760 IAC 1-68-12 - Forms
Authority: IC 27-1-34-9
Affected: IC 4-21.5; IC 27-1-34
Sec. 12.
(a) No
participation agreement or contract form, application form, certificate, rider,
endorsement, summary plan description, or other evidence of coverage may be
issued unless the form, and any subsequent changes to the form, has been filed
with the commissioner. The form may not be used for thirty (30) days after the
filing unless the commission gives written approval of the form before the
expiration of thirty (30) days.
(b)
The commissioner may, within thirty (30) days after the filing of a form,
disapprove the form if the form:
(1) violates
or does not comply with this rule or any applicable statute;
(2) contains or incorporates by reference
inconsistent, ambiguous, or misleading clauses or exceptions and conditions
that deceptively affect the risk proposed to be assumed in the general coverage
of the contract;
(3) has any title
heading or other indication of its provision that is misleading;
(4) is printed or otherwise reproduced in
such manner as to render any material provision of the form substantially
illegible; or
(5) contains any
provision that is unfair, inequitable, or encourages
misrepresentation.
(c) A
disapproval must:
(1) be in writing;
and
(2) identify the reason for the
denial and provide an opportunity for a hearing on the matter.
(d) The commissioner may, after
notice and a hearing, withdraw approval of a form for the reasons stated in
subsection (b).
(e) Any final
order of the commissioner under this section is a final order and subject to
judicial review under IC 4-21.5-5.
(f) All filings under this section shall be
accompanied by the filing fee required by section 17 of this
rule.
Notes
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