Chapter Ins 2

Ins 2.16(2)(b)9. 9. A policyholder’s deposit account established solely to facilitate payment of regular premiums.

Ins 2.16(2)(b)10. 10. Settlement options under life insurance or annuity contracts.

Ins 2.16(3) (3) Definitions. In this section:

Ins 2.16(3)(a) (a)

Ins 2.16(3)(a)1. 1. “Advertisement” means:

Ins 2.16(3)(a)1.a. a. Printed and published material, audio visual material and descriptive literature of an insurer or intermediary used in direct mail, newspapers, magazines, other periodicals, radio and TV scripts, billboards and similar displays, excluding advertisements prepared for the sole purpose of obtaining employees, intermediaries or agencies;

Ins 2.16(3)(a)1.b. b. Descriptive literature and sales aids of all kinds authored, issued, distributed or used by an insurer, intermediary or third party for presentation to members of the public, including but not limited to circulars, leaflets, booklets, depictions, illustrations and form letters. Descriptive literature and sales aids do not include material in house organs of insurers, communications within an insurer’s own organization not intended for dissemination to the public, individual communications of a personal nature, and correspondence between a prospective group or blanket policyholder and an insurer in the course of negotiating a group or blanket policy, and general announcements from group or blanket policyholders to eligible individuals that a contract has been written;

Ins 2.16(3)(a)1.c. c. Prepared sales talks, presentations and material for use by intermediaries and representations made by intermediaries in accordance therewith, excluding materials to be used solely by an insurer for the training and education of its employees or intermediaries; and

Ins 2.16(3)(a)1.d. d. Packaging, including but not limited to envelopes, used in connection with subd. 1. a., b., and c.

Ins 2.16(3)(a)2. 2. Advertisement does not include a policy summary as defined in s. Ins 2.14 (3) (d), the “buyer’s guide to life insurance” as set forth in s. Ins 2.14, an illustration as defined in s. Ins 2.17 (3) (i), a contract summary as defined in s. Ins 2.15 (4) (a), a preliminary contract summary as defined in s. Ins 2.15 (4) (b), and a buyer’s guide as defined in s. Ins 2.15 (4) (c).

Ins 2.16(3)(b) (b) “Analysis” means the separation of a life insurance policy or annuity contract into constituent parts for comparison, special emphasis, or other purposes.

Ins 2.16(3)(c) (c) “Appraisal” means an evaluation or estimate of the quality or other features of a life insurance policy or annuity contract. Appraisal does not include a statement which is also an endorsement or testimonial.

Ins 2.16(3)(d) (d) “Endorsement” means any statement promoting the insurer, its policy, or both, made by an individual, group of individuals, society, association or other organization which makes no reference to the endorser’s experience under the policy.

Ins 2.16(3)(e) (e) “Guaranteed interest rate” means the lowest rate of interest which an insurer may pay under the terms of a policy during the duration of the policy.

Ins 2.16(3)(f) (f) “Illustrated rate” means a rate shown in an advertisement, representation, or solicitation which an insurer may guarantee for a limited period of time, but not guarantee for the duration of the policy.

Ins 2.16(3)(g) (g) “Individual policy issued on a group basis” means an individual policy issued for which:

Ins 2.16(3)(g)1. 1. Coverage is provided to employees or members or classes of employees or members defined in terms of conditions pertaining to employment or membership in an association or other group which is eligible for franchise or group insurance as defined in s. 600.03 (22) and (23), Stats.;

Ins 2.16(3)(g)2. 2. The coverage is not available to the general public and can be obtained and maintained only because of the covered person’s membership in or connection with the group;

Ins 2.16(3)(g)3. 3. The employer, association or other group, or a designated person acting on behalf of one of these persons, pays premiums or subscription charges to the insurer; and

Ins 2.16(3)(g)4. 4. The employer, association or other group sponsors the insurance plan.

Ins 2.16(3)(h) (h) “Institutional advertisement” means an advertisement which is prepared solely to promote the reader’s or listener’s interest in the concept of life insurance or annuities, or of promoting the insurer sponsoring the advertisement, or both.

Ins 2.16(3)(i) (i) “Intermediary” has the meaning provided in s. 628.02 (1), Stats.

Ins 2.16(3)(j) (j) “Policy” means any document, including a policy, plan, contract, agreement, rider or endorsement, used to set forth in writing life insurance or annuity benefits.

Ins 2.16(3)(k) (k) “Representation” means any communication, other than an advertisement or solicitation, relating to an insurance policy, the insurance business, any insurer, or any intermediary.

Ins 2.16(3)(L) (L) “Solicitation” means an attempt to persuade a person to make an application for an insurance policy.

Ins 2.16(3)(m) (m) “Testimonial” means any statement made by a policyholder, certificate holder or other person covered by the insurer which promotes the insurer and its policy or contract by describing the person’s benefits, favorable treatment or other experience under the policy or contract.

Ins 2.16(4) (4) Application of this section.

Ins 2.16(4)(a) (a) The commissioner shall construe this section in a manner which does not unduly restrict, inhibit or retard the promotion, sale and expansion of life insurance policies or annuity contracts. The commissioner shall consider differences in the purposes served by various advertisements and in the insurance product being advertised when interpreting this section. When applying this section to a specific advertisement, the commissioner shall consider the detail, character, purpose, use and entire content of the advertisement.

Ins 2.16(4)(b) (b) The extent to which a person subject to this section shall disclose policy provisions in an advertisement will depend on the content, detail, character, purpose and use of the advertisement and the nature of any qualifications involved. The principal criterion is whether the advertisement has the capacity or tendency to mislead or deceive if such a provision is not disclosed.

Ins 2.16(4)(c) (c) The commissioner shall determine whether an advertisement has the capacity or tendency to mislead or deceive from the overall impression that the advertisement may be reasonably expected to create upon a person of average education or intelligence within the segment of the public to which it is directed.

Ins 2.16(5) (5) Advertisements, representations, and solicitations in general.

Ins 2.16(5)(a) (a) Advertisements, representations, and solicitations shall be truthful and not misleading in fact or in implication and shall accurately describe the policy, the insurance business, any insurer, or any intermediary to which they apply. No advertisement may contain words or phrases the meaning of which is clear only by implication or by familiarity with insurance terminology.

Ins 2.16(5)(b) (b) Oral representations and solicitations shall conform to the requirements of this section.

Ins 2.16(6) (6) Suitability of policies. No insurer or intermediary may recommend to a prospective buyer the purchase or replacement of any individual life insurance policy or annuity contract without reasonable grounds to believe that the recommendation is not unsuitable to the applicant. The insurer or intermediary shall make all necessary inquiries under the circumstances to determine that the purchase of the insurance is not unsuitable for the prospective buyer. This subsection does not apply to an individual policy issued on a group basis.

Ins 2.16(7) (7) Deceptive words, phrases or illustrations.

Ins 2.16(7)(a) (a) No person subject to this section may use an advertisement that exaggerates a benefit or minimizes cost by overstatement, understatement or incompleteness. No advertisement may omit information or contain words, phrases, statements, references or illustrations if the omission or use has the capacity, tendency, or effect of misleading or deceiving purchasers or prospective purchasers as to the nature or extent of any policy benefit payable, loss covered, premium payable or state or federal tax consequences. An advertisement referring to any policy benefit payable, loss covered, premium payable, or state or federal tax consequences shall be sufficiently complete and clear as to avoid deception or the capacity or tendency to mislead or deceive.

Ins 2.16(7)(b) (b) No advertisement may state or imply that life insurance arrangements are the same as savings accounts or deposits in banking or savings institutions. No person subject to this section may use policies which resemble savings bank passbooks. If savings accounts or deposits in banking and savings institutions are utilized in connection with life insurance arrangements, this paragraph does not prohibit the use of an accurate description of the life insurance arrangement.

Ins 2.16 Note Note: Annuity contracts are subject to the same limitations under s. Ins 2.15 (9) (h).

Ins 2.16(7)(c) (c) No advertisement may contain the terms “investment,” “investment plan,” “founder’s plan,” “charter plan,” “deposit,” “expansion plan,” “profit,” “profits,” “profit sharing,” “interest plan,” “savings,” “savings plan,” or other similar terms in connection with a policy in a context or under circumstances or conditions as to have the capacity or tendency to mislead a purchaser or prospective purchaser of the policy to believe that he or she will receive, or that it is possible that he or she will receive, something other than a policy or some benefit not available to other persons of the same class and equal expectation of life.

Ins 2.16(7)(d) (d) An advertisement may refer to immediate coverage or guaranteed issuance of a policy only if suitable administrative procedures exist so that the policy is issued within a reasonable time after the application is received.

Ins 2.16(7)(e) (e) No advertisement may refer to a policy or coverage as“special” unless a person subject to this section can show that a reasonable basis exists for the use of this term.

Ins 2.16(8) (8) Identity of insurer.

Ins 2.16(8)(a) (a) Each advertisement shall clearly identify the insurer. If an application is a part of the advertisement, the application shall show the name of the insurer.

Ins 2.16(8)(b) (b) No advertisement may contain a trade name, an insurance group designation, the name of the parent company of the insurer, the name of a government agency or program, the name of a department or division of an insurer, the name of an agency, the name of any other organization, a service mark, a slogan, a symbol or any other device which has the capacity or tendency to mislead or deceive as to the identity of the insurer or create the impression that an entity other than the insurer has any responsibility for the financial obligation under any policy.

Ins 2.16(8)(c) (c) No advertisement may contain any combination of words, symbols or materials which, by its content, phraseology, shape, color, nature or other characteristics, is so similar to combinations of words, symbols or materials used by federal, state or local government agencies that it tends to confuse or mislead prospective buyers into believing that the solicitation is in some manner connected with such a government agency.

Ins 2.16(8)(d) (d) No advertisement may refer to an affiliate of the insurer without disclosing that the 2 organizations are separate legal entities.

Ins 2.16(8)(e) (e) No advertisement may indicate an address for an insurer in any manner that may mislead or deceive as to the insurer’s identity or licensing status. An advertisement which indicates an address for an insurer other than that of its home office shall clearly identify the address other than that of its home office and clearly disclose the actual city and state of domicile of the insurer.

Ins 2.16(9) (9) Testimonials, endorsements, appraisals, analysis or commendations by third parties.

Ins 2.16(9)(a) (a) No advertisement may contain a testimonial, endorsement or other commendatory statement concerning the insurer, its policies or activities by any person who receives any pay or remuneration, directly or indirectly, from the insurer in connection with the testimonial, endorsement or statement unless the advertisement, testimonial or endorsement includes a full and prominent disclosure therein of the relationship, direct or indirect, including but not limited to the existence of any financial interest, remuneration, or both, between the insurer and the person making the testimonial, endorsement or statement. The provisions of this paragraph do not apply to any person holding a Wisconsin intermediary’s license nor to any radio or television announcer or other person employed or compensated on a salaried or union wage scale basis.

Ins 2.16(9)(b) (b) A testimonial, endorsement, appraisal, or analysis used in an advertisement shall be genuine, represent the current opinion of the author, apply to the policy advertised and be accurately reproduced.

Ins 2.16(9)(c) (c) No person subject to this section may use a testimonial, endorsement, appraisal or analysis:

Ins 2.16(9)(c)1. 1. Which is fictional;

Ins 2.16(9)(c)2. 2. If the insurer has information indicating a substantial change of view on the part of the author;

Ins 2.16(9)(c)3. 3. If a reasonable person would conclude that the views expressed do not correctly reflect the current opinion of the author;

Ins 2.16(9)(c)4. 4. For more than 2 years after the date on which it was originally given or 2 years after the date of a prior confirmation without obtaining a confirmation that the statement represents the author’s current opinion;

Ins 2.16(9)(c)5. 5. Which does not accurately reflect the present practices of the insurer;

Ins 2.16(9)(c)6. 6. To advertise a policy other than the policy for which the author gave the statement, unless the statement clearly has some reasonable application to the second policy;

Ins 2.16(9)(c)7. 7. Which effects a change or omission which alters or distorts its meaning or intent as originally written; or

Ins 2.16(9)(c)8. 8. Which does not disclose the true nature of the insurance coverage under which the benefits were paid if it contains a description of benefit payments.

Ins 2.16(9)(d) (d) No advertisement may state or imply, unless true, that an individual, group of individuals, society, association or other organization approves or endorses an insurer or a policy. An advertisement shall disclose any affiliated relationship between the society, association or other organization and the insurer. If the insurer or the person or persons who own or control the insurer has formed or owns or controls the society, association or other organization, the advertisement shall clearly disclose this fact.

Ins 2.16(9)(e) (e) If a testimonial refers to benefits received under a policy, the insurer shall retain a summary of the pertinent claim information including claim number and date of loss with the advertisement in the advertising file required by sub. (30).

Ins 2.16(9)(f) (f) No advertisement may state or imply that a government publication commends or recommends the insurer or its policy.

Ins 2.16(10) (10) Jurisdictional licensing; approval by governmental agency.

Ins 2.16(10)(a) (a) No advertisement which may be seen or heard beyond the limits of the jurisdiction in which the insurer is licensed may state or imply licensing beyond those limits.

Ins 2.16(10)(b) (b) In any advertisement any reference to licensing shall contain an appropriate disclaimer that the viewer, listener, or reader should not construe the reference as an endorsement or implied endorsement of the insurer or its products by any agency of this state or the commissioner of insurance.

Ins 2.16(10)(c) (c) No advertisement may state or imply that the insurer, its financial condition or status, the payment of its claims, its policy forms or the merits or desirability of its policy forms or kinds or plans of insurance are approved, endorsed or accredited by any agency of this state or the federal government.

Ins 2.16(10)(d) (d) No advertisement may contain a reproduction of a portion of a state insurance department report of examination.

Ins 2.16(11) (11) Introductory, initial or special offers and limited enrollment periods.

Ins 2.16(11)(a) (a) No advertisement may state or imply, unless true, that a policy or combination of policies is an introductory, initial or special offer and that the applicant will receive advantages not available at a later date by accepting the offer, that only a limited number of policies will be sold, that a time is fixed for the discontinuance of the sale of the policy advertised because of special advantages available in the policy, or that an individual will receive special advantages by enrolling within an open enrollment period or by a deadline date.

Ins 2.16(11)(b) (b) No advertisement may state or imply that enrollment under a policy is limited to a specific period unless the advertisement discloses the period of time permitted to enroll. This period of time may not be less than 10 days and not more than 40 days from the date of the advertisement.

Ins 2.16(11)(c) (c) If the insurer making an introductory, initial or special offer has previously offered the same or similar policy on the same basis or intends to repeat the current offer for the same or similar policy, the advertisement shall disclose this fact.

Ins 2.16(11)(d) (d) No insurer may establish for residents of this state a limited enrollment period within which a person may purchase an individual policy less than 6 months after the close of an earlier limited enrollment period for the same or similar policy. The restriction shall apply to all advertisements in newspapers, magazines and other periodicals circulated in this state, all mail advertisements sent to residents of this state and all radio and TV advertisements broadcast in this state. This restriction does not apply to the solicitation of enrollments under individual policies issued on a group basis.

Ins 2.16(11)(e) (e) Where an insurer is an affiliate of a group of insurers under common management and control, the word “insurer” for the purposes of this subsection means the insurance group. The requirements and restrictions applicable to an insurer shall apply to the insurance group.

Ins 2.16(12) (12) Mail order refusal form. No person subject to this section may use a mail order advertisement which requires the recipient, in order to refuse a policy, to sign a refusal form and return it to a specified person or insurer.

Ins 2.16(13) (13) Group, quasi-group or special class implications. No advertisement may state or imply, unless true, that prospective policyholders or members of a particular class of individuals become group or quasi-group members or are uniquely eligible for a special policy or coverage and will be subject to special rates or underwriting privileges or that a particular coverage or policy is exclusively for preferred risks, a particular segment of people, or a particular age group or groups.

Ins 2.16(14) (14) Inspection of policy.

Ins 2.16(14)(a) (a) An offer in an advertisement of free inspection of a policy or an offer of a premium refund shall not be a cure for misleading or deceptive statements contained in such advertisement.

Ins 2.16(14)(b) (b) An advertisement which refers to the provision in the policy advertised regarding the right to return the policy shall disclose the time limitation applicable to this right.

Ins 2.16(15) (15) Identification of plan or number of policies.

Ins 2.16(15)(a) (a) When an advertisement refers to a choice regarding benefit amounts, it shall disclose that the benefit amounts provided will depend upon the plan selected and that the premium will vary with the amount of the benefits.

Ins 2.16(15)(b) (b) When an advertisement refers to various benefits, all of which can be obtained only by purchasing 2 or more policies, it shall disclose that the benefits are provided only through a combination of such policies.

Ins 2.16(16) (16) Use of statistics.

Ins 2.16(16)(a) (a) An advertisement which sets out the dollar amounts of claims paid, the number of persons insured or other statistical information shall identify the source of the statistical information. No person subject to this section may use an advertisement unless it accurately reflects all of the relevant facts. No advertisement may contain irrelevant statistical data.

Ins 2.16(16)(b) (b) No advertisement may imply that the statistical information given is derived from the insurer’s experience under the policy advertised unless true. The advertisement shall specifically so state if the information applies to other policies or plans.

Ins 2.16(16)(c) (c) An advertisement which sets out the dollar amounts of claims paid shall also indicate the period during which such claims have been paid.

Ins 2.16(17) (17) Claims. No advertisement may:

Ins 2.16(17)(a) (a) Contain untrue statements with respect to the time within which claims are paid;

Ins 2.16(17)(b) (b) State or imply that claim settlements will be liberal or generous or use words of similar import;

Ins 2.16(17)(c) (c) State or imply that claim settlements will be beyond the actual terms of the policy; or