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Covered veterinary expenses for diagnosis or treatment are payable during the policy term, subject to exclusions and other policy limitations. The document sets procedures for policy changes, claim review requests, timelines for legal actions, declarations, installment-related charges, and rules addressing fraud and concealment, including potential voiding of coverage.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/ca-major-medical-plan-2015-sample/181871/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/ca-major-medical-plan-2015-sample/181871.png","ImageObject",300,407,{"name":92,"@type":93},"Lucas Martin","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-02",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What conditions must be met to receive Major Medical Plan benefits?","Question",{"text":112,"@type":113},"Benefits are provided in return for premium payment when due and compliance with all provisions of the policy. Payments are subject to exclusions, limitations, and conditions of the insurance policy.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How can a policyholder request a review after a claim is denied?",{"text":117,"@type":113},"A review request can be made if a claim is denied in whole or in part, or to remove an Additional Excluded Condition. Requests must be submitted in writing with medical and surgical records supporting the basis for the request.",{"name":119,"@type":110,"acceptedAnswer":120},"What happens if the policyholder misrepresents or conceals material information?",{"text":121,"@type":113},"The policy will be voided from inception if material facts were misrepresented or omitted and relied upon when issuing the policy. Claims may be denied and the policy voided if material information is concealed or misrepresented in the claim.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},181871,1788346285,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":129,"read_time":144},8796095360427,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","| 1. INSURING AGREEMENT |\n| --- |\n| We will provide the benefits listed in the Major Medical Plan Benefit Schedule in return for your payment of premium when due and compliance with all provisions of this policy. We will pay covered veterinary expenses that you incur during the policy term for diagnosis or treatment of your pet’s condition. Benefit payments are subject to all exclusions, limitations, and conditions of this insurance policy. |\n| 2. DEFINITIONS |\n\n| A. This policy contains all the agreements between you and us. Its terms cannot be changed except by endorsement or rider issued by us.\u003Cbr>B. You or your spouse may request changes to your policy. Any change we make due to a request by you or your spouse is binding on all persons who have any interest under your policy.\u003Cbr>C. If we revise this policy form and broaden your coverage without charge, you will receive the broader coverage as soon as we make the revision. |\n| --- |\n| D. We may make changes to your policy. If we do, we will send you written notice thirty days before the end of the current policy term or at the time required by the law of your state of residence. You accept these changes by renewing your policy.\u003Cbr>13. REVIEW |\n| You may request a review:\u003Cbr>A. If we deny your claim in whole or in part; or\u003Cbr>B. To ask that we remove an Additional Excluded Condition listed on the Declarations Page or Renewal Certificate of your policy.\u003Cbr>You must submit your review request in writing indicating the reason for the review. You must provide us with all medical and surgical records from your veterinarian relating to any condition that is the basis of your request. If your request for review involves an Additional Excluded Condition , you must provide us with medical and surgical records or other documentation from your veterinarian demonstrating that the condition was cured at least six months before the date of your request. Chronic conditions are not eligible for removal. All review decisions are final.\u003Cbr>14. SUIT AGAINST US |\n| You may not bring a legal action against us unless you have complied with all provisions of this policy. You must begin any legal action against us within one year of your pet’s first treatment for any condition identified in your legal action.\u003Cbr>15. DECLARATIONS |\n| By accepting this policy, you agree that all the statements in your application and the declarations are true and that you have provided us with all material information about your pet’s health. You agree that this policy and any endorsements or riders issued to you is the entire and only agreement between you and us. |\n| 16. FRAUD AND CONCEALMENT |\n| We will void your policy from its inception if we discover that you have misrepresented or omitted any material fact and we relied on your misrepresentation or omission in issuing this policy to you. We may deny your claim and void your policy if you conceal material information or make any material misrepresentation in your claim.\u003Cbr>17. INSTALLMENT PAYMENT SERVICE CHARGE |\n\n| Code | Diagnosis |\n| --- | --- |\n\n\n| A |\n| --- |\n| Primary\u003Cbr>Diagnosis\u003Cbr>Allowance |\n| $530\u003Cbr>1640\u003Cbr>835\u003Cbr>745\u003Cbr>-\u003Cbr>725\u003Cbr>-\u003Cbr>-\u003Cbr>760\u003Cbr>660\u003Cbr>-\u003Cbr>-\u003Cbr>-\u003Cbr>-\u003Cbr>$290\u003Cbr>340\u003Cbr>-\u003Cbr>310\u003Cbr>765\u003Cbr>755\u003Cbr>720\u003Cbr>490\u003Cbr>465\u003Cbr>475\u003Cbr>715\u003Cbr>-\u003Cbr>-\u003Cbr>-\u003Cbr>-\u003Cbr>-\u003Cbr>-\u003Cbr>$380655\u003Cbr>735\u003Cbr>-\u003Cbr>-\u003Cbr>$425700\u003Cbr>530\u003Cbr>680\u003Cbr>-\u003Cbr>-\u003Cbr>-\u003Cbr>$980\u003Cbr>1075\u003Cbr>645\u003Cbr>-\u003Cbr>-\u003Cbr>- |\n\n\n| B |\n| --- |\n| Secondary\u003Cbr>Diagnosis\u003Cbr>Allowance |\n| $210655\u003Cbr>330\u003Cbr>285\u003Cbr>255\u003Cbr>285\u003Cbr>380\u003Cbr>370\u003Cbr>295\u003Cbr>270\u003Cbr>$2105\u003Cbr>645\u003Cbr>2525\u003Cbr>940\u003Cbr>$115\u003Cbr>135\u003Cbr>360\u003Cbr>120\u003Cbr>305\u003Cbr>240\u003Cbr>290\u003Cbr>195\u003Cbr>195\u003Cbr>190\u003Cbr>285\u003Cbr>$600\u003Cbr>660\u003Cbr>1030\u003Cbr>695\u003Cbr>265\u003Cbr>560\u003Cbr>$155260\u003Cbr>295\u003Cbr>$1440\u003Cbr>1220\u003Cbr>$160275\u003Cbr>225\u003Cbr>275\u003Cbr>$445780\u003Cbr>780\u003Cbr>$375430\u003Cbr>260\u003Cbr>$1195\u003Cbr>685\u003Cbr>645 |\n\n| Code | Diagnosis |\n| --- | --- |\n\n\n| B |\n| --- |\n| Secondary\u003Cbr>Diagnosis\u003Cbr>Allowance |\n| $410\u003Cbr>340\u003Cbr>430\u003Cbr>265\u003Cbr>220\u003Cbr>315\u003Cbr>290\u003Cbr>$240\u003Cbr>1575\u003Cbr>1120\u003Cbr>2175\u003Cbr>1245\u003C","cbCailjEya9Y1M5W","https://ap.wps.com/l/cbCailjEya9Y1M5W","pdf",273827,13,"English","# Insuring Agreement\n# Definitions\n## Review\n## Suit Against Us\n## Declarations\n## Fraud and Concealment\n## Installment Payment Service Charge\n## Diagnosis Allowances","[{\"question\":\"What conditions must be met to receive Major Medical Plan benefits?\",\"answer\":\"Benefits are provided in return for premium payment when due and compliance with all provisions of the policy. Payments are subject to exclusions, limitations, and conditions of the insurance policy.\"},{\"question\":\"How can a policyholder request a review after a claim is denied?\",\"answer\":\"A review request can be made if a claim is denied in whole or in part, or to remove an Additional Excluded Condition. Requests must be submitted in writing with medical and surgical records supporting the basis for the request.\"},{\"question\":\"What happens if the policyholder misrepresents or conceals material information?\",\"answer\":\"The policy will be voided from inception if material facts were misrepresented or omitted and relied upon when issuing the policy. Claims may be denied and the policy voided if material information is concealed or misrepresented in the claim.\"}]","CA Major Medical Plan 2015 SAMPLE | PDF",33]