(a) Question
concerning replacement. Individual and direct response solicited long-term care
insurance application forms shall include a question designed to elicit
information as to whether the proposed insurance policy is intended to replace
any other accident and sickness or long-term care insurance policy presently in
force. A supplementary application or other form to be signed by the applicant
containing such a question may be used.
(b) Solicitations other than direct response.
Upon determining that a sale will involve replacement, an insurer; other than
an insurer using direct response solicitation methods, or its agent; shall
furnish the applicant, prior to issuance or delivery of the individual
long-term care insurance policy, a notice regarding replacement of accident and
sickness or long-term care coverage. 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. The required notice shall be provided in the following
manner:
NOTICE TO APPLICANT REGARDING REPLACEMENT OF INDIVIDUAL
ACCIDENT AND SICKNESS OR LONG-TERM CARE INSURANCE
According to [your application] [information you have
furnished], you intend to lapse or otherwise terminate existing accident and
sickness or long-term care insurance and replace it with an individual
long-term care insurance policy to be issued by [company name] Insurance
Company. Your new policy provides thirty (30) 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. This could result in denial or delay in payment
of 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 interest 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 had 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)
______________________
(Applicant's Signature)
(c) Direct response solicitations. Insurers
using direct response solicitation methods shall deliver a notice regarding
replacement of accident and sickness or long-term care coverage to the
applicant upon issuance of the policy. The required notice shall be provided in
the following manner.
NOTICE TO APPLICANT REGARDING REPLACEMENT OF ACCIDENT
AND SICKNESS OR LONG-TERM CARE INSURANCE
According to [your application] [information you have
furnished], you intend to lapse or otherwise terminate existing accident and
sickness or long-term care insurance and replace it with the long-term care
insurance policy delivered herewith issued by [company name] Insurance Company.
Your new policy provides thirty (30) 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. This could result in denial or delay in payment
of 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 interest 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 thirty (30) days if any information is not correct and complete, or if
any past medical history has been left out of the application.
___________________
(Company Name)
