Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-12 - ADVERTISING ACCIDENT AND SICKNESS INSURANCE › Rule 120-2-12-.05 - Form and Content of Advertisements

Current through Rules and Regulations filed through June 27, 2024
1. The format and content of an advertisement
				of an accident or sickness insurance policy shall be accurate and shall be
				sufficiently complete and clear to avoid deception or the capacity or tendency
				to mislead or deceive. Whether an advertisement has a capacity or tendency to
				mislead or deceive shall be determined by the Insurance Commissioner from the
				overall impression that the advertisement may be reasonably expected to create
				upon a person of average education or intelligence, within the segment of the
				public to which it is directed, or within a segment of the public to which such
				advertisement may be reasonably calculated to reach.
2. Advertisement shall be truthful and not
				misleading in fact or in implication. Words or phrases, the meaning of which is
				clear only by implication or by familiarity with insurance terminology, shall
				not be used.
3. The advertising of
				hospital or medical policies or plans shall clearly and accurately state the
				dollar limits of benefits where applicable, and time limits of benefits where
				applicable, in lieu of, or in conjunction with descriptive words which might
				imply "full coverage" for all expenses normally related to hospitalization or
				medical care.
4. An advertisement
				for a policy providing benefits for specified illnesses only, such as cancer,
				or for specified accidents only, such as automobile accidents, shall clearly
				and conspicuously in prominent type state the limited nature of the policy. The
				statement shall be worded in language identical to, or substantially similar to
				the following: "THIS IS A LIMITED POLICY;" "THIS IS A CANCER ONLY POLICY;"
				"THIS IS AN AUTOMOBILE ACCIDENT ONLY POLICY."
5. If a policy provides different benefits as
				to amount or time for the same loss occurring under different circumstances or
				from different causes, the smaller benefits payable shall be given the same
				prominence as the larger benefits.
6. All policies advertised shall be correctly
				identified by names reasonably calculated to describe their contents, FOR
				EXAMPLE: Hospital and Surgical Expense Policy; Hospital Income Policy; Hospital
				Confinement Policy; Disability Income Policy; Senior Citizen Hospital Expense
				Policy; Medical Care Accident and Health Policy; . . . etc.
The use of such terms as "Pay Check Plan;" "Hospital
				  Dollars;" "Extra-income Plan;" "Extra Cash Plan;" "Extra Pay Plan;" "Hard Cash
				  Plan;" "White Cross Plan;" "Doctors' Plan;" or similar words or phrases which
				  do not correctly identify the policy, shall be prohibited.
In addition, all advertised policies must be identified by
				  Form Number.
7. Any
				Optional Benefit advertised shall be captioned as "Optional Benefits" and shall
				be prominently and conspicuously displayed in immediate conjunction with the
				conditions to qualify for such Optional Benefits. An advertisement must contain
				a statement that in order to obtain such optional benefits there will be an
				additional premium charged for each optional benefit desired. A statement must
				also be included in the advertisement as to what conditions, if any, must be
				met to qualify for such benefits.
8. All advertisements of accident and
				sickness insurance in this State shall include the name, address and phone
				number of the Home or Principal Office and/or of the nearest representative or
				representatives of the insurer authorized to handle claims and to provide
				service and information to applicants and/or insureds.
9. Any advertisement making reference to
				"Medicare Supplement Insurance" or to coverage designed to supplement
				"Medicare," shall contain a clear, prominent and conspicuous statement in
				language identical to or substantially the same as the following: "THIS IS A
				LIMITED POLICY DESIGNED TO COVER ONLY THOSE EXPENSES WHICH MEDICARE DOES NOT
				COVER." Furthermore, such advertisements must clearly, prominently and
				conspicuously disclose the exact benefits payable under such advertised policy.
If such advertised Medicare Supplement Policy supplements
				  only Medicare Part A (or hospital benefits only), this shall be clearly,
				  prominently and conspicuously displayed in the advertisement; nor shall such
				  advertisements use the maximum amount payable without giving an exact example
				  of the conditions which must be met in order for a policyholder to collect the
				  maximum amount.
10. Any
				advertisement which refers to maximum dollar amount of benefits which can be
				paid for any period greater than one day shall disclose at the same time, in an
				equally prominent, frequent, and conspicuous manner, and in immediate
				conjunction therewith, the daily rate of benefits, and when applicable, the
				fact that said benefits are payable only for the actual number of days of
				hospital confinement and, when applicable, the limit on the number of days for
				which coverage is provided.
11.
				Words and phrases used in an advertisement to describe policy limitations,
				exceptions, and reductions shall fairly, accurately, and clearly describe in
				understandable terms the negative features of such limitations, exceptions and
				reductions of the policy.
Ga. L. 1960, pp. 289 to
				  755.