Connecticut Administrative Code › Title 38a - Insurance Department › 505 - Individual Accident and Sickness Insurance Minimum Standards › Section 38a-505-11 - Requirements for replacement

Current through July 10, 2024
(A) Application
			 forms shall include a question designed to elicit information as to whether the
			 insurance to be issued is intended to replace any other accident and sickness
			 insurance presently in force. A supplementary application or other form to be
			 signed by the applicant containing such a question may be used.
(B) Upon determining that a sale will involve
			 replacement, an insurer, other than a direct response insurer, or its agent
			 shall furnish the applicant, prior to issuance or delivery of the policy, the
			 notice described in (C) below. One (1) copy of such notice shall be retained by
			 the applicant and an additional copy signed by the applicant shall be retained
			 by the insurer. A direct response insurer shall deliver to the applicant upon
			 issuance of the policy, the notice described in (D) below. In no event,
			 however, will such a notice be required in the solicitation of the following
			 types of policies: accident only and single premium nonrenewable
			 policies.
(C) The notice required
			 by (B) above for an insurer, other than a direct response insurer, shall
			 provide, in substantially the following form:
Notice to Applicant Regarding Replacement
of Accident and Sickness Insurance
According to (your application) (information you have
				furnished), you intend to lapse or otherwise terminate existing accident and
				sickness insurance and replace it with a policy to be issued by (Company Name)
				Insurance Company. For your own information and protection, you should be aware
				of and seriously consider certain factors which may affect the insurance
				protection available to you under the new policy.
(1) Health conditions which you may presently
			 have (pre-existing conditions) may not be immediately or fully covered under
			 the new policy. This could result in denial or delay of a claim for benefits
			 under the new policy, whereas a similar claim might have been payable under
			 your present policy.
(2) You may
			 wish to secure the advice of your present insurer or its agent regarding the
			 proposed replacement of your present policy. This is not only your right, but
			 it is also in your best interests to make sure you understand all the relevant
			 factors involved in replacing your present coverage.
(3) If, after due consideration, you still
			 wish to terminate your present policy and replace it with new coverage, be
			 certain to truthfully and completely answer all questions on the application
			 concerning your medical/health history. Failure to include all material medical
			 information on an application may provide a basis for the company to deny any
			 future claims and to refund your premium as though your policy had never been
			 in force. After the application has been completed and before you sign it,
			 re-read it carefully to be certain that all information has been properly
			 recorded.
The above "Notice to Applicant" was delivered to me on:
__________________________________________
(date)
__________________________________________
(applicant's signature)