Md. Code, Ins. § 19-1104

Current with changes from the 2024 Legislative Session
Section 19-1104 - [Effective 1/1/2025] Disclosure
(a) A pet insurer transacting pet insurance shall disclose the following to consumers:
(1) all policy exclusions, including exclusions of coverage due to:
(i) a preexisting condition;
(ii) a hereditary disorder;
(iii) a congenital anomaly or disorder; or
(iv) a chronic condition;
(2) any policy provision that limits coverage through a waiting period, a deductible, coinsurance, or an annual or lifetime policy limit;
(3) whether the pet insurer reduces coverage or increases premiums based on the insured's claim history, the age of the covered pet, or a change in the geographic location of the insured; and
(4) the identity of the underwriting company if the company differs from the brand name used to market and sell the pet insurance policy.
(b)
(1) A notice shall be prominently printed on or attached to the face of the pet insurance policy that states that:
(i) the policy may be surrendered to the insurer for cancellation within 10 days after the date the policy is delivered to the insured; and
(ii) if a policy is canceled during the 10-day period, a pro rata premium for the unexpired term of the policy shall be returned to the insured.
(2) An insured is not entitled to a pro rata premium in accordance with paragraph (1)(ii) of this subsection if the insured has made a claim under the pet insurance policy.
(c) A pet insurer shall clearly disclose a summary description of the basis or formula on which the pet insurer determines claim payments under a pet insurance policy:
(1) within the policy;
(2) before issuing the policy; and
(3) through a clear and conspicuous link on the main page of the website of the pet insurer or pet insurer's program administrator.
(d) If a pet insurer uses a benefit schedule to determine claim payment under a pet insurance policy, the pet insurer shall:
(1) clearly disclose the applicable benefit schedule in the policy; and
(2) disclose all benefit schedules used by the pet insurer under its pet insurance policies through a clear and conspicuous link on the main page of the website of the pet insurer or pet insurer's program administrator.
(e) If a pet insurer determines claim payments under a pet insurance policy that are based on usual and customary fees, or any other reimbursement limitation based on prevailing veterinary practitioner charges, the pet insurer shall:
(1) include a usual and customary fee limitation provision in the policy that clearly describes:
(i) the pet insurer's basis for determining usual and customary fees; and
(ii) how the basis is applied in calculating claim payments; and
(2) disclose the pet insurer's basis for determining usual and customary fees through a clear and conspicuous link on the main page of the website of the pet insurer or pet insurer's program administrator.
(f) If a medical examination by a veterinary practitioner is required to begin coverage, the pet insurer shall:
(1) clearly and conspicuously disclose the required aspects of the examination before purchase of the pet insurance policy; and
(2) disclose that examination documentation may result in a preexisting condition exclusion.
(g) A pet insurer shall clearly and prominently disclose any waiting periods and the requirements applicable to the waiting periods before purchase of the pet insurance policy.
(h)
(1) A pet insurer shall:
(i) include with a copy of the pet insurance policy a summary of all policy provisions required in accordance with subsections (a) through (g) of this section in a separate document in at least 12 point type titled: "Insurer Disclosure of Important Policy Provisions"; and
(ii) include the document required under item (i) of this paragraph on the website of the pet insurer or pet insurer's program administrator through a clear and conspicuous link on the main page of the website.
(2) The document required under paragraph (1)(i) of this subsection shall include all relevant definitions established under § 19-1101 of this subtitle.
(i) At the time a pet insurance policy is issued or delivered to a policyholder, the pet insurer shall include the following information, printed in 12 point boldface type:
(1) the Administration's mailing address, toll -free telephone number, and website address;
(2) the address and customer service telephone number of the pet insurer or the insurance producer of record for the pet insurer; and
(3) if the policy was issued or delivered by an insurance producer, a statement advising the policyholder to contact the insurance producer for assistance.
(j) The disclosure requirements required in accordance with this section shall be in addition to any other applicable disclosure requirements under this article or regulations adopted under this article.

Md. Code, IN § 19-1104

Added by 2024 Md. Laws, Ch. 740,Sec. 1, eff. 1/1/2025.