Washington Administrative Code › Title 284 - Insurance Commissioner, Office of the › Chapter 284-50 - Washington disability insurance regulations › MINIMUM STANDARDS FOR INDIVIDUAL POLICIES › Section 284-50-430 - Requirements for replacement

Current through Register Vol. 24-14, July 15, 2024
(1)
				Application forms shall include a question designed to elicit information as to
				whether the insurance to be issued is intended to replace any other disability
				insurance presently in force. A supplementary application or other form to be
				signed by the applicant containing such a question may be used.
(2) Upon determining that a sale will involve
				replacement, an insurer, other than a direct response insurer, or its agent
				shall furnish the applicant, prior to issuance or delivery of the policy, the
				notice described in subsection (3) of this section. One copy of such notice
				shall be retained by the applicant and an additional copy signed by the
				applicant shall be retained by the insurer. A direct response insurer shall
				deliver to the applicant upon issuance of the policy, the notice described in
				subsection (4) of this section. In no event, however, will such a notice be
				required in the solicitation of the following types of policies: accident only
				and single premium nonrenewable policies.
(3) The notice required by subsection (2) of
				this section for an insurer, other than a direct response insurer, shall
				provide, in substantially the following form:
NOTICE TO APPLICANT REGARDING REPLACEMENT
OF ACCIDENT AND SICKNESS INSURANCE
According to (your application) (information you have
				  furnished), you intend to lapse or otherwise terminate existing accident and
				  sickness insurance and replace it with a policy to be issued by
(Company Name)
Insurance Company. 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.
1.
Health conditions which you may presently have,
								(preexisting conditions) may not be immediately or fully covered under the new
								policy. This could result in denial or delay of a claim for benefits under the
								new policy, whereas a similar claim might have been payable under your present
								policy.
2.
You may wish to secure the advice of your present
								insurer or its agent regarding the proposed replacement of your present policy.
								This is not only your right, but it is also in your best interests to make sure
								you understand all the relevant factors involved in replacing your present
								coverage.
3.
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 has never been
								in force. After the application has been completed and before you sign it,
								reread it carefully to be certain that all information has been properly
								recorded.
The above "Notice to Applicant" was delivered to me
				  on:
. . . . . . . . . . ..
(Date)
. . . . . . . . . . ..
(Applicants' Signature)
(4) The notice
				required by subsection (2) of this section, for a direct response insurer,
				shall be as follows:
NOTICE TO APPLICANT REGARDING REPLACEMENT
OF ACCIDENT AND SICKNESS INSURANCE
According to (your application) (information you have
				  furnished) you intend to lapse or otherwise terminate existing accident and
				  sickness insurance and replace it with the policy delivered herewith issued by
(Company Name)
. Your new policy provides 10 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.
1.
Health conditions which you may presently have,
								(preexisting conditions) may not be immediately or fully covered under the new
								policy, whereas a similar claim might have been payable under your present
								policy.
2.
You may wish to secure the advice of your present
								insurer or its agent regarding the proposed replacement of your present policy.
								This is not only your right, but it is also in your best interests to make sure
								you understand all the relevant factors involved in replacing your present
								coverage.
3.
(To be included only if the application is attached
								to the policy.) If, after due consideration, you still wish to terminate your
								present policy and replace it with new coverage, read the copy of the
								application attached to your new policy and be sure that all questions are
								answered fully and correctly. Omissions or misstatements in the application
								could cause an otherwise valid claim to be denied. Carefully check the
								application and write to
(Company Name and Address)
within 10 days if any information is not correct and complete, or if any past
								medical history has been left out of the application.
. . . . . . . . . . ..
(Company Name)
(5) The
				required notice may be modified if preexisting conditions are covered under the
				new policy.
Order R-76-4, §
											284-50-430, filed 10/29/76,
					 effective 3/1/77.