not limited to, the underwriting file, the claims investigation file and the Policy file. MARC reserves the right to revise or adjust the aforementioned thresholds at any time for any reason.
(iv) If the death occurs outside of the United States, the Ceding Company will provide MARC with the claim investigation documents prior to communicating a decision to the beneficiary.
Incontestable Claims. An “Incontestable Claim” is a claim for benefits that falls outside of the period of time during which the Ceding Company may challenge the validity of the Policy.
(i) Upon the Ceding Company’s request for payment of a domestic Incontestable Claim where Munich Re, U.S. (Life)’s share is less than $500,000, the Ceding Company shall provide Munich Re, U.S. (Life) with the death certificate, policy face amount, reinsured amount, retention amount, and other agreed upon information necessary for Munich Re, U.S. (Life) to adjudicate the claim (“Claim Proofs”).
(ii) In addition, upon request for payment of a domestic Incontestable claim where Munch Re’s share is greater than or equal to $500,000, the Ceding Company shall also provide Munich Re, U.S. (Life) with a claimant’s statement and proof of payment.
(iii) In addition, if the Incontestable Claim relates to a Policy for which Munich Re, U.S. (Life)’s net amount at risk is equal to or exceeds $1,000,000.00 and the duration of the Policy is five (5) years or less, the Ceding Company shall promptly provide Munich Re, U.S. (Life) with all other documentation maintained by the Ceding Company related to the claim and issuance of the Policy including, but not limited to, the underwriting file, the claims investigation file and the Policy file. Munich Re, U.S. (Life) reserves the right to revise or adjust the aforementioned thresholds at any time for any reason.
(iv) If the death occurs outside of the United States, the Ceding Company will provide Munich Re, U.S. (Life) with the claim investigation documents prior to communicating a decision to the beneficiary.