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92-1 019284 <br />M 19279 <br />CMP-0260.1C <br />Page 2 of3 <br />c. Arising out of oral or written publica- <br />tion of material, in any manner, <br />whose first publication took place <br />before the beginning of the policy <br />period, <br />Under SECTION II — MEDICAL i <br />PENSES, Paragraph 1.d.(2) under Cover- <br />age M - Medical Expenses is replaced by <br />the following. <br />(2) Executes authorization to allow us to <br />obtain copies of medical bills, medical <br />records, and any other information we <br />deem necessary to substantiate the <br />claim. <br />Such authorizations must not. <br />(a) Restrict us from performing our <br />business functions in. <br />I. Obtaining records, bills, infor- <br />mation, and data, or <br />ii. Using or retaining records, bills, <br />information, and data collected <br />or received by us, <br />(b) Require us to violate federal or <br />state laws or regulations; <br />(c) Prevent us from fulfilling our data <br />reporting and data retention obliga- <br />tions to insurance regulators, or <br />(d) Prevent us from disclosing claim in- <br />formation and data. <br />1. To enable performance of our <br />business functions, <br />ii. To meet our reporting obliga- <br />tions to insurance regulators; <br />III. To meet our reporting obliga- <br />tions to insurance data consoli- <br />dators; and <br />iv. As otherwise permitted by law. <br />If the holder of the information re- <br />fuses to provide it to us despite the <br />authorization, then at our request <br />the person making claim or his or <br />her legal representative must ob- <br />tain the information and promptly <br />provide itto us; and <br />d. SECTION II — DEFINITIONS is amended <br />as follows. <br />(1) Paragraphs 181. and 18.g are replaced <br />by the fallowing. <br />f. The use of another's advertising <br />idea in your 'advertisement"; or <br />g. Infringing upon anothel's copyright, <br />trade dress or slogan in your "ad- <br />vertisement'. <br />(2) Paragraph 18.h. is deleted. <br />4. The following are added to SECTION I AND <br />SECTION II — COMMON POLICY CONDI- <br />TIONS <br />Our Rights Regarding Claim Information <br />a. We will collect, receive, obtain, use, and re- <br />tain all the items described in Paragraph <br />b.(1) below and use and retain the infor- <br />mation described in Paragraph b.(3Rb) be- <br />low, in accordance with applicable federal <br />and state laws and regulations and con- <br />sistent with the performance of our busi- <br />ness functions. <br />I Subject to Paragraph a. above, we will not <br />be restricted in or prohibited from: <br />(1) Collecting, receiving, or obtaining rec- <br />ords, receipts, invoices, medical bills, <br />medical records, wage information, sal- <br />ary information, employment information, <br />data, and any other information, <br />(2) Using any of the items described in Par- <br />agraph b.(1) above; or <br />(3) Retaining. <br />(a) Any of the items in Paragraph b.(1) <br />abovo or <br />(b) Any other information we have in <br />our possession as a result of our <br />processing, handling, or otherwise <br />resolving claims submitted under <br />this policy. <br />c. We may disclose any of the items in Para- <br />graph b.(1) above and any of the infor- <br />mation described in Paragraph b.(3)(b) <br />above. <br />(1) To enable performance of our business <br />functions, <br />(2) To meet our reporting obligations to in- <br />surance regulators, <br />m, Copyright, State Faun Mutual Automobile Insurance Company, 2019 <br />Inolludes copyrighted material of Insurance Services Office. Inc.. with Its permission. <br />o...... Rink ManagemedDiviairnt <br />o` v REMEW DSAPPROVIMBY: <br />F.� i:. VLCP.snzFk <br />Risk Management Analyst <br />