reglab/statecodes huggingface dataset:
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0428 - LIFE INSURANCE ADVERTISING: IDENTITY OF INSURER

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The name of
				the insurer shall be clearly identified in all advertisements, and if any
				specific individual policy is advertised it shall be identified either by form
				number or other appropriate description. If an application is a part of the
				advertisement, the name of the insurer shall be shown on the application. An
				advertisement shall not use a trade name, an insurance group designation, name
				of the parent company of the insurer, name of a particular division of the
				insurer, service mark, slogan, symbol or other device or reference without
				disclosing the name of the insurer, if the advertisement would have the
				capacity or tendency to mislead or deceive as to the true identity of the
				insurer or create the impression that a company other than the insurer would
				have any responsibility for the financial obligation under a policy.
(b) No advertisement shall use any
				combination of words, symbols or physical materials which by their content,
				phraseology, shape, color or other characteristics are so similar to a
				combination of words, symbols or physical materials used by a governmental
				program or agency or otherwise appear to be of such nature that they tend to
				mislead prospective insureds into believing that the solicitation is in some
				manner connected with such governmental program or agency.
Authority
				  G.S.
				  58-2-40;
				  58-58-40;
				  58-63-15;
Eff.
				  February 1, 1976;
Readopted Eff. September 26, 1978;
Amended Eff. April 1, 1989;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0429 - LIFE INSURANCE ADVERTISING: LICENSING: STATUS OF INSURER

Current through Register Vol. 39, No. 2, July 15, 2024
(a) An advertisement which is intended to be
				seen or heard beyond the limits of the jurisdiction in which the insurer is
				licensed shall not imply licensing beyond such limits.
(b) An advertisement may state that an
				insurer is licensed in the state where the advertisement appears, provided it
				does not exaggerate such fact or suggest or imply that competing insurers may
				not be so licensed.
(c) An
				advertisement shall not create the impression that the insurer, its financial
				condition or status, the payment of its claims, or the merits, desirability, or
				advisability of its policy forms or kinds of plans of insurance are recommended
				or endorsed by any governmental entity. However, where a governmental entity
				has recommended or endorsed a policy form or plan, such recommendation or
				endorsement may be stated if the entity authorizes such use.
Authority
				  G.S.
				  58-2-40;
				  58-58-40;
				  58-63-15;
Eff.
				  February 1, 1976;
Readopted Eff. September 26, 1978;
Amended Eff. April 1, 1989;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0430 - LIFE INSURANCE ADVERTISING: STATEMENTS ABOUT THE INSURER

Current through Register Vol. 39, No. 2, July 15, 2024
An advertisement shall not contain statements, pictures or
				  illustrations which are false or misleading, in fact or by implication, with
				  respect to the assets, liabilities, insurance in force, corporate structure,
				  financial condition, age or relative position of the insurer in the insurance
				  business. An advertisement shall not contain a recommendation by any commercial
				  rating system unless it clearly defines the scope and extent of the
				  recommendation.
Authority
				  G.S.
				  58-2-40;
				  58-58-40;
				  58-63-15;
Eff.
				  February 1, 1976;
Readopted Eff. September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0431 - LIFE INSURANCE ADVERTISING: ENFORCEMENT PROCEDURES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Each
				insurer shall maintain at its home or principal office a complete file
				containing a specimen copy of every printed, published or prepared
				advertisement of its policies, hereafter disseminated in this state, with a
				notation indicating the manner and extent of distribution and the form number
				of any policy advertised. Such file shall be subject to inspection by this
				department. All such advertisements shall be maintained in said file for a
				period of either three years or until the filing of the next regular report on
				examination of the insurer, whichever is the longer period of time.
(b) Each insurer subject to the provisions of
				11 NCAC
				12 .0424 to
				12 .0433 shall file with this
				department with its annual statement a certificate of compliance executed by an
				authorized officer of the insurer wherein it is stated that to the best of his
				knowledge, information and belief the advertisements which were disseminated by
				or on behalf of the insurer in this state during the preceding statement year,
				or during the portion of such year when
				11 NCAC
				12 .0424 to
				12 .0433 were in effect, complied
				or were made to comply in all respects with the provisions of
				11 NCAC
				12 .0425 to
				12 .0433 and the insurance laws of
				this state as implemented and interpreted by
				11 NCAC
				12 .0424 to
				12 .0433.
(c) Every written advertisement created or
				developed by an insurance agent that describes a policy in any manner shall be
				filed with and approved by the home office of the insurance company offering
				the policy before the advertisement may be used by the agent.
Authority
				  G.S.
				  58-2-40;
				  58-58-40;
				  58-63-15;
Eff.
				  February 1, 1976;
Readopted Eff. September 26, 1978;
Amended Eff. February 1, 1992; April 1, 1989;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0432 - LIFE INSURANCE ADVERTISING: ADVERTISING EXPENSE

Current through Register Vol. 39, No. 2, July 15, 2024
Total advertising expense incurred by the insurer or by an
				  affiliated corporation on behalf of the insurer for the purposes of
				  solicitation and conservation of life insurance business shall be included as
				  line items in the expense exhibits of all statutory financial statements filed
				  by a licensed insurer with the department.
Authority
				  G.S.
				  58-2-40;
				  58-58-40;
				  58-63-15;
Eff.
				  February 1, 1976;
Readopted Eff. September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0433 - LIFE INSURANCE ADVERTISING: PRIOR REVIEW OR PRIOR APPROVAL

Current through Register Vol. 39, No. 2, July 15, 2024
The commissioner may, when in his discretion he deems it in
				  the public interest, require the filing of all or any part of the advertising
				  material of an insurer with this department for review prior to its use. All
				  advertising material subject to review prior to its use shall be filed with
				  this department 30 days prior to its intended use. In instances where charges
				  are pending against an insurer, the commissioner may, during the period such
				  charges are pending but not to exceed 30 days unless extended by consent order,
				  by order require all or any part of the advertising material be filed for
				  review prior to its use or for prior approval. The commissioner may within his
				  discretion refuse to approve all or any part of the advertising material so
				  filed. All advertising material subject to prior approval shall be filed with
				  this department 60 days prior to its intended use. When it has been determined
				  by the commissioner after notice and hearing that an insurer has violated any
				  of the insurance laws of this state or rules of the commissioner, the
				  commissioner may in his discretion, by order require that all or any part of
				  the advertising material be filed with this department for review prior to its
				  use or for prior approval. The commissioner may within his discretion refuse to
				  approve all or any part of the advertising material so filed. In any case where
				  review prior to its use or prior approval is required, a shorter period of time
				  may be allowed by the commissioner.
Authority
				  G.S.
				  58-2-40;
				  58-58-40;
				  58-63-15;
Eff.
				  February 1, 1976;
Readopted Eff. September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0436 - INSURANCE POLICY REQUIREMENTS

Current through Register Vol. 39, No. 2, July 15, 2024
The Commissioner shall not approve any variable life
				  insurance form filed pursuant to this Rule unless it conforms to the
				  requirements of this Section:
(1)
				Filing of Variable Life Insurance Policies. All variable life insurance
				policies, and all riders, endorsements, applications and other documents which
				are to be attached to and made a part of the policy and which relate to the
				variable nature of the policy, shall be filed with the Commissioner and
				approved by him in writing prior to delivery or issuance for delivery in this
				state:
(a) The procedures and requirements
				for such filing and approval shall be, to the extent appropriate and not
				inconsistent with this Rule, the same as those otherwise applicable to other
				life insurance policies.
(b) The
				Commissioner may approve variable life insurance policies and related forms
				with provisions the Commissioner deems to be not less favorable to the
				policyholder and the beneficiary than those required by this Rule.
(c) The requirements of Sub-item (3)(e) of
				this Rule shall not apply to variable life insurance policies and related forms
				issued in connection with pension, profit-sharing and retirement plans if
				separate accounts for such policies are exempt pursuant to Section 3(c)(11) of
				the Investment Company Act of 1940.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0438 - SEPARATE ACCOUNTS

Current through Register Vol. 39, No. 2, July 15, 2024
The following requirements apply to the establishment and
				  administration of variable life insurance separate accounts:
(1) Establishment and Administration of
				Separate Accounts. An insurer issuing variable life insurance in this state
				shall establish one or more separate accounts pursuant to
				G.S.
				58-7-95 of the insurance laws of this state:
(a) If no law or other regulation provides
				for the custody of separate account assets and if the insurer itself is not the
				custodian of such assets, all contracts for such custody shall be in writing
				and the commissioner of the insurer's state of domicile shall approve of both
				the terms of any such contract and the proposed custodian prior to the transfer
				of custody.
(b) An insurer shall
				not without the prior written approval of the commissioner employ in any
				material connection with the handling of separate account assets any person
				who:
(i) within the last 10 years has been
				convicted of any felony or a misdemeanor arising out of such person's conduct
				involving embezzlement, fraudulent conversion, or misappropriation of funds or
				securities or involving violation of Sections 1341 to 1343 of Title 18, United
				States Code; or
(ii) within the
				last 10 years has been found by any state regulatory authority to have violated
				or has acknowledged violation of any provision of any state insurance law
				involving fraud, deceit, or knowing misrepresentation; or
(iii) within the last 10 years has been found
				by federal or state regulatory authorities to have violated or has acknowledged
				violation of any provision of federal or state securities laws involving fraud,
				deceit, or knowing misrepresentation.
(c) All persons with access to the cash,
				securities, or other assets of the separate account shall be under good and
				sufficient bond.
(d) If an insurer
				establishes more than one separate account for variable life insurance,
				justification for the establishment of each additional separate account shall
				also be filed with the commissioner and shall be subject to his
				approval.
(e) The assets of such
				separate accounts established for variable life insurance policies shall be
				valued at least as often as variable benefits are determined but in any event
				at least monthly.
(f) A separate
				account exempt pursuant to Section 3(c)(11) of the Investment Company Act of
				1940 because of the tax qualified status of the policies funded thereby shall
				not be used to fund other variable life insurance policies.
(g) Except for separate accounts exempt
				pursuant to Section 3(c)(11) of the Investment Company Act of 1940, variable
				life insurance separate accounts shall not be used for variable annuities or
				for the investment of funds corresponding to dividend accumulations or other
				policyholder liabilities not involving life contingencies.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0439 - INFORMATION FURNISHED TO APPLICANTS

Current through Register Vol. 39, No. 2, July 15, 2024
An insurer delivering or issuing for delivery in this state
				  any variable life insurance policies shall deliver to the applicant for the
				  policy, and obtain a written acknowledgment of receipt from such applicant
				  coincident with or prior to the execution of the application, a prospectus
				  included in a registration statement relating to the policies which satisfied
				  the requirements of the Securities Act of 1933 and which was declared effective
				  by the Securities and Exchange Commission, or if the policies are exempted from
				  the registration requirements of such act by section 3(a)(2) thereof, the
				  insurer shall furnish all information and reports required by the Employee
				  Retirement Income Security Act of 1974.
Authority
				  G.S.
				  58-2-40(1);
				  58-7-95;
Eff. January
				  1, 1978;
Readopted Eff. September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0440 - APPLICATIONS

Current through Register Vol. 39, No. 2, July 15, 2024
The application for a variable life insurance policy shall
				  contain:
(1) a prominent statement
				that the death benefit may be variable or fixed under specified
				conditions;
(2) a prominent
				statement that cash values may increase or decrease in accordance with the
				experience of the separate account (subject to any specified minimum
				guarantees);
(3) questions designed
				to elicit information which enables the insurer to determine the suitability of
				variable life insurance for the applicant.
Authority
				  G.S.
				  58-2-40(1);
				  58-7-95;
Eff. January
				  1, 1978;
Readopted Eff. September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0442 - FOREIGN COMPANIES

Current through Register Vol. 39, No. 2, July 15, 2024
If the law or regulation in the place of domicile of a
				  foreign company provides a degree of protection to the policyholders and the
				  public which is substantially equal to that provided by these regulations, the
				  commissioner, to the extent deemed appropriate by him in his discretion may
				  consider compliance with such law or regulation as compliance with the
				  regulations.
Authority
				  G.S.
				  58-2-40(1);
				  58-7-95;
Eff. January
				  1, 1978;
Readopted Eff. September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0443 - QUALIFICATION: FOR THE SALE OF VARIABLE LIFE INSURANCE

Current through Register Vol. 39, No. 2, July 15, 2024
(a)
				Qualifications to Sell Variable Life Insurance
(1) No person may sell or offer for sale in
				this state any variable life insurance policy unless such person is an agent
				and has filed with the commissioner, in a form satisfactory to the
				commissioner, evidence that such person holds any license or authorization
				which may be required for the solicitation or sale of variable life insurance
				by any federal or state securities law.
(2) Any examination administered by the
				department for the purpose of determining the eligibility of any person for
				licensing as an agent shall, after the effective date of this Regulation,
				include such questions concerning the history, purpose, regulation, and sale of
				variable life insurance as the commissioner deems appropriate.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0444 - REPEALED - SEPARABILITY ARTICLE

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
				  G.S.
				  58-9(1);
				  58-79.2;
Eff. January
				  1, 1978;
Readopted Eff. September 26, 1978;
Repealed
				  Eff. July 1, 1988.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0445 - INTEREST CHARGES ON MISSTATEMENT OF AGE OR SEX

Current through Register Vol. 39, No. 2, July 15, 2024
Interests on overpayments made by an insurer because of
				  misstatement of age or sex shall not be charged unless an equal rate of
				  interest is paid by the insurer for under payments.
Authority
				  G.S.
				  58-2-40;
				  58-58-1;
Eff.
				  September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0446 - SOUND HEALTH

Current through Register Vol. 39, No. 2, July 15, 2024
No policy of life insurance shall contain a provision that
				  the policy will be voided if the insured is not in sound or good health on the
				  effective date of the policy, or date of reinstatement unless such provision
				  contains the following:
(1) The burden
				of proof as to whether the condition was material lies solely with the
				insurer;
(2) If voided, there will
				be a full refund of premium;
(3)
				Reference to such condition was not contained in the written
				application.
Authority
				  G.S.
				  58-2-40;
				  58-58-1;
Eff.
				  September 26, 1978;
Amended Eff. April 1, 1989;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0447 - FREE LOOK PROVISION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) An insurer,
				prior to the time that any individual life insurance or annuity policy is
				issued for delivery or delivered, shall ensure that a "Ten Day Free Look"
				provision is displayed by sticker or printed on the face of each life insurance
				or annuity policy.
(b) The free
				look provision required by this Rule shall afford the policyholder a period of
				time, following receipt of the policy, during which the policy may be returned
				to the company for a prompt refund of the premium paid. This Rule also applies
				to any group life insurance or annuity policy or certificate that contains a
				free look provision.
Authority
				  G.S.
				  58-2-40;
				  58-58-1;
Eff.
				  September 26, 1978;
Amended Eff. August 1, 2004; February 1, 1992;
				  April 1, 1989; July 1, 1982;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0448 - WAITING PERIODS ON LIFE INSURANCE RIDERS

Current through Register Vol. 39, No. 2, July 15, 2024
On all life insurance riders providing additional benefits,
				  attached subsequent to the date of the policy, a sticker shall be attached in a
				  prominent place on the rider stating, when appropriate, substantially the
				  following: "PLEASE READ THIS RIDER CAREFULLY".
THE WAITING PERIODS IN THE SUICIDE AND/OR INCONTESTABILITY
				  PROVISIONS ARE DIFFERENT FROM THOSE IN THE POLICY AND BEGIN ON THE EFFECTIVE
				  DATE OF THE RIDER.
Authority
				  G.S.
				  58-2-40;
				  58-58-1;
Eff.
				  September 26, 1978;
Amended Eff. February 1, 1992;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0449 - LIMITED INITIAL DEATH BENEFIT

Current through Register Vol. 39, No. 2, July 15, 2024
No policy or certificate of life insurance which provides a
				  limited death benefit for a stated initial period shall be issued except on a
				  guaranteed issue basis. Such policy shall have printed on the face in bold type
				  Graded Death Benefit.
Authority
				  G.S.
				  58-2-40;
				  58-3-150;
				  58-58-1;
Eff.
				  September 26, 1978;
Amended Eff. February 1, 1996; July 1,
				  1986;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0450 - REQUIREMENT FOR MODIFIED PREMIUM LIFE INSURANCE

Current through Register Vol. 39, No. 2, July 15, 2024
The application for a modified premium life insurance policy
				  which has a higher first year premium shall contain an acknowledgment, signed
				  by the applicant, stating that he understands:
(1) He is paying a higher first year premium;
				and
(2) If he discontinues the
				coverage, the only benefits available to him are those set forth in the
				non-forfeiture provision, regardless of the money paid in.
Authority
				  G.S.
				  58-2-40;
				  58-58-1;
Eff.
				  September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0451 - REPEALED - POLICY LOAN INTEREST RATES

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
				  G.S.
				  58-9;
				  58-195;
Eff. September
				  26, 1978;
Repealed Eff. July 1,
				  1988.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0452-0456

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
				  G.S.
				  58-9;
				  58-25.1;
				  58-26;
				  58-33;
				  58-42;
				  58-42.1;
				  58-54.4;
				  58-195;
				  58-198;
58-199;
Eff. April 26, 1979;
Repealed Eff. June 16,
				  1979.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0457 - REPEALED - CREDIT INSURANCE: AUTOMOBILE LEASES

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
				  G.S.
				  58-9;
Eff. July 1,
				  1986;
Repealed Eff. April 1,
				  1989.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0460 - REPEALED - PREARRANGEMENT INSURANCE DISCLOSURE

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
				  G.S.
				  58-2-40;
				  58-58-1;
				  58-60-35;
Eff.
				  February 1, 1992;
Repealed Eff. February 1,
				  1996.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0461 - USE OF SENIOR-SPECIFIC CERTIFICATIONS AND PROFESSIONAL DESIGNATIONS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) This Rule applies to the solicitation,
				sale, or purchase of, or advice made in connection with the solicitation, sale
				or purchase of a life insurance or annuity product.
(b) The NAIC Model Regulation on the Use of
				Senior-Specific Certifications and Professional Designations ("Model
				Regulation"), as adopted by the National Association of Insurance Commissioners
				at the Fall National Meeting of 2008, including subsequent amendments and
				editions, is hereby incorporated by reference. Copies of the Model Regulation
				are available free of charge from the Life and Health Division by email at
				l&hinbox@ncdoi.gov or the Department of Insurance Website at
				www.ncdoi.com.
(c) As used in the
				Model Regulation, "reference to State unfair trade practices act" means Article
				63 of Chapter 58 of the General Statutes and "insert reference to enabling
				legislation" means
				G.S.
				58-63-75.
Authority
				  G.S.
				  58-2-40;
				  58-63-75;
Eff.
				  February 1, 2010;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0400 - LIFE: GENERAL NATURE › Section 12 .0462 - SUITABILITY IN ANNUITY TRANSACTIONS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				NAIC Suitability in Annuity Transactions Model Regulation (#275) ("NAIC Model
				Regulation #275"), as adopted by the National Association of Insurance
				Commissioners at the Spring National Meeting of 2020, including subsequent
				amendments and editions, is hereby incorporated by reference. Copies of the
				Model Regulation are available free of charge from the Life and Health Division
				by email at l&hinbox@ncdoi.gov, the Department of Insurance website at
www.ncdoi.com
, or the NAIC Model Law website
				at
https://content.naic.org/model-laws
.
(b) As used in NAIC Model Regulation #275,
				"insert reference to enabling legislation" means S.L. 2017-136.
Authority
				  G.S.
				  58-2-40; S.L. 2017-136;
Eff.
				  January 1, 2023.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0501 - REPEALED - ACCIDENT AND HEALTH: GENERAL NATURE

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
				  G.S.
				  57-4;
				  57-7;
				  58-9;
Eff. February 1,
				  1976;
Readopted Eff. September 26, 1978;
Repealed Eff.
				  July 1, 1988.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0502 - REPEALED - RATE INCREASES FOR INDIVIDUAL AND BLANKET POLICIES

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
				  G.S.
				  58-251.2;
Eff. February 1,
				  1976;
Readopted Eff. September 26, 1978;
Repealed Eff.
				  April 1, 1989.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0503 - WAITING PERIOD

Current through Register Vol. 39, No. 2, July 15, 2024
(a) If a sickness
				or disease first manifests itself during the waiting period, it must be covered
				at the end of said waiting period.
(b) If the company can prove that the
				condition existed prior to the effective date of coverage, the company will not
				be required to pay benefits until the end of the time period prescribed in part
				b of "Time Limit on Certain Defenses."
(c) If the policy is issued to an individual
				over age 65, any condition not specifically excluded must be covered at the end
				of the waiting period.
Authority
				  G.S.
				  58-2-40;
				  58-51-1;
				  58-51-60;
				  58-65-1;
				  58-65-40;
Eff.
				  February 1, 1976;
Readopted Eff. September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0504 - REPEALED - APPROVAL OF FILING: 90 DAY DEEMER NOT IN EFFECT

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
				  G.S.
				  58-254.7;
				  58-370(a);
Eff. February 1, 1976;
Readopted Eff. September 26,
				  1978;
Amended Eff. April 1, 1989;
Repealed Eff.
				  February 1, 1992.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0505 - REPEALED - MAIL ORDER APPLICATION: ACCIDENT AND HEALTH

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
				  G.S.
				  58-257;
Eff. February 1,
				  1976;
Readopted Eff. September 26, 1978;
Repealed Eff.
				  July 1, 1986.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0506 - MASS MARKETING APPLICATION

Current through Register Vol. 39, No. 2, July 15, 2024
Applications used in the solicitation for accident and health
				  insurance on a mass marketing basis may not require information on pre-existing
				  conditions dating back further than five years prior to the date of the
				  application.
Authority
				  G.S.
				  58-2-40(1);
Eff.
				  February 1, 1976;
Readopted Eff. September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0507 - REPEALED - FRATERNAL ORDERS: SOCIETIES AND ASSOCIATIONS

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
				  G.S.
				  58-9(1);
Eff.
				  February 1, 1976;
Readopted Eff. September 26, 1978;
Repealed Eff. March 1, 1992.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0508 - ACCIDENT AND HEALTH TRAVEL: NEWSPAPER SUBSCRIPTIONS

Current through Register Vol. 39, No. 2, July 15, 2024
Travel insurance procured in connection with newspaper
				  subscriptions must comply with the following procedures:
(1) All advertising matters shall be
				published over the name of the regularly licensed agent.
(2) The policies shall be offered to all
				readers of the newspaper and not restricted to subscribers only and a
				subscription to the paper shall not be a prerequisite to obtaining these
				policies.
Authority
				  G.S.
				  58-2-40(1);
				  58-51-1;
Eff. February
				  1, 1976;
Readopted Eff. September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0509 - ACCIDENT AND HEALTH INSURANCE: NATURAL DEATH BENEFIT

Current through Register Vol. 39, No. 2, July 15, 2024
No policy of accident and health insurance may be issued in
				  North Carolina which contains a provision wherein the company promises to pay a
				  funeral benefit, a fatal sickness benefit, a natural death benefit or other
				  additional benefit, the payment of which is contingent upon the natural death
				  of the insured. Provided, industrial weekly or monthly premium or assessment
				  policies containing provision for payment of weekly indemnity on account of
				  sickness and accident, and in addition to natural death benefit not in excess
				  of one hundred fifty dollars ($150.00) are exempt from this ruling if such
				  policies clearly set forth the additional premium or assessment (or proportion
				  thereof) to be charged for continuation of the natural death benefit after
				  termination of the accident and health provisions.
Authority
				  G.S.
				  58-2-40(1);
				  58-51-1;
Eff. February
				  1, 1976;
Readopted Eff. September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0510 - ACCIDENT AND HEALTH INSURANCE: TOTAL TEMPORARY DISABILITY

Current through Register Vol. 39, No. 2, July 15, 2024
Accident and health policies providing total temporary
				  disability benefits must provide for the payment of at least three months
				  benefits if the insured is prevented from performing the duties of his
				  occupation.
Authority
				  G.S.
				  58-2-40(1);
				  58-51-1;
Eff. February
				  1, 1976;
Readopted Eff. September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0511 - GROUP ACCIDENT AND HEALTH INSURANCE: EXCLUSIONS

Current through Register Vol. 39, No. 2, July 15, 2024
Individual accident and health certificates issued under a
				  group accident and health policy must contain all exclusions that are set out
				  in the master policy.
Authority
				  G.S.
				  58-2-40(1);
				  58-51-1;
Eff. February
				  1, 1976;
Readopted Eff. September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0512 - ACCIDENT AND HEALTH INSURANCE: EFFECTIVE DATE

Current through Register Vol. 39, No. 2, July 15, 2024
The effective date of an accident and health policy shall be
				  the date of issue when the premium or policy fee is paid in advance. This does
				  not prevent the policy from containing some provision that coverage on the
				  policy does not begin because of sickness for a certain period after the
				  effective date, neither does it intend to interfere with provisions for the
				  elimination of benefits for the first specified days of accident or
				  illness.
Authority
				  G.S.
				  58-2-40(1);
				  58-51-1;
Eff. February
				  1, 1976;
Readopted Eff. September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0513 - ACCIDENT AND HEALTH: RIDER OR ELIMINATION ENDORSEMENT

Current through Register Vol. 39, No. 2, July 15, 2024
All companies writing non-group accident, health or
				  hospitalization insurance policies shall print in bold type on the face of the
				  policy a notification that a rider or elimination endorsement has been
				  attached. The requirement shall be waived for individual health riders when the
				  applicant signs the rider.
Authority
				  G.S.
				  58-2-40;
				  58-65-1;
				  58-65-40;
Eff.
				  February 1, 1976;
Readopted Eff. September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0514 - COORDINATION: GROUP A/H CONTRACT BENEFITS: GROUP COVERAGES

Current through Register Vol. 39, No. 2, July 15, 2024
Purpose. In order to promote consistency in liability for
				  claims and claims determination for group accident and health coverage, when a
				  person has more than one type of group insurance and there is a basis for a
				  claim under two or more group insurance plans, each group accident and health
				  policy and any accident and health certificates issued under a group accident
				  and health policy shall contain uniform order of benefit determination
				  provisions as outlined in this Rule.
(1) Applicability:
(a) These Coordination of Benefits ("COB")
				provisions apply when an employee or the employee's covered dependent has
				health care coverage under This Plan and one or more other Health Plans as
				defined in Sub-item (2)(a) of these provisions and when there is a basis for a
				claim under This Plan and the other Health Plan(s).
(b) If these COB provisions apply, whether
				This Plan is the Primary Plan or the Secondary Plan is determined pursuant Item
				(3) of these provisions.
(c) When
				This Plan is a Primary Plan, its benefits shall be determined before those of
				the other Secondary Plan(s) and without considering the Secondary Plan's
				benefits. When there are more than two other Health Plans covering the person,
				This Plan may be a Primary Plan as to one or more other Health Plans and may be
				a Secondary Plan as to a different Health Plan or Health Plans.
(d) When This Plan is a Secondary Plan, its
				benefits shall be determined without considering the benefits of the Primary
				Plan or any other Secondary Plan and it shall credit to the deductible any
				amount that would otherwise be credited to it in the absence of coverage by
				another Health Plan. When This Plan is a Secondary Plan, any amount of those
				benefits paid for any Allowable Expense may be reduced to the amount of the
				Allowable Expense that is unpaid by the Primary Plan to prevent the payment of
				benefits under more than one Health Plan that would total more than 100 percent
				of the total expense for that claim.
(e) The benefits of This Plan:
(i) Shall not be reduced when, pursuant to
				Item (3) of these provisions, it is determined to be the Primary Plan;
				but
(ii) May be reduced when,
				pursuant to Item (3) of these provisions, it is determined to be the Secondary
				Plan.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0515 - REPEALED - COUNTERSIGNATURE BY AGENT

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
				  G.S.
				  58-9(1);
				  58-44;
Eff. February
				  1, 1976;
Readopted Eff. September 26, 1978;
Repealed
				  Eff. April 1, 1989.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0516 - ACCIDENT AND HEALTH ADVERTISING: RESPONSIBILITY OF INSURER

Current through Register Vol. 39, No. 2, July 15, 2024
Every insurer shall establish and at all times maintain a
				  system of control over the content, form and method of dissemination of all
				  advertisements of its policies. All such advertisements, regardless of by whom
				  written, created, designed or presented, shall be the responsibility of the
				  insurer whose policies are so advertised. Such advertisements shall be made in
				  accordance with the provisions of
				  11 NCAC
				  12 .0516 to
				  12 .0536.
Authority
				  G.S.
				  58-2-40(1);
				  58-63-15;
Eff.
				  February 1, 1976;
Readopted Eff. September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0517 - ACCIDENT AND HEALTH ADVERTISING: DEFINITIONS

Current through Register Vol. 39, No. 2, July 15, 2024
The following definitions are applicable to accident and
				  health advertising Rules
				  11 NCAC
				  12 .0516 to
				  12 .0536 only:
(1) "Advertisement" is defined as:
(a) printed and published material, audio
				visual material, and descriptive literature of an insurer used in direct mail,
				newspapers, magazines, radio scripts, TV scripts, billboards and similar
				displays; and
(b) descriptive
				literature and sales aids of all kinds issued by an insurer, agent or broker
				for presentation to members of the insurance buying public, including but not
				limited to circulars, leaflets, booklets, depictions, illustrations, and form
				letters; and
(c) prepared sales
				talks, presentations and material for use by agents, brokers and
				solicitors.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0518 - ADVERTISING: DISCLOSURE OF REQUIRED INFORMATION

Current through Register Vol. 39, No. 2, July 15, 2024
All information required to be disclosed shall be set out
				  conspicuously and in close conjunction with the statements to which such
				  information relates or under appropriate captions of such prominence that it
				  shall not be minimized, rendered obscure or presented in an ambiguous fashion
				  or intermingled with the context of the advertisement so as to be confusing or
				  misleading.
Authority
				  G.S.
				  58-2-40(1);
				  58-63-15;
Eff.
				  February 1, 1976;
Readopted Eff. September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0519 - ACCIDENT AND HEALTH ADVERTISING: FORM AND CONTENT

Current through Register Vol. 39, No. 2, July 15, 2024
The format and content of an advertisement of an accident or
				  sickness insurance policy shall be sufficiently complete and clear to avoid
				  deception or the capacity or tendency to mislead or deceive. Whether an
				  advertisement has a capacity or tendency to mislead or deceive shall be
				  determined by the commissioner, from the overall impression that the
				  advertisement may be reasonably expected to create upon a person of average
				  education or intelligence, within the segment of the public to which it is
				  directed.
Advertisements shall be truthful and not misleading in fact
				  or in implication. Words or phrases, the meaning of which is clear only by
				  implication or by familiarity with insurance terminology, shall not be
				  used.
Authority
				  G.S.
				  58-2-40(1);
				  58-63-15;
Eff.
				  February 1, 1976;
Readopted Eff. September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.
North Carolina Administrative Code › Title 11 - INSURANCE › Chapter 12 - LIFE AND HEALTH DIVISION › Section .0500 - ACCIDENT AND HEALTH: GENERAL NATURE › Section 12 .0521 - ACCIDENT: HEALTH ADVERTISING: EXCEPTIONS AND LIMITATIONS

Current through Register Vol. 39, No. 2, July 15, 2024
When an advertisement which is an invitation to contract
				  refers to either a dollar amount, or a period of time for which any benefit is
				  payable, or the cost of the policy, or specific policy benefit, or the loss for
				  which such benefit is payable, it shall also disclose those exceptions,
				  reductions and limitations affecting the basic provisions of the policy without
				  which the advertisement would have the capacity or tendency to mislead or
				  deceive.
When a policy contains a waiting, elimination, probationary
				  or similar time period between the effective date of the policy and the
				  effective date of coverage under the policy or at a time period between the
				  date a loss occurs and the date benefits begin to accrue for such loss, an
				  advertisement which is subject to the requirements of the preceding Paragraph
				  shall disclose the existence of such periods.
An advertisement shall not use the words "only"; "just";
				  "merely"; "minimum" or similar words or phrases to describe the applicability
				  of any exceptions and reductions, such as: "This policy is subject to the
				  following minimum exceptions and reductions."
Authority
				  G.S.
				  58-2-40(1);
				  58-63-15;
Eff.
				  February 1, 1976;
Readopted Eff. September 26, 1978;
Pursuant to
				  G.S.
				  150B-21.3A, rule is necessary without
				  substantive public interest Eff. May 1, 2018.