§ 24-A §2208 — Content of disclosure authorization forms

Notwithstanding any other provision of law, a regulated insurance entity or insurance support organization may not use a disclosure authorization form unless the form or statement:
1.
Signed.
Is signed by the insurance consumer except that:
2.
Plain language.
Is written in plain language;
3.
Dated.
Is dated;
4.
Persons authorized to disclose.
Specifies the types of persons authorized to disclose information about the consumer;
5.
Nature of information.
Specifies the nature of the information authorized to be disclosed;
6.
Name of regulated insurance entity.
Names the regulated insurance entity and identifies by generic reference representatives of the carrier to whom the consumer is authorizing information to be disclosed;
7.
Purpose.
Specifies the purposes for which the information is collected;
8.
Time period of authorization.
Specifies the period of time the authorization remains valid. The period of time may be no longer than:
9.
Right to copy.
Advises the consumer or a person authorized to act on behalf of the consumer that the consumer or the consumer's authorized representative is entitled to receive a copy of the authorization form;
10.
Revocation.
Advises the consumer how to revoke the authorization and that the revocation may be a basis for denying insurance benefits; and
11.
Failure to sign.
Advises the consumer that failure to sign an authorization form may impair the ability of a regulated insurance entity to evaluate or process an application or claim and may be a basis for denying an application or claims for benefits.

Legislative History

PL 1997, c. 677, §3 (NEW). PL 1997, c. 677, §5 (AFF). PL 2017, c. 402, Pt. C, §75 (AMD). PL 2017, c. 402, Pt. F, §1 (AFF). PL 2019, c. 417, Pt. B, §14 (AFF).