Indiana Administrative Code › Title 760 - DEPARTMENT OF INSURANCE › Article 2 - LONG TERM CARE INSURANCE COVERAGE › Rule 8 - Application Forms and Replacement Coverage › Section 8-4 - Direct response solicitations

Current through July 10, 2024
Authority: IC
				  27-8-12-7
Affected: IC
				  27-8-12
Sec. 4.
Insurers using direct response solicitation methods shall
				  deliver a notice regarding replacement of accident and sickness or long term
				  care coverage to the applicant upon issuance of the policy, certificate, or
				  subscriber agreement. The required notice shall be provided in the following
				  manner:
NOTICE TO APPLICANT REGARDING
REPLACEMENT OF ACCIDENT AND SICKNESS
OR LONG TERM CARE INSURANCE
[Insurance company's 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 the long term care
				  insurance [policy] [certificate] [subscriber agreement] delivered herewith
				  issued by [company name]. Your new [policy] [certificate] [subscriber
				  agreement] provides thirty (30) days within which you may decide, without cost,
				  whether you desire to keep the [policy] [certificate] [subscriber agreement].
				  For your own information and protection, you should be aware of and seriously
				  consider certain factors that may affect the insurance protection available to
				  you under the new [policy] [certificate] [subscriber agreement].
You should review this new coverage carefully, comparing it
				  with all accident and sickness or long term care insurance coverage you now
				  have, and terminate your present policy only if, after due consideration, you
				  find that purchase of this long term care coverage is a wise decision.
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. Your 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.
				[To be included only if the application is attached to the policy.] If, after
				due consideration, you still wish to terminate your present policy and replace
				it with new coverage, read the copy of the application attached to your new
				policy and be sure that all questions are answered fully and correctly.
				Omissions or misstatements in the application could cause an otherwise valid
				claim to be denied. Carefully check the application and write to [company name
				and address] within thirty (30) days if any information is not correct and
				complete, or if any past medical history has been left out of the application.
(Company Name)