Chapter 11
Basic insurance policy forms or application forms must be filed with the Commissioner for approval
90 days before use.
Policy loan
After a policy has been in effect for 3 years,
Right to return (free-look)
After examination of the policy, the insured has a right to return the policy within 10 days after receipt if not satisfied for any reason, and have full premium refunded;
Grace period
An insured is entitled to a grace period of 30 days
Grace period
An insured is entitled to a grace period of 30 days,
Grace period
An insured is entitled to a grace period of 30 days, in which the policy premium may be paid, and the policy must remain in force;
Proof of loss
An insured must submit written proof of loss to an insurer, no later than 90 days from the date of such loss;
Incontestability
An insurer may not deny a claim due to statements on the application after the policy has been in force for 2 years;
Time limit on certain defenses
An insurer may not deny a claim due to statements on the application after the policy has been in force for 2 years;
Claim forms
An insurer must furnish an insured with proof of loss forms within 10 working days of a notice of claim;
Time of payment of claims
An insurer must pay claim benefits, no later than 30 days from receiving proof of loss;
Each insurer must maintain at its home office or principal office, a complete file containing one copy of each document authorized by the insurer for use in sales presentations.
Each insurer must maintain at its home office or principal office, a complete file containing one copy of each document authorized by the insurer for use in sales presentations.
Dividends
In participating policies, beginning no later than the end of the 3rd policy year,
Each insurer is required to maintain a compete file of all printed, published, or prepared advertisements
Insurance Department and must be kept either for 4 years or until the next regular examination by the Department, whichever is longer.
Legal action
No legal action may be brought against an insurer any sooner than 60 days before or 3 years after proof of loss.
Time of payment of claims
No legal action may be brought against an insurer any sooner than 60 days before or 3 years after proof of loss.
The replacement regulation does not apply to the following:
Replacement of annuity contracts; Credit life insurance; Group life insurance; and Life insurance issued in connection with a pension, profit-sharing or other benefit plan qualifying for tax deductibility of premiums.
replacing insurers
Send each existing insurer a copy of the replacement notice and a written communication advising of the proposed replacement within 3 working days of receipt of the application or the date the policy issued, whichever is earlier.
Notice of claims
Written notice of a claim must be submitted to an insurer within 20 days of a loss;
Payment of claims
after receiving written proof of loss, the insurer must pay death claims as quickly as possible, but no later than 2 months; and
Advertisements must
clearly identify and prominently display the name of the insurer.
Time limit on certain defensesGrace period
for 2 years;
conservation.
he act of trying to discourage a policyholder from replacing an existing policy is called
Accident and sickness insurance
is provided under a policy that insures one person and their dependents.
Life Insurance Solicitation Regulation
is to provide buyers with information which will improve their ability to select the most appropriate life insurance products to serve their needs, improve their understanding of the basic features of the policy, and improve their ability to evaluate the relative costs of similar plans of life insurance.
Conservation
means any attempt by the existing insurer or its producer, or by a broker, to dissuade a current policyowner from the replacement of existing life insurance or annuity. This does not include such routine administrative procedures as late payment reminders, late payment offers or reinstatement offers.
Existing life insurance or annuity
means any life insurance or annuity in force, including life insurance under a binding or conditional receipt or a life insurance policy or annuity that is within an unconditional refund period.
Advertisement
means any material designed to persuade the public to purchase life insurance, including the following:
Replacement
means any transaction in which new life insurance or a new annuity is to be purchased, and as a result, an existing policy has been or will be
Replacing insurer
means the insurance company that issues or proposes to issue a new policy or contract that is a replacement of existing life insurance or annuity.
Existing insurer
means the insurance company whose policy is being replaced.
Every individual accident and sickness policy
must provide for a 10-day free-look period that allows the policyowner to return the policy if dissatisfied for any reason
Existing insurers
must provide policyowners with a policy summary for the existing life insurance within 10 working days of receiving the written communication and replacement if requested.
In a replacement situation
new life insurance may exceed the insurance being surrendered when an entity has a proper insurable interest and the authority to effectuate life insurance contracts on others, and to the extent that the cash surrender value of the old policy,