| The Mutual Aid Association may pay none or only part of the benefit to the member or his/her dependent(s) under the following circumstances. |
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(1) |
The individual causes an insurable event by intention or gross negligence. |
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(2) |
The individual causes an insurable event by, with no justifiable reason, not complying with the physician’s or the Association’s instructions regarding medical treatment, or the individual intentionally interrupts recovery from illness or injury. |
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(3) |
The individual does not comply with any justifiable reason when the Mutual Aid Association requests that the individual receive treatment necessary for the benefit. |
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(4) |
The individual does not pay the premium to the Mutual Aid Association by the last day of the month following the month in which the payment was due. |
