Section 45-06-04-07 - Preexisting conditions1. An advertisement which is subject to the requirements of section 45-06-04-06 must, in negative terms, disclose the extent to which any loss is traceable to a condition existing prior to the effective date of the policy. The use of the term "preexisting condition" without an appropriate definition or description may not be used.2. When a policy does not cover losses resulting from preexisting conditions, no advertisement of the policy may state or imply that the applicant's physical condition or medical history will not affect the issuance of the policy or payment of a claim thereunder. This rule prohibits the use of the phrase "no medical examination required" and phrases of similar import, but does not prohibit explaining "automatic issue". If an insurer requires a medical examination for a specified policy, the advertisement if it is an invitation to contract must disclose that a medical examination is required.3. When an advertisement contains an application form to be completed by the applicant and returned by mail for a direct response insurance product, such application form must contain a question requiring a response by the applicant or a statement in prominent type, all in capital letters, which reflects the preexisting condition provisions of the policy immediately preceding the blank space for the applicant's signature. For example, such an application form must contain a question substantially as follows: "Do you understand that this policy will not pay benefits during the first - year(s) after the issue date for a disease or physical condition which you now have or have had in the past?"--------Yes
Or a statement in prominent type, all capitalized, substantially as follows:
"I UNDERSTAND THAT THE POLICY APPLIED FOR WILL NOT PAY BENEFITS FOR ANY LOSS INCURRED DURING THE FIRST-------YEAR(S) AFTER THE ISSUE DATE ON ACCOUNT OF DISEASE OR PHYSICAL CONDITION WHICH I NOW HAVE OR HAVE HAD IN THE PAST"
N.D. Admin Code 45-06-04-07
General Authority: NDCC 26.1-04-08, 28-32-02
Law Implemented: NDCC 26.1-04-03(1), 26.1-04-03(2), 26.1-04-07