Caution: If your answers on this application are incorrect or untrue, (insurer) has the right to deny benefits or rescind your coverage.
Caution: The issuance of this group short-term care insurance certificate is based upon your responses to the questions on your application. A copy of your application (is enclosed) (was retained by you when you applied). If your answers are incorrect or untrue, the insurer has the right to deny benefits or rescind your coverage. The best time to clear up any questions is now, before a claim arises! If, for any reason any of your answers are incorrect, contact the insurer at this address: (Insert address).
Conn. Agencies Regs. § 38a-528a-7