The superintendent shall disapprove any form filed under section 2412, or withdraw
any previous approval thereof, only on one or more of the following grounds:
A. If it is in any respect in violation of or does not comply with this Title; [1969, c. 132, §1 (NEW).]
B. If it contains or incorporates by reference, where such incorporation is otherwise
permissible, any inconsistent, ambiguous or misleading clauses, or exceptions and
conditions which deceptively affect the risk purported to be assumed in the general
coverage of the contract; [1969, c. 132, §1 (NEW).]
C. If it has any title, heading or other indication of its provisions which is misleading; [1969, c. 132, §1 (NEW).]
D. As to an individual health insurance policy, if the benefits provided therein are
unreasonable in relation to the premium charged; or, as to any health insurance contract,
if it contains any unjust, unfair or inequitable provision or provisions; [1969, c. 132, §1 (NEW).]
E. As to a life insurance or health insurance policy, if it contains a provision or
provisions such as to encourage misrepresentation; [1991, c. 211, §1 (AMD).]
F. As to Medicare supplement policies or contracts, as defined in chapter 67, if the
policy cannot be anticipated, as estimated for the entire period for which rates are
to be computed to provide coverage, on the basis of incurred claims experience and
earned premiums for that period and in accordance with accepted actuarial principles
and practices, to return to policyholders in the form of aggregate benefits provided
under the policy at least 65% of the aggregate amount of premiums collected in the
case of individual policies and at least 75% of the aggregate amount of premiums collected
in the case of group policies; or [1991, c. 211, §2 (AMD).]
G. As to an individual health insurance policy, contract or rider, if it insures against
a specific disease and does not meet the minimum loss ratio standards specified in
(1) As used in this paragraph, unless the context otherwise indicates, the following
terms have the following meanings.
(a) "Conditionally renewable" means renewal may be declined by the insurer by class,
geographic area or for stated reasons other than health.
(b) "Guaranteed renewable" means renewal may be declined by the insurer only for
nonpayment of premium but rates may be revised on a class basis.
(c) "Noncancelable" means renewal may not be declined by the insurer and rates may
not be revised.
(d) "Optionally renewable" means renewal is at the option of the insurer.
(2) The loss ratio standards for each type of renewal clause are:
(a) Optionally renewable insurance, 60%;
(b) Conditionally renewable insurance, 55%; and
(c) Guaranteed renewable and noncancelable insurance, 50%. [1991, c. 211, §3 (NEW).]
1991, c. 211, §§1-3 (AMD)
The insurer shall not use in this State any such form after disapproval or withdrawal
1969, c. 132, §1 (NEW)
1969, c. 132, §1 (NEW).
1973, c. 585, §12 (AMD).
1981, c. 234, §§2,3 (AMD).
1989, c. 27, §1 (AMD).
1991, c. 211, §§1-3 (AMD).
Data for this page extracted on 12/03/2013 11:59:41.
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