(1) PURPOSE. The interest of the public and
the maintenance of a fair and honest life insurance market must be safeguarded
by identifying and prohibiting certain types of policy forms and policy
provisions and by requiring certain insurance premiums to be separately stated.
This rule implements and interprets applicable statutes including ss.
628.34,
631.20,
632.44(1) and
632.62,
Stats.
(2) SCOPE. This rule shall
apply to the kinds of insurance authorized by s.
Ins 6.75(1)
(a), and shall also apply to fraternal
benefit societies.
(3) DEFINITIONS.
For the purpose of this rule certain life insurance policy forms and provisions
referred to herein shall have the following meaning:
(a) "Coupon policy" is any policy form which
includes a series of coupons prominently and attractively featured in
combination with an insurance contract. Such coupons are one-year pure
endowments whether or not so identified and whether or not physically attached
to the insurance contract. The coupons are devised to give the appearance of
the interest coupons that are frequently attached to investment bonds. Although
the face amount of the coupon benefit is essentially a refund of premium
previously paid by a policyholder, it is frequently represented that is the
earnings or return on the investment of the policyholder in life
insurance.
(b) "Charter policy" is
a term or name assigned by an insurance company to a policy form. Such a policy
is usually issued by a newly organized company and it is sold on the basis that
its availability will be limited to a specific predetermined number of units of
a fixed dollar amount. Such policies generally provide that the policyholder
shall participate in the earnings resulting from either or both participating
policies and non-participating policies. It is characteristic of such a policy
that in its presentation to the public it is represented that the policyholder
will receive a special advantage in any future distribution of earnings,
profits, dividends or abatement of premium. It is also represented that such
advantage will not be made available to the persons holding other types of
policies issued by the company. Other names such as Founders, President, and
Executive Special are frequently used for policies of the type herein
described, and for the purpose of this rule when they are so used they shall be
considered as charter policies.
(c)
A "Profit-sharing policy" is any policy form which contains provisions
representing that the policyholder will be eligible to participate, with
special advantage not available to the persons holding other types of policies
issued by the same company, in any future distribution of general corporate
profits. Such policy forms are so drafted that it appears to a prospective
policyholder that he or she is purchasing a preferential share of the future
profit and earnings of the insurance corporation rather than purchasing a life
insurance policy which may be subject to refund of excess premium payments. The
provisions of the policy may incorrectly represent the amount and source of
surplus that will be available for apportionment and return to policyholders in
the form of dividends. Policy forms using such terms as profits, surplus, or
surplus-sharing in the manner herein described shall, for the purpose of this
rule, be considered as profit-sharing policies.
(4) PROHIBITIONS, REGULATIONS, AND DISCLOSURE
REQUIREMENTS. In accordance with the purpose expressed in sub. (1) and in
consideration of the apparent intent of the legislature, the use in this state
of certain types of policy forms and policy provisions shall be subject to the
following prohibitions and regulations:
(a)
Coupon policy forms misrepresent, distort, and disguise the true nature of the
insurance purchased. Therefore, no coupon policy shall be approved for use and
no coupon policy heretofore approved shall be issued or delivered in this state
on or after June 15, 1962.
(b) Any
policy, except a policy which is only used as a funding medium to provide gifts
to a corporation without profit, as provided in s. 615.04, Stats., containing a
series of one-year pure endowments or a series of guaranteed periodic benefits
maturing during the premium-paying period of the policy in which the amount of
any pure endowment or periodic benefit or benefits payable during any policy
year is less than the total annual policy premium for such year has special
characteristics making such policy peculiarly susceptible to misrepresentation
and misunderstanding. Such policies are founded on the utmost good faith of the
company, and the public interest requires that the premium charged for such
benefits shall be fully and fairly disclosed to the policyholder without
deception or misrepresentation. Therefore, on or after April 1, 1965, no such
policy herein described shall be approved for use and no such policy heretofore
approved shall be issued or delivered in this state unless:
Note: Section 615.04, Stats., was repealed.
1. The policy is nonparticipating.
2. The payment of a pure endowment or
guaranteed periodic benefit is not contingent on the payment of premiums
falling due on or after the time such pure endowment has matured,
3. The gross premium for the pure endowment
or guaranteed periodic benefits is shown prominently and separately in the
policy distinct from the regular insurance premium,
4. The gross premium for the pure endowment
or guaranteed periodic benefits is based on reasonable assumptions as to
interest, mortality, and expense,
5. The number of one-year endowment or
guaranteed periodic benefits provided by the policy equals the number of annual
premiums for such benefits,
6. All
advertisements, sales materials, agent's presentations, and other
representations of the policy to the public represent the pure endowment or
guaranteed periodic benefits of the policy to be nothing other than insurance
benefits for which a premium is being paid,
7. All representations of the total premium
for the policy contract also show the gross premium for the pure endowment or
guaranteed periodic benefits to an extent such that the prospect or purchaser
is fully informed as to the separate costs involved.
(c) Charter policy forms are defined by s.
628.33, 1987 stats., to be an unfair method of competition. They purport to
provide a means to an end result that is not authorized by statute and an end
result that is without reasonable expectation of achievement. Such policy forms
misrepresent the responsibility and obligation of the company for equitable
distribution of dividends or abatement of premiums. Therefore, no charter
policy shall be approved for use and no charter policy heretofore approved
shall be issued or delivered in this state on or after June 15, 1962.
(d) Profit-sharing policy forms are contrary
to statute and the public interest by representing as an inducement to
insurance that the person who purchases such a policy is procuring a
preferential interest in the future profits and earnings of the insurance
corporation. Any distribution to a policyholder of the company of earnings,
profits, or surplus is a refund of the excess premiums paid by that
policyholder. Such distribution must be fair and equitable to all
policyholders, it must not discriminate unfairly between individuals of the
same class and equal expectation of life, and it must be in the best interest
of the company and its policyholders. Therefore, no profit-sharing policy shall
be approved for use and no profit-sharing policy heretofore approved shall be
issued or delivered in this state on or after June 15, 1962. Further, on or
after June 15, 1962, no participating policy shall be approved and no
participating policy heretofore approved shall be issued or delivered in this
state unless the policy provides without deception or misrepresentation that
the source of any dividends or abatement of premium is limited to the divisible
surplus derived from participating business.
See historical note relating to s. Ins 2.08 as printed with
this rule as released in December, 1984.