New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 10 - HEALTH INSURANCE › Part 15 - LONG-TERM CARE INSURANCE › Section 13.10.15.27 - DIRECT RESPONSE SOLICITATIONS

Current through Register Vol. 35, No. 13, July 16, 2024
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. 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 delivered herewith issued
						  by [company name] Insurance Company. Your new policy provides thirty (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 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 agent 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)