210 Neb. Admin. Code, ch. 22, § 004 - Provisions of policies of insurance, certificates of insurance, applications for insurance and notices of proposed group credit insurance-, disclosure to debtors

004.01 As required by the Act, all credit life insurance and credit accident and health insurance subject to the Act shall be evidenced by an individual policy or, in the case of group insurance, by a certificate of group insurance.

004.02 In order to insure that the provisions of the forms required by this Act to be filed with the Department of Insurance are not unjust, unfair, inequitable, misleading or deceptive and to insure that such provisions do not encourage misrepresentation of the coverage, the following are adopted as basic guides for forms submitted to the Director of Insurance for approval:

004.02A Each such policy or certificate of group insurance shall set forth, in addition to the matters required by the Act and in addition to other requirements of law, a provision for refund as set forth in Section 005 hereof.

004.02B Application for individual policies of insurance and notices of proposed group insurance, required by the Act in those situations in which the individual policy or certificate of group insurance is not delivered to the debtor at the time the indebtedness is incurred, shall contain, in addition to the matters required by the Act and in addition to other requirements of law, a statement that if the insurance is declined by the insurer or for some other reason does not become effective, any premium or identifiable charge will be refunded to the debtor pursuant to the provisions of Section 005 of this Rule.

004.02C Each policy of credit accident and health insurance shall contain a provision that no claim for disability shall be reduced or denied on the ground that diseases or conditions arose from a condition which had existed prior to the effective date of the policy, or the effective date of the coverage under a group certificate, unless such exclusion or coverage for disability arising from preexisting conditions shall be prominently and explicitly set forth on the face of the policy or certificate, delivered to the debtor, by overprinting such exclusions diagonally across the face of such policy or certificate in at least 18 point contrasting color type.

004.02D No policy of credit accident and health insurance shall contain any provision which excludes or restricts liability in the event of disability caused in a certain specified manner except provisions excluding or restricting coverage in the event of disability as a result of pre-existing conditions excluded in accordance with subsection 004.02C, pregnancy, mental or nervous disease or disorder, intentionally self-inflicted injuries, foreign travel or residence, travel in non-scheduled aircraft, war, or military service. Any such excluding or restricting provision must be prominently and explicitly set forth in the policy or certificate delivered to the debtor.

004.02E No policy of credit life insurance or credit accident and health insurance subject to the Act will be approved unless the benefits provided bear a reasonable relationship to the rates to be used in conjunction therewith. The reasonableness of such relationship will be determined on the basis of studies made by the Department of Insurance and after considering all factors involved.

Notes

210 Neb. Admin. Code, ch. 22, § 004