Compilation of Rules and Regulations of the State of Georgia
Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER
Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE
Subject 120-2-12 - ADVERTISING ACCIDENT AND SICKNESS INSURANCE
Rule 120-2-12-.05 - Form and Content of Advertisements

1. The format and content of an advertisement of an accident or sickness insurance policy shall be accurate and shall be sufficiently complete and clear to avoid deception or the capacity or tendency to mislead or deceive. Whether an advertisement has a capacity or tendency to mislead or deceive shall be determined by the Insurance Commissioner 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, or within a segment of the public to which such advertisement may be reasonably calculated to reach.

2. Advertisement shall be truthful and not misleading in fact or in implication. Words or phrases, the meaning of which is clear only by implication or by familiarity with insurance terminology, shall not be used.

3. The advertising of hospital or medical policies or plans shall clearly and accurately state the dollar limits of benefits where applicable, and time limits of benefits where applicable, in lieu of, or in conjunction with descriptive words which might imply "full coverage" for all expenses normally related to hospitalization or medical care.

4. An advertisement for a policy providing benefits for specified illnesses only, such as cancer, or for specified accidents only, such as automobile accidents, shall clearly and conspicuously in prominent type state the limited nature of the policy. The statement shall be worded in language identical to, or substantially similar to the following: "THIS IS A LIMITED POLICY;" "THIS IS A CANCER ONLY POLICY;" "THIS IS AN AUTOMOBILE ACCIDENT ONLY POLICY."

5. If a policy provides different benefits as to amount or time for the same loss occurring under different circumstances or from different causes, the smaller benefits payable shall be given the same prominence as the larger benefits.

6. All policies advertised shall be correctly identified by names reasonably calculated to describe their contents, FOR EXAMPLE: Hospital and Surgical Expense Policy; Hospital Income Policy; Hospital Confinement Policy; Disability Income Policy; Senior Citizen Hospital Expense Policy; Medical Care Accident and Health Policy; . . . etc.

The use of such terms as "Pay Check Plan;" "Hospital Dollars;" "Extra-income Plan;" "Extra Cash Plan;" "Extra Pay Plan;" "Hard Cash Plan;" "White Cross Plan;" "Doctors' Plan;" or similar words or phrases which do not correctly identify the policy, shall be prohibited.

In addition, all advertised policies must be identified by Form Number.

7. Any Optional Benefit advertised shall be captioned as "Optional Benefits" and shall be prominently and conspicuously displayed in immediate conjunction with the conditions to qualify for such Optional Benefits. An advertisement must contain a statement that in order to obtain such optional benefits there will be an additional premium charged for each optional benefit desired. A statement must also be included in the advertisement as to what conditions, if any, must be met to qualify for such benefits.

8. All advertisements of accident and sickness insurance in this State shall include the name, address and phone number of the Home or Principal Office and/or of the nearest representative or representatives of the insurer authorized to handle claims and to provide service and information to applicants and/or insureds.

9. Any advertisement making reference to "Medicare Supplement Insurance" or to coverage designed to supplement "Medicare," shall contain a clear, prominent and conspicuous statement in language identical to or substantially the same as the following: "THIS IS A LIMITED POLICY DESIGNED TO COVER ONLY THOSE EXPENSES WHICH MEDICARE DOES NOT COVER." Furthermore, such advertisements must clearly, prominently and conspicuously disclose the exact benefits payable under such advertised policy.

If such advertised Medicare Supplement Policy supplements only Medicare Part A (or hospital benefits only), this shall be clearly, prominently and conspicuously displayed in the advertisement; nor shall such advertisements use the maximum amount payable without giving an exact example of the conditions which must be met in order for a policyholder to collect the maximum amount.

10. Any advertisement which refers to maximum dollar amount of benefits which can be paid for any period greater than one day shall disclose at the same time, in an equally prominent, frequent, and conspicuous manner, and in immediate conjunction therewith, the daily rate of benefits, and when applicable, the fact that said benefits are payable only for the actual number of days of hospital confinement and, when applicable, the limit on the number of days for which coverage is provided.

11. Words and phrases used in an advertisement to describe policy limitations, exceptions, and reductions shall fairly, accurately, and clearly describe in understandable terms the negative features of such limitations, exceptions and reductions of the policy.