# COMAR Title 31 — Maryland Insurance Administration

## Subtitle 10 — Health Insurance — General

### Chapter 25 — Required Standard Provisions for Individual Nonprofit Health Service Plan Contracts

#### Regulation .05 Limitations and Exclusions.

*COMAR 31.10.25.05*

A. Crime.

  (1) An individual contract may not include a limitation or exclusion for loss to which a contributing cause was the covered individual's commission of or attempt to commit a crime.

  (2) An individual contract may not include a limitation or exclusion for loss for which a contributing cause was the commission of or the attempt to commit a crime by an individual other than the covered individual.

B. Illegal Occupation. An individual contract may not include a limitation or exclusion for loss to which a contributing cause was the covered individual's being engaged in an illegal occupation.

C. Intoxicants or Narcotics or Use of Intoxicants or Narcotics.

  (1) An individual contract may not include a limitation or exclusion for loss sustained or contracted in consequence of the covered individual's being intoxicated or under the influence of any drug.

  (2) An individual contract may not include a limitation or exclusion for loss due to:

    (a) The use of alcohol;

    (b) The use of drugs or narcotics; or

    (c) Alcoholism or drug addiction.

D. Preexisting Condition. If an individual contract contains a preexisting condition limitation or exclusion, the limitation or exclusion may not apply to a condition which the applicant revealed in the application for the contract, unless the condition is excluded by means of a signed waiver rider attached to the contract.