New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 4 - ACTUARIAL SERVICES
Subchapter 41 - STANDARDS FOR INDIVIDUAL LIFE INSURANCE POLICY FORMS
Section 11:4-41.14 - Standards for smoker/nonsmoker and/or tobacco/nontobacco reclassification
Current through Register Vol. 56, No. 6, March 18, 2024
(a) The standards set forth in this section shall apply to individual life insurance policies that:
(b) Any permitted change in premiums, costs or benefits due to smoking and/or tobacco use habits which meets the definition of a "re-entry or requalification feature" as defined at 11:4-41.2 shall be subject to the requirements of 11:4-41.1 1, Standards for re-entry or requalification features for individual life forms, in addition to the requirements of this section. The requirements of this section shall apply in the case of any conflict.
(c) Any policy subject to these requirements shall contain:
(d) Insurers electing not to endorse previously-approved forms to include the provision required by (c) above shall provide insureds with the information contained in (c) above in a premium notice or other written notice no later than the next premium due date or December 27, 2002, whichever is later, and shall immediately comply with all other requirements of this section.
(e) The submission for filing of any policy form subject to this section shall specify the mechanism to adjust premiums, any other cost factors and change in benefits if the insured is reclassified. This mechanism shall be applied consistently to all premiums and cost and benefit factors. The permissible mechanisms are:
(f) The standards set forth in this subchapter shall apply separately to the original benefits provided by the policy and any increases in benefits subsequent to the issue date for which the insured was required to provide evidence of smoking and/or tobacco use status.
(g) Upon reclassification, the form shall be endorsed or reissued to specify any new cash values, premiums, cost of insurance charges or other policy cost or benefit factors which change as a result of the reclassification. Such endorsement and any related policy schedule pages shall display the effective date of reclassification.
(h) Contestability based upon evidence of insurability shall be limited as to time and amount as specified in 11:4-41.3(b)3 ii(2).
(i) Any evidence of insurability provided in support of reclassification, if used as a basis for contest, shall be attached to and made part of the policy, and the form shall so state.
(j) Insurers shall not assign insureds a less favorable classification as a result of receiving any evidence of insurability provided in support of reclassification.