US Laws, Codes, Statutes & Cases

                                  TITLE  41
                                  INSURANCE
                                  CHAPTER 42
                             INDIVIDUAL ACCIDENT
                        AND HEALTH INSURANCE POLICIES
    41-4205.  OUTLINE OF COVERAGE. (1) In order to provide for full and fair
disclosure in the sale of individual disability insurance policies or nongroup
subscriber contracts of a nonprofit hospital, medical or dental service
association, or nongroup subscriber contracts of health maintenance
organizations, no such policy or contract shall be delivered or issued for
delivery in this state unless:
    (a)  in the case of a direct response insurance product, the outline of
coverage described in subsection (2) of this section accompanies the policy;
    (b)  in all other cases, the outline of coverage described in subsection
(2) of this section is delivered to the applicant at the time application is
made and an acknowledgment of receipt of certificate of delivery of such
outline is provided the insurer with the application. In the event the policy
is issued on a basis other than that applied for, the outline of coverage
properly describing the policy or contract must accompany the policy or
contract when it is delivered and clearly state that it is not the policy or
contract for which application was made.
    (2)  The director shall prescribe the format and content of the outline of
coverage required by subsection (1) of this section. "Format" means style,
arrangement, and overall appearance, including such items as the size, color,
and prominence of type and the arrangement of text and captions. Such outline
of coverage shall include:
    (a)  A statement identifying the applicable category or categories of
coverage provided by the policy or contract as prescribed in section 41-4204
of this act;
    (b)  A description of the principal benefits and coverage provided in the
policy or contract;
    (c)  A statement of the exceptions, reductions and limitations contained
in the policy or contract;
    (d)  A statement of the renewal provisions including any reservation by
the insurer or nonprofit hospital, medical or dental service association, or
health maintenance organization of a right to change premiums;
    (e)  A statement that the outline is a summary of the policy or contract
issued or applied for and that the policy or contract should be consulted to
determine governing contractual provisions.