Code of Maine Rules
02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
031 - BUREAU OF INSURANCE
Chapter 140 - ADVERTISEMENT OF HEALTH INSURANCE
Section 031-140-5 - Pre-existing conditions

Current through 2024-38, September 18, 2024

A. An advertisement covered by Section 3B shall, in negative terms, disclose the extent to which any loss is not covered if the cause of such loss is traceable to a condition existing prior to the effective date of the policy. The term "pre-existing condition" shall not be used unless adequately defined.

B. When a policy does not cover losses traceable to pre-existing conditions, no advertisement of the policy shall state or imply that the applicant's physical condition or medical history will not effect the issuance of the policy or payment of a claim thereunder. This limits the use of the phrase "no medical examination required" and phrases of similar import.

C. When an advertisement contains an application form to be completed by the applicant and returned by mail, such application form shall contain a statement which reflects the pre-existing condition provisions of the policy immediately preceding the blank space for the applicant's signature. For example, a statement substantially as follows:

"I understand that this policy will not pay benefits during the first ___ year(s) after the issue date for a disease or physical condition which I now have or have had in the past."

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