Common use of Rescission for Fraud or Intentional Misrepresentations of Material Fact Clause in Contracts

Rescission for Fraud or Intentional Misrepresentations of Material Fact. Blue Shield has the right to rescind this Agreement if the information contained in the application or otherwise provided to Blue Shield by the Subscriber or anyone acting the Subscriber’s behalf in connection with the application was intentionally and materially inaccurate or incomplete. This Agreement also may be rescinded if the Subscriber or anyone acting on his or her behalf failed to disclose to Blue Shield any new or changed facts arising after the application was submitted but before this Agreement was issued, when those facts pertained to matters inquired about in the application. However, after 24 months following the issuance of the Agreement, Blue Shield will not rescind the Agreement for any reason. If after enrollment, Blue Shield investigates the application information, Blue Shield will not rescind this Agreement without first notifying the Subscriber of the investigation and offering an opportunity to respond. If this Agreement is rescinded, it means that the Agreement is voided retroactive to its inception as if it never existed. This means that the Subscriber and Dependents will lose coverage back to the original Effective Date. If the Agreement is properly rescinded, Blue Shield will refund any Premium payments made, but, to the extent permitted by applicable law, may reduce that refund by the amount of any medical expenses that Blue Shield paid under the Agreement or is otherwise obligated to pay. In addition, Blue Shield may, to the extent permitted by California law, be entitled to recoup from the Subscriber all amounts paid by Blue Shield under the Agreement. If this Agreement is rescinded, Blue Shield will provide a 30-day advance written notice that will:

Rescission for Fraud or Intentional Misrepresentations of Material Fact. Blue Shield has the right to rescind this Agreement if the information contained in the application or otherwise provided to Blue Shield by the Subscriber or anyone acting the Subscriber’s behalf in connection with the application was intentionally and materially inaccurate or incomplete. This Agreement also may be rescinded if the Subscriber or anyone acting on his or her behalf failed to disclose to Blue Shield any new or changed facts arising after the application was submitted but before this Agreement was issued, when those facts pertained to matters inquired about in the application. However, after 24 months following the issuance of the Agreement, Blue Shield will not rescind the Agreement for any reason. If after enrollment, Blue Shield investigates the application information, Blue Shield will not rescind this Agreement without first notifying the Subscriber of the investigation and offering an opportunity to respond. If this Agreement is rescinded, it means that the Agreement is voided retroactive to its inception as if it never existed. This means that the Subscriber and Dependents will lose coverage back to the original Effective Date. If the Agreement is properly rescinded, Blue Shield will refund any Premium payments made, but, to the extent permitted by applicable law, may reduce that refund by the amount of any medical expenses that Blue Shield paid under the Agreement or is otherwise obligated to pay. In addition, Blue Shield may, to the extent permitted by California law, be entitled to recoup from the Subscriber all amounts paid by Blue Shield under the Agreement. If this Agreement is rescinded, Blue Shield will provide a 30-day advance written notice that will:: (1) explain the basis of the decision and appeal rights, including the right to request assistance from the California Department of Managed Health Care; (2) clarify that those Members whose application information was not false or incomplete are entitled to new coverage, and will explain how those Members may obtain this coverage; and (3) explain that the monthly Premiums for those Members will be determined based on the number of individuals that remain Blue Shield Members.

Rescission for Fraud or Intentional Misrepresentations of Material Fact. Blue Shield has the right to rescind this Agreement if the information contained in the application or otherwise provided to Blue Shield by the Subscriber or anyone acting the Subscriber’s behalf in connection with the application was intentionally and materially inaccurate or incomplete. This Agreement also may be rescinded if the Subscriber or anyone acting on his or her behalf failed to disclose to Blue Shield any new or changed facts arising after the application was submitted but before this Agreement was issued, when those facts pertained to matters inquired about in the application. However, after 24 months following the issuance of the Agreement, Blue Shield will not rescind the Agreement for any reason. If after enrollment, Blue Shield investigates the application information, Blue Shield will not rescind this Agreement without first notifying the Subscriber of the investigation and offering an opportunity to respond. If this Agreement is rescinded, it means that the Agreement is voided retroactive to its inception as if it never existed. This means that the Subscriber and Dependents will lose coverage back to the original Effective Date. If the Agreement is properly rescinded, Blue Shield will refund any Premium payments made, but, to the extent permitted by applicable law, may reduce that refund by the amount of any medical expenses that Blue Shield paid under the Agreement or is otherwise obligated to pay. In addition, Blue Shield may, to the extent permitted by California law, be entitled to recoup from the Subscriber all amounts paid by Blue Shield under the Agreement. If this Agreement is rescinded, Blue Shield will provide a 30-day advance written notice that will:: (1) explain the basis of the decision and appeal rights, including the right to request assistance from the California Department of Managed Health Care; (2) clarify that those Members whose application information was not false or incomplete are entitled to new coverage, and will explain how those