1.Disclosure to persons eligible for coverage.
For any policy or contract subject to this chapter that provides disability income benefits, if the benefits under that policy
or contract are subject to reduction due to other sources of income, then the insurer shall include in any written enrollment
material and certificate of coverage developed by the insurer that is intended to be distributed to persons eligible for coverage
under the policy or contract a clear and conspicuous notice that accurately explains all types of other sources of income
that may result in a reduction of the benefits payable under the policy or contract. The notice requirement under this section
does not apply to an advertisement intended for the general public.
[
2005, c. 42, §2 (NEW)
.]
2.Recovery of disability benefit overpayments.
For claims filed after January 1, 2006, an insurer that is entitled to reduce disability income benefit payments when the
insured receives income from other sources and that is entitled to recover overpayments through offsets against current payments
to the insured may not recover such overpayments at a rate greater than 20% of the net benefit per benefit payment period
unless:
A. For policies applied for after September 13, 2003, the insurer has complied with the requirements of subsection 1; [2005, c. 42, §2 (NEW).]
B. The insurer effects the offset of benefits within 60 days of notice to the insurer, or such later date as the insurer begins
paying benefits to the insured, that the insured is receiving or is entitled to receive income that may result in a reduction
of benefits payable under the policy; [2005, c. 42, §2 (NEW).]
C. The overpayment did not result from the insurer's miscalculation of benefit reductions or the insurer's miscalculation of
benefits payable under the policy; and [2005, c. 42, §2 (NEW).]
D. The insurer provided the insured with clear and conspicuous written notice that accurately explains to the insured all types
of other sources of income that may result in a reduction of the benefits payable under the policy within 30 days of the date
a claim for disability benefits was filed. [2005, c. 42, §2 (NEW).]
[
2005, c. 42, §2 (NEW)
.]
SECTION HISTORY
2003, c. 321, §2 (NEW).
2005, c. 42, §2 (RPR).
Data for this page extracted on 10/16/2012 08:29:52.