Oklahoma Administrative Code › Title 365 - Insurance Department › Chapter 10 - Life, Accident and Health › Subchapter 3 - Advertising › Part 1 - ACCIDENT AND HEALTH INSURANCE › Section 365:10-3-6 - Advertisements of benefits payable, losses covered or premiums payable

Current through Vol. 41, No. 20, July 1, 2024
Advertisements of accident, health, hospitalization and
					 disability insurance policies shall comply with the following:
(1)
Deceptive words, phrases or
				  illustrations prohibited.
(A) 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 as to the nature or
				  extent of any policy.
(B) 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 fill some of the gaps that Medicare and your present insurance leave
				  out"; "this policy will help pay your hospital and surgical bills"; "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.
(C) An advertisement shall not contain
				  descriptions 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 pre-existing 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.
(D) 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 them to make a profit from
				  being hospitalized.
(E) 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.
(F) No
				  advertisement of a policy covering only one disease or a list of specified
				  diseases shall imply coverage beyond the terms of the policy. Synonymous terms
				  shall not be used to refer to any disease so as to imply broader coverage than
				  is fact.
(G) An advertisement for a
				  policy providing benefits for specified illnesses only, such as cancer, or for
				  specified accidents only, such as automobile accidents, shall clearly and
				  conspicuously in prominent type state the limited nature of the policy. The
				  statement shall be worded in language identical to, or substantially similar to
				  the following: "THIS IS A LIMITED POLICY"; "THIS IS A CANCER ONLY POLICY";
				  "THIS IS AN AUTOMOBILE ACCIDENT ONLY POLICY".
(H) No advertisement shall use words or
				  phrases such as "No agent will call", "No Insurance Agent will call", "No
				  commission will be paid to agents", or "Low Cost Plan" or use other similar
				  words or phrases.