West Virginia Code of State Rules
Agency 114 - Insurance Commission
Title 114 - LEGISLATIVE RULE INSURANCE COMMISSIONER
Series 114-17 - Medicare Supplement Insurance Coverage
Section 114-17-8 - Prohibited Acts or Practices
Universal Citation: 114 WV Code of State Rules 114-17-8
Current through Register Vol. XLI, No. 38, September 20, 2024
8.1. Solicitation or sale. -- No person shall engage in any unfair, deceptive, misleading or unreasonably confusing act or practice in the promotion, solicitation or sale of accident and health insurance delivered or issued for delivery in this State to persons eligible for Medicare by reason of age.
8.2. Prima facie violations. -- The following acts and practices shall be deemed prima facie evidence of a violation of this section:
(a)
Any act which encourages an applicant to omit pertinent underwriting information
from an application;
(b) Any act which
induces a prospective insured to sign a blank or incomplete application,
acknowledgment or form;
(c) Failure to
disclose, during initial solicitation to a prospective insured, any affiliation with
an insurer;
(d) Any representations,
expressed or implied, unless specifically authorized in writing by the organization,
of affiliation with or authorization by any civic, social or other nongovernmental
organization;
(e) Any representation,
expressed or implied, of affiliation with or authorization by any governmental
agency or of access to any information from any such agency which is not generally
available to the public;
(f) The making
of any false or misleading statements as to the length of time an insurance policy
or contract may or may not be available;
(g) The issuance of any policy or contract, which
has not been submitted to and approved by the Commissioner;
(h) The sale of Medicare Supplement or Limited
Benefit Medicare Supplement insurance to any person not eligible for
Medicare;
(i) The sale of any accident
and/or sickness insurance policy or contract to any person without ascertaining
whether the person is eligible for Medicare by reason of age;
(j) The sale of any accident and sickness
insurance policy or contract to any person who indicates eligibility for Medicare by
reason of age, without strict adherence to the disclosure requirements of this
regulation;
(k) Falsely answering any
question or signing any certification in any application or form required to be
completed by the prospective insured;
(l) Failure by an agent to deliver, within seven
(7) business days, any policy sent to the agent for delivery to an
applicant;
(m) The taking of an
application, except by direct response, without inquiring and recording the reply as
to whether the proposed insurance will duplicate any insurance then enforce;
or
(n) Making any inquiry in such manner
as to invite a response contrary to fact.
Disclaimer: These regulations may not be the most recent version. West Virginia may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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