Ins 3.27(10)(h)
(h) If a medical examination is required for a policy, an invitation to apply advertisement of such policy shall disclose such requirement.
Ins 3.27(10)(i)
(i) The exceptions, reductions and limitations referred to in this subsection shall include:
Ins 3.27(10)(i)1.
1. Those which are set out in the policy under captions referring to exceptions, reductions, limitations or exclusions or are otherwise designated as such, and
Ins 3.27(10)(i)2.
2. Those which are not so captioned or designated contained in other portions of the policy such as a benefit provision, definition or uniform provision.
Ins 3.27(10)(j)
(j) The following are examples of exceptions, reductions and limitations which generally
do affect the basic policy provisions to such an extent that their absence would cause the advertisement to have the capacity and tendency to mislead or deceive.
Ins 3.27(10)(j)3.
3. Territorial restriction or coverage within United States and Canada.
Ins 3.27(10)(j)7.
7. Time limitation on death, dismemberment or commencement of disability or medical treatment following an accident.
Ins 3.27(10)(j)9.
9. Exclusion or reduction for loss due to specific diseases, classes of diseases or types of injuries.
Ins 3.27(10)(j)10.
10. Confinement restrictions in disability policies such as house confinement, bed confinement and confinement to the premises.
Ins 3.27(10)(j)26.
26. While intoxicated or under the influence of narcotics, or other language not substantially the same as the uniform individual policy provision regarding the use of intoxicants and narcotics.
Ins 3.27(10)(j)31.
31. While or as a result of riding a motorcycle or motorcycle attachment.
Ins 3.27(10)(j)34.
34. While or as a result of serving as a volunteer firefighter or in other hazardous occupations.
Ins 3.27(10)(j)43.
43. Limitations on the choice of providers or geographical area served.
Ins 3.27(10)(k)
(k) The following are examples of exceptions, reductions and limitations which generally
do not affect the basic policy provisions to such an extent that their absence would cause the advertisement to have the capacity and tendency to mislead or deceive.
Ins 3.27(10)(k)3.
3. Territorial restriction with no limitation of coverage while in United States and Canada.
Ins 3.27(10)(k)4.
4. Aviation exclusion under which passage on commercial airlines is covered.
Ins 3.27(10)(k)6.
6. All uniform individual policy provisions, both required and optional, other than those relating to other insurance.
Ins 3.27(10)(k)21.
21. Cosmetic surgery exclusion under which such surgery which results from injury is covered.
Ins 3.27(10)(k)22.
22. Dental treatment, surgery or procedures exclusion under which such treatment which results from injury to sound natural teeth is covered.
Ins 3.27(10)(k)23.
23. Bacterial infection exclusion under which pyogenic infection which results from injury is covered.
Ins 3.27(10)(k)26.
26. Exclusion of sickness or disease in a policy providing only accident coverage.
Ins 3.27(10)(k)27.
27. Exclusion for miscarriage in policy providing only accident coverage.
Ins 3.27(11)
(11)
Renewability, cancelability and termination. An advertisement shall disclose, as required below, the provisions relating to renewability, cancelability and termination and any modification of benefits, losses covered or premiums because of age or for other reasons, in a manner which shall not minimize or render obscure the qualifying conditions.
Ins 3.27(11)(a)
(a) Any advertisement which refers to renewability, cancelability or termination of a policy shall be subject to the disclosure requirements of this subsection.
Ins 3.27(11)(b)
(b) An advertisement which refers to a policy benefit and which is an invitation to apply shall be subject to the disclosure requirements of this subsection.
Ins 3.27(11)(c)
(c) An advertisement which refers to a policy benefit and which is an invitation to inquire shall not be subject to the disclosure requirements of this subsection unless:
Ins 3.27(11)(c)2.
2. Such an advertisement mentions benefits, benefit periods or premiums for the purpose of doing more than identifying the policy.
Ins 3.27(11)(d)
(d) A booklet, summary or explanation of coverage issued to insured persons shall be subject to the disclosure requirements of this subsection.
Ins 3.27(11)(e)
(e) An advertisement which refers to a policy benefit and which is an institutional advertisement shall not be subject to the disclosure requirements of this subsection unless par.
(a) or
(f) applies.
Ins 3.27(11)(f)
(f) An advertisement which states or illustrates time or age in connection with eligibility of applicants or continuation of the policy and which implies permanency shall be subject to the disclosure requirements of this subsection.
Ins 3.27(11)(g)
(g) The actual policy language concerning renewability, cancelability or termination need not be used in an advertisement subject to the disclosure requirements of this subsection. However, all pertinent information shall be disclosed.
Ins 3.27(11)(h)
(h) The qualifying conditions applicable to a non-cancellable policy and to a guaranteed renewable policy shall include age limits, aggregate benefit limits and modifications of benefits because of age, other than such modifications occurring at or about the time the policy terminates. A qualifying condition applicable to a guaranteed renewable policy shall be the insurer's reservation of the right to change premiums.
Ins 3.27(11)(i)
(i) The qualifying conditions shall be set forth with the language describing renewability.
Ins 3.27(11)(j)
(j) An advertisement of a group or blanket policy which would otherwise be subject to the disclosure requirements of this subsection need not disclose the policy's provisions relating to renewability, cancelability and termination. Such advertisement shall provide, however, as a minimum, that an insured person's coverage is contingent upon continued membership in the group and the continuation of the plan.
