376.756. Summary document, association to prepare, contents — policy not covered by guaranty association to contain notice, form determined by director.

529 words·~2 min read·/mo/chapter-376/376-756

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376.756. Summary document, association to prepare, contents — policy not covered by guaranty association to contain notice, form determined by director. — 1. The association shall prepare a summary document describing the general purposes and current limitations of the act and complying with subsection 2 of this section. This document should be submitted to the director for approval. Sixty days after receiving such approval, no insurer may deliver a policy or contract described in subsection 2 of section 376.717 to a policy owner, contract holder, certificate holder, or enrollee unless the document is delivered to the policy or contract holder prior to or at the time of delivery of the policy or contract except if subsection 3 of this section applies.

The document should also be available upon request by a policyholder , contract owner, certificate holder, or enrollee. The distribution, delivery, or contents or interpretation of this document shall not mean that either the policy or the contract or the policy owner, contract owner, certificate holder, or enrollee thereof would be covered in the event of the impairment or insolvency of a member insurer. The description document shall be revised by the association as amendments to the act may require.

Failure to receive this document does not give the policyholder , contract holder, certificate holder, enrollee, or insured any greater rights than those stated in sections 376.715 to 376.758 .

2. The document prepared under subsection 1 of this section shall contain a clear and conspicuous disclaimer on its face. The director shall promulgate a rule establishing the form and content of the disclaimer. The disclaimer shall:

(1)State the name and address of the life and health insurance guaranty association and department of commerce and insurance;

(2)Prominently warn the policy owner, contract owner, certificate holder, or enrollee that the Missouri life and health insurance guaranty association may not cover the policy or contract or, if coverage is available, it will be subject to substantial limitations, exclusions and conditioned on continued residence in the state;

(3)State that the member insurer and its agents are prohibited by law from using the existence of the life and health insurance guaranty association for the purpose of sales, solicitation or inducement to purchase any form of insurance or health maintenance organization coverage;

(4)Emphasize that the policy owner, contract owner, certificate holder, or enrollee should not rely on coverage under the Missouri life and health insurance guaranty association when selecting an insurer or health maintenance organization;

(5)Provide other information as directed by the director.

3. No insurer or agent may deliver a policy or contract described in subsection 2 of section 376.717 and excluded under subsection 3 of section 376.717 from coverage under the provisions of sections 376.715 to 376.758 unless the insurer or agent, prior to or at the time of delivery, gives the policy or contract holder a separate written notice which clearly and conspicuously discloses that the policy or contract is not covered by the Missouri life and health insurance guaranty association. The director shall by rule specify the form and content of the notice.

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(L. 1988 S.B. 430 § 36, A.L. 2018 H.B. 1690)