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Lapsed Policy

A lapsed policy is an insurance contract that has ended because the required premium was not paid within the grace period. Once a policy lapses, coverage stops, and the insurer is no longer obligated to pay any benefits for claims incurred after the lapse date. A lapse can occur in any type of insurance - including health, dental, life, or disability - when the policyholder fails to make a payment by the due date and does not bring the account up to date before the grace period expires.

In most cases, the insurer provides written notice before cancellation, giving the policyholder an opportunity to reinstate coverage. Some policies can be reinstated within a specified time frame by paying the overdue premiums and, in some cases, providing updated health information. However, if the reinstatement period passes, the policyholder must apply for a new policy, which may require medical underwriting and could result in higher premiums or declined coverage.

Example:

If your monthly health insurance premium is due on June 1 and you fail to pay by the end of the 31-day grace period, your policy will lapse on July 2. Any medical expenses after that date will not be covered until the policy is reinstated or a new plan is issued.

What to Watch For:

Set up automatic payments or reminders to avoid missing premium due dates. Once a policy lapses, reinstating it can be costly or impossible if your health status has changed. Always contact your insurer immediately if you anticipate a delay in payment, as they may provide options to maintain your coverage.

Related Terms

Long-term Disability insurance

Long-term disability (LTD) insurance provides income replacement if you are unable to work for an extended period due to illness or injury. It ensures financial stability by paying a percentage of your regular income, typically between 60 and 85 percent, after you have been disabled for a specific waiting period known as the elimination period. LTD benefits continue until you recover, reach a set benefit end date, or reach retirement age, depending on the terms of the policy.

Premium

A premium is the amount of money an individual or organization pays to an insurance company in exchange for coverage under an insurance policy. It is the cost of maintaining protection against financial loss and ensures that the insurer can pay claims, manage risk, and cover administrative expenses. Premiums can be paid monthly, quarterly, semi-annually, or annually, depending on the policy and payment arrangement.

Grace Period

A grace period is the additional time granted after a premium payment is due during which an insurance policy remains active, even though payment has not yet been received. It provides policyholders with a short window to make late payments without losing coverage. The grace period ensures continuity of protection and helps prevent accidental policy lapses caused by missed or delayed payments.

Coordination of Benefits

Coordination of benefits (COB) is the process used by insurance companies to determine the order in which multiple plans will pay for the same claim when a person is covered under more than one policy. The goal is to ensure that combined reimbursements do not exceed 100 percent of the eligible expense, while allowing the insured to receive the maximum possible coverage across all plans.

Effective Date

The effective date is the day your insurance coverage officially begins. From this date forward, you are eligible to receive benefits for covered health, dental, life, or disability expenses under the terms of your policy. The effective date is established once your application has been approved, all requirements are met, and the first premium payment has been received, unless otherwise specified in the policy.

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