Washington Administrative Code › Title 284 - Insurance Commissioner, Office of the › Chapter 284-50 - Washington disability insurance regulations › MINIMUM STANDARDS FOR INDIVIDUAL POLICIES › Section 284-50-375 - Required disclosure provisions, general rules

Current through Register Vol. 24-14, July 15, 2024
(1) Each individual disability insurance
				policy shall include a renewal, continuation, or nonrenewal provision. The
				language or specifications of such provision must be consistent with the type
				of contract to be issued. Such provision shall be appropriately captioned,
				shall appear or bear a prominent reference thereto on the first page of the
				policy, and shall clearly state the duration, where limited, of renewability
				and the duration of the term of coverage for which the policy is issued and for
				which it may be renewed.
(2) Except
				for riders or endorsements by which the insurer effectuates a request made in
				writing by the policyholder or exercises a specifically reserved right under
				the policy, all riders or endorsements added to a policy after date of issue or
				at reinstatement or renewal which reduce or eliminate benefits or coverage in
				the policy shall require signed acceptance by the policyholder. After date of
				policy issue, any rider or endorsement which increases benefits or coverage
				with a concomitant increase in premium during the policy term must be agreed to
				by the insured, except if the increased benefits or coverage is required by
				law.
(3) Where a separate
				additional premium is charged for benefits provided in connection with a rider
				or endorsement, such premium charge shall be set forth in the policy.
(4) A policy which provides for the payment
				of benefits based on standards described as "usual and customary," "reasonable
				and customary," or words of similar import shall include a definition of such
				terms and an explanation of such terms in its accompanying outline of
				coverage.
(5) If a policy contains
				any limitations with respect to preexisting conditions such limitations must
				appear as a separate paragraph of the policy and be labeled as "Preexisting
				Condition Limitations."
(6) All
				accident only policies shall contain a prominent statement on the first page of
				the policy or attached thereto in either contrasting color or in boldface type
				at least equal to the size of type used for policy captions, a prominent
				statement as follows: "This is an accident only policy and it does not pay
				benefits for loss from sickness."
(7) All policies, except single premium
				nonrenewable policies, shall have a notice prominently printed on the first
				page of the policy or attached thereto stating in substance that the
				policyholder shall have the right to return the policy within ten days of its
				delivery and to have the premium refunded if after examination of the policy
				the policyholder is not satisfied for any reason.
(8) If age is to be used as a determining
				factor for reducing the maximum aggregate benefits made available in the policy
				as originally issued, such fact must be prominently set forth in the outline of
				coverage.
(9) If a policy contains
				a conversion privilege, it shall comply, in substance, with the following: The
				caption of the provision shall be "Conversion Privilege," or words of similar
				import. The provision shall indicate the persons eligible for conversion, the
				circumstances applicable to the conversion privilege, including any limitations
				on the conversion (including those with respect to the reimposition of a time
				limit on certain defenses provision), and the person by whom the conversion
				privilege may be exercised. The provision shall specify the benefits to be
				provided on conversion or may state that the converted coverage will be as
				provided on a policy form then being used by the insurer for that
				purpose.
Order R-76-4, §
											284-50-375, filed 10/29/76,
					 effective 3/1/77.