W. Va. Code R. § 114-11A-4

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 114-11A-4 - Duties of Insurers

4.1. Requirements Applicable Generally

a. The insurer shall provide a Buyer's Guide to all prospective purchasers prior to accepting the applicant's initial premium or premium deposit. However, if the policy for which application is made contains an unconditional refund provision of at least ten (10) calendar days, the Buyer's Guide may be delivered with the policy or prior to delivery of the policy.

b. The insurer shall provide a policy summary to prospective purchasers where the insurer has identified the policy form as one that will not be marketed with an illustration. The policy summary shall show guarantees only and must consist of a separate document with all required information set out in a manner that does not minimize or render any portion of the summary obscure. Any amounts that remain level for two (2) or more years of the policy may be represented by a single number if it clearly indicates what amounts are applicable for each policy year. Amounts in paragraphs 1 through 5, subdivision e. subsection 3.7 shall be listed in total, not on a per thousand or per unit basis. If more than one insured is covered under one policy or rider and if death benefits do not differ within the class, death benefits shall be displayed separately for each insured or for each class of insureds. Zero amounts shall be displayed as a blank space. Delivery of the policy summary shall be consistent with the time for delivery of the Buyer's Guide as specified in subdivision a of this subsection.

4.2. Requirements Applicable to Existing Policies.

a. Upon request by the policyowner, the insurer shall furnish either policy data or an "in force illustration" as defined in subdivision c, subsection 3.4 of this rule as follows:

1. For policies that the insurer identified not to be used with an illustration, the insurer shall furnish policy data, limited to guaranteed values, if it has chosen not to furnish an in force illustration meeting the requirements of the rule;

2. If the policy was identified to be used with an illustration, the insurer shall provide an in force illustration;

3. Unless otherwise requested, the policy data shall be provided by the insurer for twenty (20) consecutive years beginning with the previous policy anniversary. The statement of policy data shall include nonguaranteed elements according to the current scale, the amount of outstanding policy loans and the current policy loan interest rate. Policy values shown shall be based on the current application of nonguaranteed elements in effect at the time of the request. The insurer may charge a reasonable fee, not to exceed ten dollars ($10.00), for the preparation of the statement.

b. If a life insurance company changes its method of determining scales of nonguaranteed elements on existing policies, it must, no later than when the first payment is made on the new basis, advise each affected policyowner residing in this state of the change and of its effect on affected policies. This requirement does not apply to policies for which the amount payable upon death under the basic policy on the date when advice would otherwise be required does not exceed five thousand dollars ($5,000).

c. If the insurer makes a material revision in the terms and conditions under which it limits its right to change any nonguaranteed factor, it must, no later than the first policy anniversary following the revision, advise each affected policyowner residing in this state.

W. Va. Code R. § 114-11A-4