§431:10A-104 - Form of policy.
§431:10A-104 Form of policy. (a) A
policy of accident and health or sickness insurance shall neither be delivered
nor issued for delivery to any person in this State unless:
(1) The entire monetary and other considerations are
expressed in the policy;
(2) The time at which the insurance takes effect and
terminates is expressed in or determinable from the policy;
(3) It purports to insure only one person, except
that a policy may provide family coverage as defined in section 431:10A-103 or
reciprocal beneficiary family coverage as defined in section 431:10A-601;
(4) The style, arrangement, and overall appearance of
the policy give no undue prominence to any portion of the text, and unless
every printed portion of the text of the policy and of any endorsements or
attached papers is plainly printed in light-faced type of a style in general
use, the size of which shall be uniform and not less than ten point with a
lower case unspaced alphabet length not less than one hundred twenty point.
The text shall include all printed matter except the name and address of the
insurer, name or title of the policy, a brief description, if any, and captions
and subcaptions;
(5) The exceptions and reductions of indemnity are
set forth in the policy and, except for the required and optional provisions
set forth in sections 431:10A-105 and 431:10A-106, are printed, at the
insurer's option, either included with the benefit provision to which they
apply, or under an appropriate caption such as exceptions, or exceptions and reductions;
provided that if an exception or reduction specifically applies only to a
particular benefit of the policy, a statement of the exception or reduction
shall be included with the benefit provision to which it applies;
(6) Each policy form, including riders and
endorsements, shall be identified by a form number in the lower left-hand
corner of the first page; and
(7) It does not contain any provision purporting to
make any portion of the charter, rules, constitution, or bylaws of the insurer
a part of the policy unless such portion is set forth in full in the policy,
except in the case of the incorporation of, or reference to, a statement of
rates or classification of risks, or short-rate table filed with the
commissioner.
(b) If any policy is issued by an insurer
domiciled in this State for delivery to a person residing in a territory,
district or another state of the United States, and if the official having
responsibility for the administration of the insurance laws of such state,
district or territory shall have advised the commissioner that the policy is
not subject to approval or disapproval by the official, the commissioner may by
ruling require that the policy meet the standards set forth in subsection (a)
and in section 431:10A-105 and section 431:10A-106. [L 1987, c 347, pt of §2;
am L 1997, c 383, §5; am L 2002, c 155, §51; am L 2004, c 122, §30]