Common use of Rescission of Enrollment for Fraud or Misrepresentation Clause in Contracts

Rescission of Enrollment for Fraud or Misrepresentation. A. This Agreement, or the enrollment of a Member, may be Rescinded if: 1. The Member or Application Filer has performed an act, practice, or omission that constitutes fraud; or 2. The Member or Application Filer has made an intentional misrepresentation of material fact. B. An act, practice or omission that constitutes fraud includes, but is not limited to, fraudulent use of CareFirst BlueChoice's identification card by the Member or Application Filer, the alteration or sale of prescriptions by the Member or Application Filer, or an attempt by a Subscriber to enroll non-eligible persons. CareFirst BlueChoice will provide thirty (30) days advance written notice of any Rescission. CareFirst BlueChoice shall have the burden of persuasion that its Rescission complies with applicable state law. The Rescission shall either (i) void the enrollment of the Member and any benefits paid as of the Member’s Effective Date (for fraudulent acts, practices, or omissions that occur at the time of enrollment); or (ii) in all other cases, void the enrollment of the Member and any benefits paid as of the first date that the Member or the Application Filer performed an act, practice or omission that constituted fraud or made an intentional misrepresentation of material fact. The Subscriber or Application Filer will be responsible for payment of any voided benefits paid by CareFirst BlueChoice, net of applicable Premiums paid.

Rescission of Enrollment for Fraud or Misrepresentation. A. This Agreement, or the enrollment of a Member, may be Rescinded if: 1. The Member or Application Filer has performed an act, practice, or omission that constitutes fraud; or 2. The Member or Application Filer has made an intentional misrepresentation of material fact. B. An act, practice or omission that constitutes fraud includes, but is not limited to, fraudulent use of CareFirst BlueChoice's identification card by the Member or Application Filer, the alteration or sale of prescriptions by the Member or Application Filer, or an attempt by a Subscriber to enroll non-eligible persons. SAMPLE CareFirst BlueChoice will provide thirty (30) days advance written notice of any Rescission. CareFirst BlueChoice shall have the burden of persuasion that its Rescission complies with applicable state law. The Rescission shall either (i) void the enrollment of the Member and any benefits paid as of the Member’s Effective Date (for fraudulent acts, practices, or omissions that occur at the time of enrollment); or (ii) in all other cases, void the enrollment of the Member and any benefits paid as of the first date that the Member or the Application Filer performed an act, practice or omission that constituted fraud or made an intentional misrepresentation of material fact. The Subscriber or Application Filer will be responsible for payment of any voided benefits paid by CareFirst BlueChoice, net of applicable Premiums paid.