Illinois Administrative Code › Title 50 - INSURANCE › Part 2012 - LONG-TERM CARE INSURANCE › Exhibit A - Replacement Notice for Other Than Direct Response Solicitations

Current through Register Vol. 48, No. 28, July 12, 2024
NOTICE TO APPLICANT REGARDING REPLACEMENT OF INDIVIDUAL
				ACCIDENT AND SICKNESS OR LONG-TERM CARE INSURANCE
[Insurance Company Name and Address]
SAVE THIS NOTICE! IT MAY BE IMPORTANT TO YOU IN THE
				FUTURE.
According to [your application] [information you have
				furnished], you intend to lapse or otherwise terminate existing accident and
				sickness or long-term care insurance and replace it with an individual
				long-term care insurance policy to be issued by [Company Name] Insurance
				Company. Your new policy provides 30 days within which you may decide, without
				cost, whether you desire to keep the policy. 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.
You should review this new coverage carefully, comparing it
				with all accident and sickness or long-term care insurance coverage you have,
				and terminate your policy only if, after due consideration, you find that
				purchase of this long-term care coverage is a wise decision.
STATEMENT TO APPLICANT BY AGENT [BROKER OR OTHER
				REPRESENTATIVE]: (Use additional sheets as necessary)
I have reviewed your current medical or health insurance
				coverage. I believe the replacement of insurance involved in this transaction
				materially improves your position. My conclusion has taken into account the
				following considerations, which I call to your attention:
1. Health conditions which you may presently
			 have (preexisting conditions), may not be immediately or fully covered under
			 the new policy. This could result in denial or delay in payment of benefits
			 under the new policy, whereas a similar claim might have been payable under
			 your present policy.
2. State law
			 provides that your replacement policy or certificate may not contain new
			 preexisting conditions or probationary periods. The insurer will waive any time
			 periods applicable to preexisting conditions or probationary periods in the new
			 policy (or coverage) for similar benefits to the extent such time was spent
			 (depleted) under the original policy.
3. If you are replacing existing long-term
			 care insurance coverage you may wish to secure the advice of your present
			 insurer or its insurance producer regarding the proposed replacement of your
			 present policy. This is not only your right, but it is also in your best
			 interest to make sure you understand all the relevant factors involved in
			 replacing your present coverage.
4.
			 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, reread it carefully to be certain
			 that all information has been properly recorded.
_________________________________
(Signature of Insurance Producer) [Type Name and Address of
				Insurance Producer]
The above "Notice to Applicant" was delivered to me on:
_________________________________________________
(Applicant's
				Signature)(Date)