§ 38.2-316. Policy forms to be filed with Commission; notice of approval ordisapproval; exceptions.
A. No policy of life insurance, industrial life insurance, variable lifeinsurance, modified guaranteed life insurance, group life insurance, accidentand sickness insurance, or group accident and sickness insurance; no annuity,modified guaranteed annuity, pure endowment, variable annuity, group annuity,group modified guaranteed annuity, or group variable annuity contract; nohealth services plan, legal services plan, dental or optometric servicesplan, or health maintenance organization contract; no dental planorganization dental benefit contract; and no fraternal benefit certificatenor any certificate or evidence of coverage issued in connection with suchpolicy, contract, or plan issued or issued for delivery in Virginia shall bedelivered or issued for delivery in this Commonwealth unless a copy of theform has been filed with the Commission. In addition to the aboverequirement, no policy of accident and sickness insurance shall be deliveredor issued for delivery in this Commonwealth unless the rate manual showingrates, rules, and classification of risks applicable thereto has been filedwith the Commission.
B. Except as provided in this section, no application form shall be used withthe policy or contract and no rider or endorsement shall be attached to orprinted or stamped upon the policy or contract unless the form of suchapplication, rider or endorsement has been filed with the Commission. Noindividual certificate and no enrollment form shall be used in connectionwith any group life insurance policy, group accident and sickness insurancepolicy, group annuity contract, or group variable annuity contract unless theform for the certificate and enrollment form have been filed with theCommission.
C. 1. None of the policies, contracts, and certificates specified insubsection A of this section shall be delivered or issued for delivery inthis Commonwealth and no applications, enrollment forms, riders, andendorsements shall be used in connection with the policies, contracts, andcertificates unless the forms thereof have been approved in writing by theCommission as conforming to the requirements of this title and notinconsistent with law.
2. In addition to the above requirement, no premium rate change applicable toindividual accident and sickness insurance policies, subscriber contracts ofhealth services plans, dental or optometric services plans, or fraternalbenefit contracts providing individual accident and sickness coverage asauthorized in § 38.2-4116 shall be used unless the premium rate change hasbeen approved in writing by the Commission. No premium rate change applicableto individual or group Medicare supplement policies shall be used unless thepremium rate change has been approved in writing by the Commission.
D. The Commission may disapprove or withdraw approval of the form of anypolicy, contract or certificate specified in subsection A of this section, orof any application, enrollment form, rider or endorsement, if the form:
1. Does not comply with the laws of this Commonwealth;
2. Has any title, heading, backing or other indication of the contents of anyor all of its provisions that is likely to mislead the policyholder, contractholder or certificate holder; or
3. Contains any provisions that encourage misrepresentation or aremisleading, deceptive or contrary to the public policy of this Commonwealth.
E. Within 30 days after the filing of any form requiring approval, theCommission shall notify the organization filing the form of its approval ordisapproval of the form which has been filed, and, in the event ofdisapproval, its reason therefor. The Commission, at its discretion, mayextend for up to an additional 30 days the period within which it shallapprove or disapprove the form. Any form received but neither approved nordisapproved by the Commission shall be deemed approved at the expiration ofthe 30 days if the period is not extended, or at the expiration of theextended period, if any; however, no organization shall use a form deemedapproved under the provisions of this section until the organization hasfiled with the Commission a written notice of its intent to use the formtogether with a copy of the form and the original transmittal letter thereof.The notice shall be filed in the offices of the Commission at least 10 daysprior to the organization's use of the form.
F. If the Commission proposes to withdraw approval previously given or deemedgiven to the form of any policy, contract or certificate, or of anyapplication, rider or endorsement, it shall notify the insurer in writing atleast 15 days prior to the proposed effective date of withdrawal giving itsreasons for withdrawal.
G. Any insurer or fraternal benefit society aggrieved by the disapproval orwithdrawal of approval of any form may proceed as indicated in § 38.2-1926.
H. This section shall not apply to any special rider or endorsement on anypolicy, except an accident and sickness insurance policy that relates only tothe manner of distribution of benefits or to the reservation of rights andbenefits under such policy, and that is used at the request of the individualpolicyholder, contract holder or certificate holder.
I. The Commission may exempt any categories of such policies, contracts, andcertificates and any applicable rate manuals from (i) the filingrequirements, (ii) the approval requirements of this section, or (iii) bothsuch requirements. The Commission may modify such requirements, subject tosuch limitations and conditions which the Commission finds appropriate. Inpromulgating an exemption, the Commission may consider the nature of thecoverage, the person or persons to be insured or covered, the competence ofthe buyer or other parties to the contract, and other criteria the Commissionconsiders relevant.
J. Pursuant to the authority granted by § 38.2-223, the Commission maypromulgate such rules and regulations as it may deem necessary to setstandards for policy and other form submissions required by this section or §38.2-3501.
(1952, c. 317, § 38.1-342.1; 1972, c. 836; 1973, c. 504; 1977, c. 325; 1986,c. 562; 1990, c. 332; 1994, c. 316; 1996, c. 12; 1998, c. 17; 2004, c. 668.)
§ 38.2-316. Policy forms to be filed with Commission; notice of approval ordisapproval; exceptions.
A. No policy of life insurance, industrial life insurance, variable lifeinsurance, modified guaranteed life insurance, group life insurance, accidentand sickness insurance, or group accident and sickness insurance; no annuity,modified guaranteed annuity, pure endowment, variable annuity, group annuity,group modified guaranteed annuity, or group variable annuity contract; nohealth services plan, legal services plan, dental or optometric servicesplan, or health maintenance organization contract; no dental planorganization dental benefit contract; and no fraternal benefit certificatenor any certificate or evidence of coverage issued in connection with suchpolicy, contract, or plan issued or issued for delivery in Virginia shall bedelivered or issued for delivery in this Commonwealth unless a copy of theform has been filed with the Commission. In addition to the aboverequirement, no policy of accident and sickness insurance shall be deliveredor issued for delivery in this Commonwealth unless the rate manual showingrates, rules, and classification of risks applicable thereto has been filedwith the Commission.
B. Except as provided in this section, no application form shall be used withthe policy or contract and no rider or endorsement shall be attached to orprinted or stamped upon the policy or contract unless the form of suchapplication, rider or endorsement has been filed with the Commission. Noindividual certificate and no enrollment form shall be used in connectionwith any group life insurance policy, group accident and sickness insurancepolicy, group annuity contract, or group variable annuity contract unless theform for the certificate and enrollment form have been filed with theCommission.
C. 1. None of the policies, contracts, and certificates specified insubsection A of this section shall be delivered or issued for delivery inthis Commonwealth and no applications, enrollment forms, riders, andendorsements shall be used in connection with the policies, contracts, andcertificates unless the forms thereof have been approved in writing by theCommission as conforming to the requirements of this title and notinconsistent with law.
2. In addition to the above requirement, no premium rate change applicable toindividual accident and sickness insurance policies, subscriber contracts ofhealth services plans, dental or optometric services plans, or fraternalbenefit contracts providing individual accident and sickness coverage asauthorized in § 38.2-4116 shall be used unless the premium rate change hasbeen approved in writing by the Commission. No premium rate change applicableto individual or group Medicare supplement policies shall be used unless thepremium rate change has been approved in writing by the Commission.
D. The Commission may disapprove or withdraw approval of the form of anypolicy, contract or certificate specified in subsection A of this section, orof any application, enrollment form, rider or endorsement, if the form:
1. Does not comply with the laws of this Commonwealth;
2. Has any title, heading, backing or other indication of the contents of anyor all of its provisions that is likely to mislead the policyholder, contractholder or certificate holder; or
3. Contains any provisions that encourage misrepresentation or aremisleading, deceptive or contrary to the public policy of this Commonwealth.
E. Within 30 days after the filing of any form requiring approval, theCommission shall notify the organization filing the form of its approval ordisapproval of the form which has been filed, and, in the event ofdisapproval, its reason therefor. The Commission, at its discretion, mayextend for up to an additional 30 days the period within which it shallapprove or disapprove the form. Any form received but neither approved nordisapproved by the Commission shall be deemed approved at the expiration ofthe 30 days if the period is not extended, or at the expiration of theextended period, if any; however, no organization shall use a form deemedapproved under the provisions of this section until the organization hasfiled with the Commission a written notice of its intent to use the formtogether with a copy of the form and the original transmittal letter thereof.The notice shall be filed in the offices of the Commission at least 10 daysprior to the organization's use of the form.
F. If the Commission proposes to withdraw approval previously given or deemedgiven to the form of any policy, contract or certificate, or of anyapplication, rider or endorsement, it shall notify the insurer in writing atleast 15 days prior to the proposed effective date of withdrawal giving itsreasons for withdrawal.
G. Any insurer or fraternal benefit society aggrieved by the disapproval orwithdrawal of approval of any form may proceed as indicated in § 38.2-1926.
H. This section shall not apply to any special rider or endorsement on anypolicy, except an accident and sickness insurance policy that relates only tothe manner of distribution of benefits or to the reservation of rights andbenefits under such policy, and that is used at the request of the individualpolicyholder, contract holder or certificate holder.
I. The Commission may exempt any categories of such policies, contracts, andcertificates and any applicable rate manuals from (i) the filingrequirements, (ii) the approval requirements of this section, or (iii) bothsuch requirements. The Commission may modify such requirements, subject tosuch limitations and conditions which the Commission finds appropriate. Inpromulgating an exemption, the Commission may consider the nature of thecoverage, the person or persons to be insured or covered, the competence ofthe buyer or other parties to the contract, and other criteria the Commissionconsiders relevant.
J. Pursuant to the authority granted by § 38.2-223, the Commission maypromulgate such rules and regulations as it may deem necessary to setstandards for policy and other form submissions required by this section or §38.2-3501.
(1952, c. 317, § 38.1-342.1; 1972, c. 836; 1973, c. 504; 1977, c. 325; 1986,c. 562; 1990, c. 332; 1994, c. 316; 1996, c. 12; 1998, c. 17; 2004, c. 668.)
§ 38.2-316. Policy forms to be filed with Commission; notice of approval ordisapproval; exceptions.
A. No policy of life insurance, industrial life insurance, variable lifeinsurance, modified guaranteed life insurance, group life insurance, accidentand sickness insurance, or group accident and sickness insurance; no annuity,modified guaranteed annuity, pure endowment, variable annuity, group annuity,group modified guaranteed annuity, or group variable annuity contract; nohealth services plan, legal services plan, dental or optometric servicesplan, or health maintenance organization contract; no dental planorganization dental benefit contract; and no fraternal benefit certificatenor any certificate or evidence of coverage issued in connection with suchpolicy, contract, or plan issued or issued for delivery in Virginia shall bedelivered or issued for delivery in this Commonwealth unless a copy of theform has been filed with the Commission. In addition to the aboverequirement, no policy of accident and sickness insurance shall be deliveredor issued for delivery in this Commonwealth unless the rate manual showingrates, rules, and classification of risks applicable thereto has been filedwith the Commission.
B. Except as provided in this section, no application form shall be used withthe policy or contract and no rider or endorsement shall be attached to orprinted or stamped upon the policy or contract unless the form of suchapplication, rider or endorsement has been filed with the Commission. Noindividual certificate and no enrollment form shall be used in connectionwith any group life insurance policy, group accident and sickness insurancepolicy, group annuity contract, or group variable annuity contract unless theform for the certificate and enrollment form have been filed with theCommission.
C. 1. None of the policies, contracts, and certificates specified insubsection A of this section shall be delivered or issued for delivery inthis Commonwealth and no applications, enrollment forms, riders, andendorsements shall be used in connection with the policies, contracts, andcertificates unless the forms thereof have been approved in writing by theCommission as conforming to the requirements of this title and notinconsistent with law.
2. In addition to the above requirement, no premium rate change applicable toindividual accident and sickness insurance policies, subscriber contracts ofhealth services plans, dental or optometric services plans, or fraternalbenefit contracts providing individual accident and sickness coverage asauthorized in § 38.2-4116 shall be used unless the premium rate change hasbeen approved in writing by the Commission. No premium rate change applicableto individual or group Medicare supplement policies shall be used unless thepremium rate change has been approved in writing by the Commission.
D. The Commission may disapprove or withdraw approval of the form of anypolicy, contract or certificate specified in subsection A of this section, orof any application, enrollment form, rider or endorsement, if the form:
1. Does not comply with the laws of this Commonwealth;
2. Has any title, heading, backing or other indication of the contents of anyor all of its provisions that is likely to mislead the policyholder, contractholder or certificate holder; or
3. Contains any provisions that encourage misrepresentation or aremisleading, deceptive or contrary to the public policy of this Commonwealth.
E. Within 30 days after the filing of any form requiring approval, theCommission shall notify the organization filing the form of its approval ordisapproval of the form which has been filed, and, in the event ofdisapproval, its reason therefor. The Commission, at its discretion, mayextend for up to an additional 30 days the period within which it shallapprove or disapprove the form. Any form received but neither approved nordisapproved by the Commission shall be deemed approved at the expiration ofthe 30 days if the period is not extended, or at the expiration of theextended period, if any; however, no organization shall use a form deemedapproved under the provisions of this section until the organization hasfiled with the Commission a written notice of its intent to use the formtogether with a copy of the form and the original transmittal letter thereof.The notice shall be filed in the offices of the Commission at least 10 daysprior to the organization's use of the form.
F. If the Commission proposes to withdraw approval previously given or deemedgiven to the form of any policy, contract or certificate, or of anyapplication, rider or endorsement, it shall notify the insurer in writing atleast 15 days prior to the proposed effective date of withdrawal giving itsreasons for withdrawal.
G. Any insurer or fraternal benefit society aggrieved by the disapproval orwithdrawal of approval of any form may proceed as indicated in § 38.2-1926.
H. This section shall not apply to any special rider or endorsement on anypolicy, except an accident and sickness insurance policy that relates only tothe manner of distribution of benefits or to the reservation of rights andbenefits under such policy, and that is used at the request of the individualpolicyholder, contract holder or certificate holder.
I. The Commission may exempt any categories of such policies, contracts, andcertificates and any applicable rate manuals from (i) the filingrequirements, (ii) the approval requirements of this section, or (iii) bothsuch requirements. The Commission may modify such requirements, subject tosuch limitations and conditions which the Commission finds appropriate. Inpromulgating an exemption, the Commission may consider the nature of thecoverage, the person or persons to be insured or covered, the competence ofthe buyer or other parties to the contract, and other criteria the Commissionconsiders relevant.
J. Pursuant to the authority granted by § 38.2-223, the Commission maypromulgate such rules and regulations as it may deem necessary to setstandards for policy and other form submissions required by this section or §38.2-3501.
(1952, c. 317, § 38.1-342.1; 1972, c. 836; 1973, c. 504; 1977, c. 325; 1986,c. 562; 1990, c. 332; 1994, c. 316; 1996, c. 12; 1998, c. 17; 2004, c. 668.)
