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)
2003, c. 321, §2 (NEW).
2005, c. 42, §2 (RPR).
Data for this page extracted on 04/27/2015 03:54:44.
The Revisor's Office cannot provide legal advice or
interpretation of Maine law to the public. If you need legal
advice, please consult
a qualified attorney.