A clause in a policy which requires the insured to cooperate in the investigation of a claim by producing records and submitting to examinations. This is required to help Surveyor/Loss Adjuster to establish the validity of a claim. An Evidence Clause in a health policy requires the insured to submit to physical examination.
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A clause that obligates the insured to assist the adjuster in determining the legitimacy of a claim by producing documents and being examined. In a health insurance policy, the evidence clause obligates the insured to be physically examined.
Insurance Encyclopedia
Evidence of Coverage
See: “Certificate of Coverage.”
evidence of coverage (EOC)
See: explanation of coverage (EOC) .
Evidence of funding
Proof that sufficient funds are available for completion of the project. Usually a copy of the face sheet of the grant, contract, or cooperative agreement is sufficient.
Evidence of good health
See: evidence of insurability (EOI) .
Evidence of Health
Evidence of good health is required by insurers at the outset of a health insurance and when a lapsed policy is to be revived. In group schemes it is sometimes waived. It is not required on renewal of a permanent health insurance. Policies with options to effect additional insurance may grant the option without further evidence of health being required.
Evidence of insurability
Any statement or proof of a person’s physical condition, occupation, etc., affecting his acceptance for insurance.
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Any statement of proof of a person’s physical condition and/or other factual information affecting his or her acceptance for insurance.
evidence of insurability (EOI)
Written statement of an individual’s physical condition that would affect eligibility for insurance coverage. This proof is usually necessary for those who do not enroll during an open enrollment period. Also called evidence of good health .
Evidence of insurability (Health Insurance/Life Insurance)
Any facts about the applicant’s health needed to underwrite him or her; for example, a medical physical.
evidence-based medicine (EBM)
Type of practice of medicine in which the doctor finds, assesses, and uses methods of diagnosis and treatment based on the best available evidence, current research, and clinical expertise together with the requirements and desires of the patient.