STANDARDS FOR ACCIDENT AND HEALTH INSURANCE
415-A:4 Outline of Coverage.
I. In order to provide for full and fair disclosure in the sale of all policies of accident and health insurance, no such policy 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 paragraph III accompanies the policy; and
(b) In all other cases, the outline of coverage described in paragraph III is delivered to the applicant at the time application is made and an acknowledgment of receipt or certificate of delivery of such outline is provided the insurer with the application.
II. In the event the policy is issued on a basis other than that applied for, the outline of coverage properly describing the policy must accompany the policy when it is delivered and clearly state that it is not the policy for which application was made.
III. The commissioner shall prescribe the format and content of the outline of coverage required by paragraph I. "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 categories of coverage provided by the policy or contract as prescribed in RSA 415-A:3.
(b) Description of the principal benefits and coverage provided in the policy or contract.
(c) Statement of the exceptions, reductions and limitations contained in the policy or contract.
(d) Statement of the renewal provisions including any reservation by the insurer or nonprofit hospital or medical service association of a right to change premiums.
(e) 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.
(f) Statement that a maternity benefits rider will be made available at the insured's request, if maternity care is not covered under the policy. Nothing in this subparagraph shall be construed to apply to supplemental health insurance and disability insurance policies.
Source. 1975, 494:1. 1993, 196:2, eff. Jan. 1, 1994.