5. Premium payment status.
(h) “Retained asset account” means any mechanism whereby the settlement of 22
proceeds payable under a policy or contract is accomplished by the insurer or an 23
entity acting on behalf of the insurer depositing the proceeds into an account with 24
check or draft writing privileges, where those proceeds are retained by the insurer
or its agent, pursuant to a supplementary contract not involving annuity benefits 2
other than death benefits.
(2) Insurer conduct.
(a) An insurer shall perform a comparison of its insureds' 4
in-force policies, contracts, and retained asset accounts against a death master file, 5
on at least a semi-annual basis, by using the full death master file once, and 6
thereafter using the death master file update files for future comparisons, to identify 7
potential matches of its insureds. For those potential matches identified as a result 8
of a death master file match, the insurer shall do all of the following:
1. Within 90 days of a death master file match:
a. Complete a good faith effort, which shall be documented by the insurer, to 11
confirm the death of the insured or retained asset account holder against other 12
available records and information.
b. Determine whether benefits are due in accordance with the applicable policy 14
2. If benefits are due in accordance with the applicable policy or contract:
a. Use good faith efforts, which shall be documented by the insurer, to locate 17
the beneficiary or beneficiaries.
b. Provide the appropriate claims forms or instructions to the beneficiary or 19
beneficiaries to make a claim, including the need to provide an official death 20
certificate, if applicable under the policy or contract.
(b) With respect to group life insurance, insurers are required to confirm the 22
possible death of an insured when the insurers maintain at least the following 23
information of those covered under a policy or certificate:
1. Social security number or name and date of birth.
2. Beneficiary designation information.
3. Coverage eligibility.
4. Benefit amount.
5. Premium payment status.
(c) Every insurer shall implement procedures to account for all of the following:
1. Initials used in lieu of a first or middle name, use of a middle name, 6
compound first and middle names, and interchanged first and middle names.
2. Compound last names; maiden or married names; and hyphens, blank 8
spaces, or apostrophes in last names.
3. Transposition of the month and date portions of the date of birth.
(d) To the extent permitted by law, the insurer may disclose minimum 11
necessary personal information about the insured or beneficiary to a person who the 12
insurer reasonably believes may be able to assist the insurer to locate the beneficiary 13
or a person otherwise entitled to payment of the claims proceeds.
(e) The insurer comparison of in-force policies, contracts, and retained asset 15
accounts shall be conducted first to the extent that such records are available 16
electronically and then using the most easily accessible insurer records for records 17
that are not available electronically.
(f) Nothing in this section shall limit the insurer from requesting a valid death 19
certificate as part of any claims validation process.
20(3) Fees and costs.
An insurer or its service provider shall not charge any 21
beneficiary or other authorized representative for any fees or costs associated with 22
a death master file search or verification of a death master file match conducted 23
pursuant to this section.
24(4) Payment of benefits.
The benefits from a policy, contract, or a retained 25
asset account, plus any applicable accrued contractual interest, shall first be payable
to the designated beneficiaries or owners and, in the event said beneficiaries or 2
owners cannot be found, shall escheat to the state as unclaimed property under ch. 3
177. Interest payable under s. 628.46 shall not be payable as unclaimed property 4
under s. 177.07.
5(5) Unclaimed proceeds.
An insurer shall report and remit unclaimed 6
insurance proceeds in accordance with the requirements of ch. 177.
7(6) Unfair marketing practices.
Failure to meet any requirement of this 8
section with such frequency as to constitute a general business practice is a violation 9
of s. 628.34. Nothing in this section shall be construed to create or imply a private 10
cause of action for a violation of this section.
The commissioner may make an order regarding any of the 12
(a) Limiting an insurer's death master file comparisons required under sub. (2) 14
(a) to the insurer's electronic searchable files or approving a plan and timeline for 15
conversion of the insurer's files to electronic searchable files.
(b) Exempting an insurer from the death master file comparisons required 17
under sub. (2) (a) or permitting an insurer to perform such comparisons less 18
frequently than semi-annually upon a demonstration of hardship by the insurer.
(c) Phasing in compliance with this section according to a plan and timeline 20
approved by the commissioner.
The commissioner may adopt rules implementing and 22
administering this section.
This act takes effect on the first day of the 13th month beginning after 2