38.2-3531 - Additional exclusions and limitations. - Virginia Statutes

§ 38.2-3531. Additional exclusions and limitations.

A. Each group accident and sickness insurance policy shall contain aprovision specifying all additional exclusions or limitations applicableunder the policy for any disease or physical condition of a person, nototherwise excluded from the person's coverage by name or specific descriptioneffective on the date of the person's loss, which existed prior to theeffective date of the person's coverage under the policy.

B. Any such exclusion or limitation may only apply to a disease or physicalcondition for which medical advice or treatment was received by the personduring the twelve months prior to the effective date of the person'scoverage. The exclusion or limitation shall not apply to loss incurred ordisability commencing after the earlier of (i) the end of a continuous periodof twelve months commencing on or after the effective date of the person'scoverage during which the person receives no medical advice or treatment inconnection with the disease or physical condition, or (ii) the end of thetwo-year period commencing on the effective date of the person's coverage.

C. This section shall not apply to group accident and sickness policiesproviding hospital, medical and surgical or major medical coverage on anexpense incurred basis to an employer's employees and their dependents.

(1986, c. 562; 1998, c. 24.)