Illinois Administrative Code › Title 50 - INSURANCE › Part 2007 - MINIMUM STANDARDS OF INDIVIDUAL ACCIDENT AND HEALTH INSURANCE › Section 2007.90 - Requirements for Replacement

Current through Register Vol. 48, No. 28, July 12, 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 health 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 subsection (d). One copy of the
			 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
			 subsection (e).
c) 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.
d) The notice required by
			 subsection (b) for an insurer, other than a direct response insurer, shall
			 provide, in substantially the following form:
NOTICE TO APPLICANT REGARDING REPLACEMENT
OF ACCIDENT AND HEALTH INSURANCE
According to (your application) (information you have
				furnished), you intend to lapse or otherwise terminate existing accident and
				health 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 that you may presently
			 have (preexisting conditions) may not be immediately or fully covered under the
			 new policy insofar as excepted benefit policies and grandfathered health plans
			 are concerned. Generally, excepted benefits involve coverage only for accident
			 or disability income insurance, or coverage issued as a supplement to liability
			 insurance, or other separately offered coverage such as dental or vision
			 benefits. 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