West Virginia Code of State Rules › Agency 114 - Insurance Commission › Title 114 - LEGISLATIVE RULE INSURANCE COMMISSIONER › Series 114-10 - Advertisement Of Accident And Sickness Insurance › Section 114-10-6 - Advertisements Of Benefits Payable, Losses Covered Or Premiums Payable

Current through Register Vol. XLI, No. 28, July 12, 2024
6.1. 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 or prospective purchasers as to the nature or
				extent of any policy benefit payable, loss covered or premium payable. The fact that
				the policy offered is made available to a prospective insured for inspection prior
				to consummation of the sale or an offer is made to refund the premium if the
				purchaser is not satisfied, does not remedy misleading statements.
(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 pay your hospital and surgical bills"; "This
				policy will help fill some of the gaps that medicare and your present insurance
				leave out"; "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 preexisting conditions are covered after two (2)
				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 in 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 the fact.
(g) An advertisement for a policy providing
				benefits for specified illnesses only, such as cancer or for specified 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) An advertisement of a direct response
				insurance product shall not imply that because "No insurance agent will call and no
				commissions will be paid to agents" that it is "A Low Cost Plan," or use other
				similar words or phrases because the cost of advertising and servicing such policies
				is a substantial cost in the marketing of a direct response insurance
				product.