South Carolina Code of Regulations
Chapter 69 - DEPARTMENT OF INSURANCE
Section 69-34.2 - Replacement of Accident and Health Insurance
Current through Register Vol. 48, 12, December 27, 2024
A. Table of Contents: |
B ....... |
Purpose |
C ....... |
Applicability and Scope |
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D ....... |
Definitions |
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E ....... |
Replacement |
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F ....... |
Replace After Indication of No Replacement |
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G ....... |
Severability |
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H ....... |
Effective Date |
B. Purpose: The purpose of this regulation is to eliminate unfair and deceptive practices in the replacement of individual accident and health insurance policies that insure persons who are eligible for Medicare by reason of age and to persons who have a current medicaid eligibility card. medicaid eligibility card.
C. Applicability and Scope: This Regulation shall apply only to solicitations and sale of individual accident and health insurance policies to persons who are eligible for Medicare by reason of age or to persons who have a current medicaid eligibility card. This Regulation shall not apply to credit health insurance. This Regulation shall be in addition to any other applicable regulations previously adopted.
D. Definitions: As used in this Regulation, the following terms shall have the meanings indicated:
E. Replacement:
In addition, the licensee shall furnish the applicant with a complete comparison in writing of the benefits afforded by the new policy and the policy to be replaced. Such comparison shall include but not be limited to the benefits contained in the two policies, the renewability provisions of the two policies, and the respective definitions of pre-existing illnesses or diseases.
A direct response insurer shall, upon issuance of the policy, deliver to the applicant the notice described in (4) below. The comparison statement and the notice will not be required if the insurance to be replaced is accident only or a single premium nonrenewable policy.
NOTICE TO APPLICANT REGARDING REPLACEMENT
OF ACCIDENT AND HEALTH INSURANCE
According to (your application) (information you have furnished), you intend to lapse or otherwise terminate existing accident and health insurance and replace it with a policy issued by (insert Company Name) Insurance Company. For your own information and protection, you should be aware of and seriously consider certain factors which may affect the insurance protection available to you under the new policy. In particular, study the comparison statement which your agent is required to furnish you upon taking your application.
The above "Notice to Applicant" was delivered to me on:
____________________________________
(Date)
____________________________________
(Applicant's Signature)
NOTICE TO APPLICANT REGARDING REPLACEMENT
OF ACCIDENT AND HEALTH INSURANCE
According to (your application) (information you have furnished) you intend to lapse or otherwise terminate existing accident and health insurance and replace it with the policy delivered herewith issued by (insert Company Name) Insurance Company. Your new policy provides 10 days within which you may decide without cost whether you desire to keep the policy. For your own information and protection you should be aware of and seriously consider certain factors which may affect the insurance protection available to you under the new policy.
____________________________________
(Company Name)
F. Replacement After Indication of No Replacement.
Policyholders have the right to replace existing accident and health insurance after indicating in or as a part of applications for new insurance that such is not their intention; however, patterns of such action by policyholders on the same agent shall be evidence of the agent's knowledge that replacement was intended in connection with such transactions and indicate that the agent intended to violate the statute.
G. Severability: Each provision of this Regulation is deemed to be severable and the determination that any provision is invalid for any reason shall not invalidate the remaining provisions of the Regulation.
H. Effective Date: This Regulation shall become effective six months after adoption by the General Assembly and final publication in the State Register.