Current through
Register Vol. 48, No. 18, September 15, 2023
PURPOSE: This rule is intended to outline the
requirements for all life insurance and annuity contracts which are to be sold
in Missouri.
(1) No life
insurance or annuity contract, including applications, riders, endorsements,
policies, and certificates, shall be approved for use in this
state unless it conforms to the following:
(A) Each life insurance or annuity contract,
including applications, riders, endorsements, policies and certificates, shall
be identified by a form number in the lower left-hand corner of the first page
or face page;
(B) Each life
insurance or annuity contract shall contain accurate information regarding all
coverages and benefits for which premiums are being paid. This information
shall individually identify each coverage and the respective premium required
to maintain each coverage;
(C) No
application for a life insurance or annuity contract or any coverage pertaining
thereto, shall contain a statement such as, "No information acquired by any
representative of the company or conveyed to any prospective insured by such
representative shall be binding upon the company unless written herein." The
company may specifically disclaim any insurance producer's authority to waive a
complete answer to any question in the application, pass on insurability, make
or alter any contract or waive any of the company's other rights or
requirements;
(D) Effective June
30, 1990, all individual life insurance or annuity contracts and all mass
marketed or individually solicited group life insurance or annuity certificates
for which the insured pays the entire premium must contain a provision which
states, in substance, that the person to whom the coverage is issued shall have
an unconditional right to return the coverage within at least ten (10) days of
its delivery for a full refund of all premium paid. This rule shall not apply
to-
1. Coverage issued under group contracts
as defined in section
376.691,
RSMo. Mass marketed life insurance for purposes of this rule means the
insurance under any individual, franchise, group or blanket policy of life or
health insurance which is offered by means of direct response solicitation
through a sponsoring organization or through the mails or other mass
communications media and under which the person insured pays all or
substantially all of the cost of his/her insurance;
2. Life insurance issued to college students
and subject to
20 CSR
400-5.500;
3. Single premium short duration trip or
travel-type coverage; or
4. Graded
benefit life insurance coverage which is subject to
20 CSR
400-1.040;
(E) Each individual life insurance or annuity
contract which develops cash or loan values and which provides the insured the
right to borrow against this cash or loan values, either by virtue of the
existence of a policy loan provision or an automatic premium loan provision,
shall state in substance that the contract will lapse at the expiration of a
grace period of at least thirty-one (31) days if there is an outstanding policy
loan or the policy is being maintained by an automatic premium loan and the
accrued cash value is insufficient to pay the necessary interest, or both,
premium then due. The contract shall state in substance that the company will
notify the owner at least thirty-one (31) days prior to discontinuing the
contract in this manner;
(F) For
the purposes of any waiver of premium benefit provided in conjunction with a
life insurance or annuity contract, the contract shall state in substance that
the owner shall be considered totally disabled if s/he is unable to perform the
material and substantial duties of any occupation for which s/he is suited by
means of education, training or experience. Any waiver of premium benefit which
requires the insured to be totally disabled for a period of time exceeding
thirty (30) days before benefits are payable, also shall provide in substance
that all premiums paid by the insured from the date of disability will be
waived retrospectively. However, no premium need be waived for a period of
disability originating prior to twelve (12) months from the date of notice of
disability if proof was not given as soon as reasonably possible. In no
instance shall the insured be required to be disabled for a period exceeding
one hundred eighty (180) days before s/he is entitled to benefits under a
waiver of premium provision;
(G)
For the purposes of any total disability benefit provided in conjunction with a
life insurance or annuity contract, the insured shall be considered totally
disabled if s/he is unable to perform the material and substantial duties of
his/her regular occupation. After an initial benefit period of twelve (12)
months, the insured shall be considered totally disabled if s/he is unable to
perform the material and substantial duties of any occupation for which s/he is
suited by means of education, training or experience; and
(H) Any accidental death or dismemberment
benefit provided in or supplemental to a life insurance or annuity contract
shall not include any language which requires that accidental bodily injury be
effected solely through external, violent, and accidental means. Any benefit
for accidental death or dismemberment provided in, or supplemental to, a life
insurance or annuity contract shall not exclude payment of these benefits for
any covered loss, as provided in the contract, due to unintentionally
self-inflicted injuries; unintentional or nonvoluntary inhalation of gas or
taking of poisons; pyogenic infections which result from an accidental bodily
injury; bacterial infections which result from the accidental ingestion of
contaminated substances; or the insured's being under the influence of drugs,
if the drugs were taken as prescribed by a physician.
(2) In addition to the requirements of
section (1), each life insurance policy shall contain in substance the
following provision, if applicable to the form of policy being filed:
(A) The policy, including the endorsements
and attached application, if any, constitutes the entire contract of insurance.
No change in the policy shall be valid until approved by an executive officer
of the insurer and unless the approval is attached to the policy. No insurance
producer has authority to change this policy or to waive any of its
provisions;
(B) The policy, with
the exception of any accidental death, waiver of premium or total disability
benefits, shall be incontestable after it has been in force during the lifetime
of the insured, for a period of two (2) years from the earlier of the policy
date or the issue date, except in the event of nonpayment of
premiums;
(C) A grace period of
thirty-one (31) days without interest will be allowed for every premium after
the first, during which the policy shall continue in force. If the insured dies
during the grace period, any premiums then due may be deducted from the
proceeds of the policy;
(D) If, at
the time of application, the age or sex of the insured is misstated, the amount
of coverage provided shall be such as the premium paid would have purchased at
the correct age and sex according to the company's published rate at the date
of issue of the policy;
(E) Unless
changed as provided in the policy, the beneficiary shall be as designated in
the policy; and
(F) The policy,
unless surrendered for its cash value, may be reinstated at any time within
five (5) years after date of default in payment of premium upon presentation of
evidence of insurability satisfactory to the company, payment or reinstatement
of any indebtedness at date of default, the payment of all premiums in arrears
and the payments of interest in an amount not to exceed the applicable policy
loan interest rate(s) during the period of lapse, assessed per annum and
compounded annually, on the indebtedness and on each unpaid premium from its
due date.
(3) If either
of the following provisions is contained in a life insurance policy, it shall
be no less favorable to the insured than as follows:
(A) The insurer, at its own expense, shall
have the right and opportunity to have an autopsy performed on the deceased
insured, unless otherwise precluded by law; and
(B) Any amount payable on the death of the
insured will be paid only after receipt of proof of death on forms acceptable
to the company.
(4)
Individual life contracts issued on a term basis which are guaranteed renewable
for successive term periods must contain a schedule of rates which are the
guaranteed maximum renewal rates for continuing the term coverage at the time
of guaranteed renewal. This requirement shall not apply to contracts which
contain variable premium provisions.
(5) Individual life contracts issued as a
family plan which develop cash values for each life insured and which provide
that a portion of any policy indebtedness outstanding is to be subtracted from
any death proceeds payable shall contain a provision no less favorable to the
insured than the following: "The company will subtract from policy proceeds
payable on the life of any insured a portion of any policy indebtedness
outstanding. The amount subtracted will be determined by prorating the total
indebtedness by the ratio which the deceased insured's cash value bears to the
total cash value of all insureds."
(6) Each company, within sixty (60) days of
the date of an application for a life insurance or annuity contract, shall
notify a prospective insured as to whether or not the application has been
accepted or else give the prospective insured the reason for any further
delay.
AUTHORITY: sections
374.045,
376.670,
376.673,
and 376.675, RSMo 2000 and section
376.671,
RSMo Supp. 2007.* This rule was previously filed as 4 CSR 190-13.230. Original
rule filed May 13, 1983, effective Nov. 11 , 1983. Amended: Filed Dec. 1, 1989,
effective June 29, 1990. Amended: Filed July 12, 2002, effective Jan. 30, 2003.
Amended: Filed May 28, 2008, effective Nov. 30, 2008.
*Original authority: 374.045, RSMo 1967, amended 1993,
1995; 376.670, RSMo 1943, amended 1959, 1961, 1965, 1975, 1979, 1982; 376.671,
RSMo 1979, amended 2002, 2004; 376.673, RSMo 1967; and 376.675, RSMo 1963,
amended 1984.
