Authority: IC 27-8-12-7
Affected: IC 27-8-12
section shall not apply to life insurance policies that accelerate benefits for
long term care.
health care service plan, or other entity marketing long term care insurance
(the "issuer") shall do the following:
Develop and use suitability standards to determine whether the purchase or
replacement of long term care insurance is appropriate for the needs of the
(2) Train its insurance
producers in the use of its suitability standards.
(3) Maintain a copy of its suitability
standards and make them available for inspection upon request by the
determine whether the applicant meets the standards developed by the issuer,
the insurance producer and issuer shall develop procedures that take the
following into consideration:
(1) The ability
to pay for the proposed coverage and other pertinent financial information
related to the purchase of the coverage.
(2) The applicant's goals or needs with
respect to long term care and the advantages and disadvantages of insurance to
meet these goals or needs.
values, benefits, and costs of the applicant's existing insurance, if any, when
compared to the values, benefits, and costs of the recommended purchase or
issuer and, where an insurance producer is involved, the insurance producer
shall make reasonable efforts to obtain the information set out in subsection
(c). The efforts shall include presentation to the applicant, at or prior to
application, of the "Long Term Care Insurance Personal Worksheet". The personal
worksheet used by the issuer shall contain, at a minimum, the information in
the format contained in 760 IAC 2-19.5
, in not less than 12-point type. The
issuer may request the applicant to provide additional information to comply
with its suitability standards. A copy of the issuer's personal worksheet shall
be filed with the commissioner.
A completed personal worksheet shall be returned to the issuer prior to the
issuer's consideration of the applicant for coverage, except the personal
worksheet need not be returned for sales of employer group long term care
insurance to employees and their spouses.
(f) The sale or dissemination outside the
company or agency by the issuer or insurance producer of information obtained
through the personal worksheet is prohibited.
(g) The issuer shall use the suitability
standards it has developed under this section in determining whether issuing
long term care insurance coverage to an applicant is appropriate.
(h) Producers shall use the suitability
standards developed by the issuer in marketing long term care
At the same time as
the personal worksheet is provided to the applicant, the disclosure form
entitled "Things You Should Know Before You Buy Long Term Care Insurance" shall
be provided. The form shall be in the format contained in
760 IAC 2-19.5-3
in not less than 12-point type.
If the issuer determines that the applicant does not meet its financial
suitability standards or if the applicant has declined to provide the
information, the issuer may reject the application. However, if the applicant
has declined to provide financial information, the issuer may use some other
method to verify the applicant's intent. Either the applicant's returned letter
or a record of the alternative method of verification shall be made part of the
shall report annually to the commissioner the total number of the following:
(1) Applications received from residents of
(2) Those who declined
to provide information on the personal worksheet.
(3) Applicants who did not meet the
who chose to confirm after receiving a suitability letter.