New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter IX - Unfair Trade Practices › Part 215 - Advertisements Of Accident And Health Insurance › Section 215.6 - Advertisements of benefits payable, losses covered or premiums payable

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Deceptive
				words, phrases or illustrations prohibited.
(1) No advertisement shall omit information
				or use words, phrases, statements, references or illustrations if the omission
				of such information or use of such words, phrases, statements, references or
				illustrations has the capacity, tendency or effect of misleading or deceiving
				purchasers or prospective purchasers as to the nature or extent of any policy
				benefit payable, loss covered or premium payable. The fact that the policy
				offered is made available to a prospective insured for inspection prior to
				consummation of the sale or an offer is made to refund the premium if the
				purchaser is not satisfied, does not remedy misleading statements.
(2) No advertisement shall contain or use
				words or phrases such as, "all", "full", "complete", "comprehensive",
				"unlimited", "up to", "as high as", "this policy will help pay your hospital
				and surgical bills", "this policy will help fill some of the gaps that Medicare
				and your present insurance leave out", "this policy will help to replace your
				income" (when used to express loss of time benefits), or similar words and
				phrases, in a manner which exaggerates any benefits beyond the terms of the
				policy.
(3) No advertisement shall
				contain any description of a policy limitation, exception, or reduction, worded
				in a positive manner to imply that it is a benefit, such as, describing a
				waiting period as a "benefit builder," or stating "even preexisting conditions
				are covered after two years." Words and phrases used in an advertisement to
				describe such policy limitations, exceptions and reductions shall fairly and
				accurately describe the negative features of such limitations, exceptions and
				reductions of the policy offered.
(4) No advertisement of a benefit for which
				payment is conditional upon confinement in a hospital or similar facility shall
				use words or phrases such as "tax free," "extra cash", "extra income", "extra
				pay", or substantially similar words or phrases because such words and phrases
				have the capacity, tendency or effect of misleading the public into believing
				that the policy advertised will, in some way, enable persons to make a profit
				from being hospitalized.
(5) No
				advertisement of a hospital or other similar facility confinement benefit shall
				advertise that the amount of the benefit is payable on a monthly or weekly
				basis when, in fact, the amount of the benefit payable is based upon a daily
				pro rata basis relating to the number of days of confinement. When the policy
				contains a limit on the number of days of coverage provided, such limit must
				appear in the advertisement.
(6) No
				advertisement of a direct response insurance product shall imply that because
				"no insurance agent will call and no commissions will be paid to agents" it is
				"a low cost plan," or use other similar words or phrases because the cost of
				advertising and servicing such policies is a substantial cost in the marketing
				of a direct response insurance product.
(7) The terms Medicare supplement, Medigap
				and words of similar import shall not be used in any advertisement of a policy,
				nor shall such advertisement otherwise imply or state that the policy is
				supplemental to Medicare unless that policy is issued in compliance with
				section
				52.11 
				and Part 58 of this Title.