Insurance Contract
This Insurance Contract (Contract) is entered into between [Insurance Provider] (Provider) and [Insurance Recipient] (Recipient).
1. Definitions
1.1 Benefits shall refer to the benefits provided by this Contract in accordance with the specific terms and conditions herein.
1.2 Insured Person(s) shall refer to Recipient, who is the primary insured, and includes any other persons permitted on the Contract as additional insured persons.
2. Policy Coverage
2.1 Provider shall provide the Benefits as outlined in this Contract to the Insured Persons.
2.2 The Benefits shall be provided in accordance with this Contract as follows: (Provide details of coverage here, for example:
* Coverage for medical expenses due to injury and illness
* Coverage for certain medical procedures
* Coverage for prescription medications
* Coverage for preventive care
2.3 Benefits shall be provided up to the maximum amount of [maximum benefit amount].
3. Period of Coverage
3.1 The period of coverage under this Contract shall be from [Start Date] to [End Date].
4. Premium Payment
4.1 Recipient shall make premium payments in the amount of [Premium Amount].
4.2 Premium shall be paid on a [Monthly/Annual] basis, with the first payment due on [Due Date].
4.3 Premiums shall be paid on or before the due date specified herein. In the event of a late payment, Recipient shall be liable for a late payment fee in the amount of [Late Fee].
5. Other Terms and Conditions
5.1 In order to receive the Benefits provided under this Contract, the Insured Person must comply with the following:
* Provide all documents and information requested by Provider
* Agree to any additional terms and conditions required by Provider
5.2 If Recipient chooses to pay the premium in installments, the premium payments will become due on the first day of each subsequent month.
5.3 The Provider reserves the right to change or modify the terms of this Contract at any time, and will provide notification in writing of any changes or modifications.
6. Dispute Resolution
6.1 In the event of a dispute related to this Contract, the parties agree to resolve any dispute through voluntary negotiation.
6.2 Any dispute unresolved by voluntary negotiation may be subject to binding arbitration administered by the American Arbitration Association.
7. Termination
7.1 This Contract shall be considered terminated when:
* Recipient has made all the required premium payments
* Coverage period has expired
* Contract has been canceled by either party
7.2 In the event of termination, Provider shall not be obligated to provide any Benefits or refunds.
In witness of agreement between the parties to this Contract, they have executed this Contract as of the day and year first above written.
[Provider Name]
[Provider Signature]
[Date]
[Recipient Name]
[Recipient Signature]
[Date]