P.R. Laws tit. 26, § 1112

2019-02-20 00:00:00+00
§ 1112. Ground for disapproval of forms

The Commissioner shall disapprove a form of policy, application, rider or endorsement, or shall withdraw his approval thereof, only:

(1) If it is in any respect in violation of or does not comply with this title.

(2) If it is inconsistent with any applicable filing theretofore made and approved.

(3) If it contains or incorporates by reference any inconsistent, ambiguous, or misleading clauses, or exceptions and conditions which deceptively affect the risk purported to be assumed in the general coverage of the contract.

(4) If it has any title, heading, or other indication of its provisions which is misleading.

(5) If any material part of the policy or form is printed or otherwise reproduced in a manner substantially illegible.

(6) If purchase of insurance thereunder is being solicited by deceptive advertising.

(7) If it is one concerning disability insurance and the benefits provided therein are unfair in relation to the premium charged.

(8) If it is one concerning disability as it appears defined in § 403 of this title, and same does not provide benefits for when an insured, through reasons of emergency or accident not covered by §§ 1–42 of Title 11, known as the “Workmen’s Accident Compensation Act”, receives hospital care in commonwealth or municipal hospitals.

(9) If the conditions or exclusions of the policy limit the insurance coverage, the sale thereof resulting in an unjust enrichment on the part of the insurer.

(10) If the grounds for the cancellation of the contract are arbitrary and unreasonable.

History —Ins. Code § 11.120; June 15, 1961, No. 69, p. 141, § 1; June 27, 1964, No. 109, p. 329, § 1; July 23, 1974, No. 133, Part 1, p. 598, § 4; May 10, 1976, No. 32, p. 84, § 9.