Current through Register Vol. XLI, No. 38, September 20, 2024
5.1. The following acts
or practices by an insurer or insurance producer constitute corrupt practices,
improper influences or inducements and are declared to be false, misleading,
deceptive or unfair:
a. Submitting, processing or
assisting in the submission or processing of any allotment form or similar device
used by the United States Armed Forces to direct a service member's pay to a third
party for the purchase of life insurance. The foregoing includes, but is not limited
to, using or assisting in using a service member's "MyPay" account or other similar
internet or electronic medium for such purposes. This subsection does not prohibit
assisting a service member by providing insurer or premium information necessary to
complete any allotment form;
b.
Knowingly receiving funds from a service member for the payment of premium from a
depository institution with which the service member has no formal banking
relationship. For purposes of this section, a formal banking relationship is
established when the depository institution:
1.
Provides the service member a deposit agreement and periodic statements and makes
the disclosures required by the Truth in Savings Act, 12 U.S.C. § 4301
et seq. and the regulations promulgated thereunder; and
2. Permits the service member to make deposits and
withdrawals unrelated to the payment or processing of insurance premiums;
c. Employing any device or method or
entering into any agreement whereby funds received from a service member by
allotment for the payment of insurance premiums are identified on the service
member's Leave and Earnings Statement or equivalent or successor form as "Savings"
or "Checking" and where the service member has no formal banking relationship as
defined in subdivision b of this subsection;
d. Entering into any agreement with a depository
institution for the purpose of receiving funds from a service member whereby the
depository institution, with or without compensation, agrees to accept direct
deposits from a service member with whom it has no formal banking
relationship;
e. Using DoD personnel,
directly or indirectly, as a representative or agent in any official or unofficial
capacity with or without compensation with respect to the solicitation or sale of
life insurance to service members who are junior in rank or grade, or to the family
members of such personnel;
f. Offering
or giving anything of value, directly or indirectly, to DoD personnel to procure
their assistance in encouraging, assisting or facilitating the solicitation or sale
of life insurance to another service member;
g. Knowingly offering or giving anything of value
to a service member with a pay grade of E-4 or below for his or her attendance at
any event where an application for life insurance is solicited; or
h. Advising a service member with a pay grade of
E-4 or below to change his or her income tax withholding or state of legal residence
for the sole purpose of increasing disposable income to purchase life
insurance.
5.2. The following
acts or practices by an insurer or insurance producer lead to confusion regarding
source, sponsorship, approval or affiliation and are declared to be false,
misleading, deceptive or unfair:
a. Making any
representation, or using any device, title, descriptive name or identifier that has
the tendency or capacity to confuse or mislead a service member into believing that
the insurer, insurance producer or product offered is affiliated, connected or
associated with, endorsed, sponsored, sanctioned or recommended by the United States
Government, the United States Armed Forces, or any state or federal agency or
government entity. Examples of prohibited insurance producer titles include, but are
not limited to, "Battalion Insurance Counselor," "Unit Insurance Advisor,"
"Servicemen's Group Life Insurance Conversion Consultant" or "Veteran's Benefits
Counselor." Nothing in this subdivision prohibits a person from using a professional
designation awarded after the successful completion of a course of instruction in
the business of insurance by an accredited institution of higher learning. Such
designations include, but are not limited to, Chartered Life Underwriter (CLU),
Chartered Financial Consultant (ChFC), Certified Financial Planner (CFP), Master of
Science In Financial Services (MSFS), or Masters of Science Financial Planning (MS);
or
b. Soliciting the purchase of any
life insurance product through the use of or in conjunction with any third party
organization that promotes the welfare of or assists members of the United States
Armed Forces in a manner that has the tendency or capacity to confuse or mislead a
service member into believing that either the insurer, insurance producer or
insurance product is affiliated, connected or associated with, endorsed, sponsored,
sanctioned or recommended by the United States Government, or the United States
Armed Forces.
5.3. The
following acts or practices by an insurer or insurance producer lead to confusion
regarding premiums, costs or investment returns and are declared to be false,
misleading, deceptive or unfair:
a. Using or
describing the credited interest rate on a life insurance policy in a manner that
implies that the credited interest rate is a net return on premium paid;
or
b. Exempt for individually issued
annuities, misrepresenting the mortality costs of a life insurance product,
including stating or implying that the product "costs nothing" or is
"free."
5.4. The following
acts or practices by an insurer or insurance producer regarding SGLI or VGLI are
declared to be false, misleading, deceptive or unfair:
a. Making any representation regarding the
availability, suitability, amount, cost, exclusions or limitations to coverage
provided to a service member or dependents by SGLI or VGLI, which is false,
misleading or deceptive;
b. Making any
representation regarding conversion requirements, including the costs of coverage,
or exclusions or limitations to coverage of SGLI or VGLI to private insurers which
is false, misleading or deceptive; or
c.
Suggesting, recommending or encouraging a service member to cancel or terminate his
or her SGLI policy or issuing a life insurance policy which replaces an existing
SGLI policy unless the replacement takes effect upon or after the service member's
separation from the United States Armed Forces.
5.5. The following acts or practices by an insurer
and or insurance producer regarding disclosure are declared to be false, misleading,
deceptive or unfair:
a. Deploying, using or
contracting for any lead-generating materials designed exclusively for use with
service members that do not clearly and conspicuously disclose that the recipient
will be contacted by an insurance producer, if that is the case, for the purpose of
soliciting the purchase of life insurance;
b. Failing to disclose that a solicitation for the
sale of life insurance will be made when establishing a specific appointment for an
in-person, face-to-face meeting with a prospective purchaser;
c. Except for individually issued annuities,
failing to clearly and conspicuously disclose the fact that the product being sold
is life insurance;
d. Failing to make,
at the time of sale or offer to an individual known to be a service member, the
written disclosures required by Section 10 of the "Military Personnel Financial
Services Protection Act," Pub.
L. No. 109-290, p.16; or
e. Except for individually issued annuities, when
the sale is conducted in-person face-to-face with an individual known to be a
service member, failing to provide the applicant at the time the application is
taken:
1. An explanation of any free look period
with instructions on how to cancel if a policy is issued; and
2. Either a copy of the application or a written
disclosure. The copy of the application or the written disclosure shall clearly and
concisely set out the type of life insurance, the death benefit applied for and its
expected first year cost. A basic illustration that meets the requirements of 114
CSR 11C is sufficient to meet this requirement for a written disclosure.
5.6. The following acts or
practices by an insurer or insurance producer with respect to the sale of certain
life insurance products are declared to be false, misleading, deceptive or unfair:
a. Except for individually issued annuities,
recommending the purchase of any life insurance product which includes a side fund
to a service member in pay grades E-4 and below unless the insurer has reasonable
grounds for believing that the life insurance death benefit, standing alone, is
suitable; or
b. Offering for sale or
selling a life insurance product which includes a side fund to a service member in
pay grades E-4 and below who is currently enrolled in SGLI, is presumed unsuitable
unless, after the completion of a needs assessment, the insurer demonstrates that
the applicant's SGLI death benefit, together with any other military survivor
benefits, savings and investments, survivor income, and other life insurance are
insufficient to meet the applicant's insurable needs for life insurance.
1. "Insurable needs" are the risks associated with
premature death, taking into consideration the financial obligations and immediate
and future cash needs of the applicant's estate and/or survivors or
dependents.
2. "Other military survivor
benefits" include, but are not limited to: the Death Gratuity, Funeral
Reimbursement, Transition Assistance, Survivor and Dependents' Educational
Assistance, Dependency and Indemnity Compensation, TRICARE Healthcare benefits,
Survivor Housing Benefits and Allowances, Federal Income Tax Forgiveness, and Social
Security Survivor Benefits.
c. Except for individually issued annuities,
offering for sale or selling any life insurance contract which includes a side fund:
1. Unless interest credited accrues from the date
of deposit to the date of withdrawal and permits withdrawals without limit or
penalty;
2. Unless the applicant has
been provided with a schedule of effective rates of return based upon cash flows of
the combined product. For this disclosure, the effective rate of return will
consider all premiums and cash contributions made by the policyholder and all cash
accumulations and cash surrender values available to the policyholder in addition to
life insurance coverage. This schedule will be provided for at least each policy
year from one (1) to ten (10) and for every fifth policy year thereafter ending at
age 100, policy maturity or final expiration; and
3. Which by default diverts or transfers funds
accumulated in the side fund to pay, reduce or offset any premiums due.
d. Except for individually issued
annuities, offering for sale or selling any life insurance contract which, after
considering all policy benefits, including but not limited to endowment, return of
premium or persistency, does not comply with the standard nonforfeiture law for life
insurance, W. Va. Code §
33-13-30;
or
e. Selling any life insurance product
to an individual known to be a service member that excludes coverage if the
insured's death is related to war, declared or undeclared, or any act related to
military service, except for an accidental death coverage, e.g.,
double indemnity, which may be excluded.