Rule 120-2-27-.08 - Minimum Requirements for Credit Accident and Sickness Insurance FormsAll credit accident and sickness insurance forms filed with the Commissioner pursuant to the provisions of Sections 33-24-9 and 33-31-8 of the Georgia Code for use in this State which do not meet the following minimum standards shall be deemed to be forms which contain provisions which are unjust, unfair, inequitable, misleading, deceptive or which encourage misrepresentation of the policy and therefore shall be disapproved by the Commissioner or the previous approval thereof withdrawn:
(1) The form shall not contain any exclusions for preexisting conditions except conditions which, within six months prior to the effective date of the coverage, manifested themselves to the insured debtor by requiring medical consultation, diagnosis, or treatment, provided that such preexisting conditions cause loss commencing within six months following the effective date of the coverage. However, disability commencing six months or more after the effective date of the coverage shall not be excluded regardless of whether or not such disability results from any preexisting condition.(2) The form must contain a definition of "total disability" which provides coverage during the first 12 months of such disability even though the insured is able to perform an occupation other than the one he held at the time such disability occurred. During the first 12 months of such disability, the definition of "total disability" must relate such disability, to the occupation of the debtor at the time the disability occurred. After such disability continues for more than 12 months, the definition of "total disability" may relate such continuing disability to the inability to perform any occupation for which the debtor is reasonably fitted by education, training or experience. The provisions of this subsection shall not apply to credit accident and sickness insurance policies which provide exclusively for payment of the policy proceeds in a lump sum in the event of "total disability."(3) The form shall provide that in event the indebtedness covered by the policy results from the refinancing in whole or in part of a prior debt with the same creditor, any period of exclusion for preexisting conditions shall be reduced by any period that creditor-debtor disability coverage was in force in connection with the prior indebtedness.(4) The form shall provide for the payment of a daily benefit equal in amount to at least one-thirtieth of the scheduled monthly payments on the indebtedness or their equivalent if the debt is repayable periodically at terms differing from monthly.(5) The form shall contain either no age restrictions whatsoever, or shall contain only those age restrictions which make ineligible for coverage debtors who have attained age 65 at the time the indebtedness is incurred or who will have attained age 66 prior to the maturity date of the indebtedness. However, coverage will remain in effect and benefits shall be payable to the beneficiaries under the policy or certificate, notwithstanding the age of the debtor, in cases where an individual policy or certificate is issued to a debtor who has correctly stated his age on the application.(6) The form shall contain either no other exclusions whatsoever or only those exclusions which exclude coverage for disability resulting from normal pregnancy, intentionally self-inflicted injuries, from flight in non-scheduled aircraft, or from war or military service.(7) The form shall state that the insurer shall not deny a claim due to the debtor's subsequent unemployment or retirement during the term of the insurance.Ga. Comp. R. & Regs. R. 120-2-27-.08
O.C.G.A. Secs. 33-2-9, 33-30-1, 33-31-7, 33-31-8, 33-31-12.
Original Rule entitled "Minimum Requirements for Credit Accident and Sickness Insurance Forms" adopted. F. Mar. 8, 1977; eff. July 1, 1977, as specified by the Agency.Amended: F. Dec. 6, 1993; eff. Dec. 26, 1993.Submitted for Publishing: Apr. 6, 2007.Amended: F. Feb. 20, 2015; eff. Mar. 12, 2015.