Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 3 - Casualty Insurance › Section Ins 3.27 - Advertisements of and deceptive practices in accident and sickness insurance

Current through June 24, 2024
(1) PURPOSE. The interest of prospective
			 purchasers of accident and sickness insurance must be safeguarded by providing
			 such persons with clear and unambiguous statements, explanations,
			 advertisements and written proposals concerning the policies offered to them.
			 This purpose can best be achieved by the establishment of and adherence to
			 certain minimum standards of and guidelines for conduct in the advertising and
			 sale of such insurance which prevent unfair competition among insurers and are
			 conducive to the accurate presentation and description to the insurance buying
			 public of policies of such insurance. This rule interprets and implements,
			 including but not limited to, the following Wisconsin Statutes: ss.
			 628.34
			 and
			 601.01(3),
			 Stats.
(2)SCOPE. This rule shall
			 apply to any solicitation, representation or advertisement in this state of any
			 insurance specified in s.
			 Ins 6.75(1) (c) or
			 (2) (c), made directly or indirectly by or on
			 behalf of any insurer, fraternal benefit society, nonprofit service plan
			 subject to ch. 613, Stats., voluntary nonprofit sickness care plan organized
			 under s.
			 185.981,
			 Stats., interscholastic benefit plan organized under s.
			 616.08,
			 Stats., or agent as defined in ch. 628, Stats.
(3)INTERPRETATION OF REQUIREMENTS APPLICABLE
			 TO ADVERTISEMENTS.
(a) The proper promotion,
			 sale and expansion of accident and sickness insurance are in the public
			 interest. This rule is to be construed in a manner which does not unduly
			 restrict, inhibit or retard such promotion, sale and expansion.
(b) In applying this rule, it shall be
			 recognized that advertising is essential in promoting a broader distribution of
			 accident and sickness insurance. Advertising necessarily seeks to serve this
			 purpose in various ways. Some advertisements are the direct or principal sales
			 inducement and are designed to invite offers to contract. In other
			 advertisements the function is to describe coverage broadly for the purpose of
			 inviting inquiry for further information. Other advertisements are for the
			 purpose of summarizing or explaining coverage after the sale has been made.
			 Still other advertisements are solely for the purpose of promoting the interest
			 of the reader in the concept of accident and sickness insurance or of promoting
			 the insurer sponsoring the advertisement. These differences shall be considered
			 in interpreting this rule.
(c) When
			 applying this rule to a specific advertisement, the type of policy to which the
			 advertisement refers and the detail, character, purpose, use and entire content
			 of the advertisement shall be taken into consideration.
(d) This rule applies to individual,
			 franchise, group and blanket accident and sickness insurance. Because these
			 types of coverage differ in some respects, one interpretation will not always
			 suffice; a specific interpretation for individual, franchise, group or blanket
			 coverage may be indicated.
(e) The
			 extent to which policy provisions need be disclosed in an advertisement will
			 depend on the content, detail, character, purpose and use of the advertisement
			 and the nature of the exceptions, reductions, limitations and other
			 qualifications involved. The principal criterion is whether the advertisement
			 has the capacity and tendency to mislead or deceive if such a provision is not
			 disclosed.
(f) Whether an
			 advertisement has the capacity and tendency to mislead or deceive shall be
			 determined by the commissioner from the overall impression that the
			 advertisement may be reasonably expected to create upon a person of average
			 education or intelligence within the segment of the public to which it is
			 directed.