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WAC 284-50-365

No agency filings affecting this section since 2003

Specified disease and specified accident coverage.

(1) "Specified disease coverage" is a policy which meets one of the following definitions:
(a) A policy which provides coverage for each person insured under the policy for a specifically named disease (or diseases) with a deductible amount not in excess of $250 and an overall aggregate benefit limit of no less than $5,000 and a benefit period of not less than two years for at least the following incurred expenses:
(i) Hospital room and board and any other hospital furnished medical services or supplies;
(ii) Treatment by a legally qualified physician or surgeon;
(iii) Private duty services of a registered nurse (R.N.);
(iv) X-ray, radium and other therapy procedures used in diagnosis and treatment;
(v) Professional ambulance for local service to or from a local hospital;
(vi) Blood transfusions, including expense incurred for blood donors;
(vii) Drugs and medicines prescribed by a physician;
(viii) The rental of an iron lung or similar mechanical apparatus;
(ix) Braces, crutches and wheel chairs as are deemed necessary by the attending physician for the treatment of the disease;
(x) Emergency transportation if in the opinion of the attending physician it is necessary to transport the insured to another locality for treatment of the disease; and
(xi) May include coverage of any other expenses necessarily incurred in the treatment of the disease.
(b) A policy which provides coverage for each person insured under the policy for a specifically named disease (or diseases) with no deductible amount, and an overall aggregate benefit limit of not less than $25,000 payable at the rate of not less than $50 a day while confined in a hospital and a benefit period of not less than 500 days.
(2) "Specified accident coverage" is an accident insurance policy which provides coverage for a specifically identified kind of accident (or accidents) for each person insured under the policy for accidental death or accidental death and dismemberment combined, with a benefit amount not less than $1,000 for accidental death; $1,000 for double dismemberment and $500 for single dismemberment.
[Order R-76-4, ยง 284-50-365, filed 10/29/76, effective 3/1/77.]