Washington Administrative Code › Title 284 - Insurance Commissioner, Office of the › Chapter 284-83 - Long-term care insurance rules › Section 284-83-063 - Notice to applicant regarding replacement of individual accident and sickness or long-term care insurance marketed by an insurance producer

Current through Register Vol. 24-14, July 15, 2024
The following notice is required in WAC
				284-83-060(3):
NOTICE TO APPLICANT REGARDING REPLACEMENT OF INDIVIDUAL
				[ACCIDENT AND SICKNESS] [HEALTH] 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] [health] or long-term care insurance and replace it with an
				individual long-term care insurance policy to be issued by [company name]
				insurance company. Your new policy provides thirty 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] [health] 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.
STATEMENT TO APPLICANT BY [INSURANCE PRODUCER OR OTHER
				REPRESENTATIVE]:
(Use additional sheets, as necessary.)
I have reviewed your current medical or health insurance
				coverage. I believe the replacement of insurance involved in this transaction
				materially improves your position. My conclusion has taken into account the
				following considerations, which I call to your attention:
(1) Health conditions that 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. The 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 appointed [insurance producer] 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) If, after due consideration, you still
			 wish to terminate your present policy and replace it with new coverage, be
			 certain to truthfully and completely answer all questions on the application
			 concerning your medical health history. Failure to include all material medical
			 information on an application may provide a basis for the company to deny any
			 future claims and to refund your premium as though your policy had never been
			 in force. After the application has been completed and before your sign it,
			 reread it carefully to be certain that all information has been properly
			 recorded.
(Signature of [Insurance Producer] or Other
				Representative)
[Typed Name and Address of [Insurance Producer]]
The above "Notice to Applicant" was delivered to me on:
(Applicant's Signature)
(Date)
Statutory Authority:
				  RCW
				  48.02.060(3)(a) and
				  48.17.010(5).
				  11-01-159 (Matter No. R 2010-09), §
										284-83-063, filed 12/22/10,
				  effective 1/22/11. Statutory Authority:
				  RCW
				   48.02.060,
				  48.83.070,
				  48.83.110,
				  48.83.120,
				  48.83.130(1), and
				  48.83.140(4)(a).
				  08-24-019 (Matter No. R 2008-09), §
										284-83-063, filed 11/24/08,
				  effective 12/25/08.
Reviser's note:
The brackets and enclosed
				  material in the text of the above section occurred in the copy filed by the
				  agency.