33-24-404 . Disclosures.
(1)Before completing the sale of a pet insurance policy, a pet insurer transacting in pet insurance shall disclose the following to consumers:
(a)if the policy excludes coverage due to any of the following:
(i)a preexisting condition;
(ii)a hereditary disorder;
(iii)a congenital anomaly or disorder; or
(b)if the policy includes any other exclusions, the following statement: "Other exclusions may apply. Please refer to the exclusions section of the policy for more information."
(c)any policy provision that limits coverage through a waiting period or affiliation period, a deductible, coinsurance, or an annual or lifetime policy limit;
(d)whether the pet insurer reduces coverage or increases premiums based on the insured's claim histo
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33-24-404 . Disclosures. (1) Before completing the sale of a pet insurance policy, a pet insurer transacting in pet insurance shall disclose the following to consumers:
(a) if the policy excludes coverage due to any of the following:
(i) a preexisting condition;
(ii) a hereditary disorder;
(iii) a congenital anomaly or disorder; or
(iv) a chronic condition;
(b) if the policy includes any other exclusions, the following statement: "Other exclusions may apply. Please refer to the exclusions section of the policy for more information."
(c) any policy provision that limits coverage through a waiting period or affiliation period, a deductible, coinsurance, or an annual or lifetime policy limit;
(d) 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
(e) if the underwriting company differs from the brand name used to market and sell the product.
(2) (a) As provided in this subsection (2), an insured has the right to examine and return the policy.
(b) Unless the insured has filed a claim under the pet insurance policy, pet insurance applicants have the right to examine and return the policy, certificate, or rider to the company or an insurance producer of the company within 15 days of its receipt and to have the premium refunded if, after examination of the policy, certificate, or rider, the applicant is not satisfied for any reason.
(c) Pet insurance policies, certificates, and riders must have a notice prominently printed on the first page or attached to the first page including specific instructions to accomplish a return. The following free look statement or language that is substantially similar must be included:
"You have 15 days from the day you receive this policy, certificate, or rider to review it and return it to the company if you decide not to keep it. You do not have to tell the company why you are returning it. If you decide not to keep it, simply return it to the company at its administrative office or to the agent/insurance producer that you bought it from, so long as you have not filed a claim. You must return it within 15 days of the day you first received it. The company will refund the full amount of any premium paid within 30 days after it receives the returned policy, certificate, or rider. The premium refund will be sent directly to the person who paid it. The policy, certificate, or rider will be void as if it had never been issued."
(3) 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 within the policy, prior to policy issuance.
(4) A pet insurer that uses a benefit schedule to determine claim payment under a pet insurance policy shall clearly disclose the applicable benefit schedule in the policy.
(5) A pet insurer that determines claim payments under a pet insurance policy based on usual and customary fees, or any other reimbursement limitation based on prevailing veterinary service provider charges, shall include a usual and customary fee limitation provision in the policy that clearly describes the pet insurer's basis for determining usual and customary fees and how that basis is applied in calculating claim payments.
(6) If a medical examination by a licensed veterinarian is required to effectuate coverage, the pet insurer shall clearly and conspicuously disclose the required aspects of the examination prior to purchase and disclose that examination documentation may result in a preexisting condition exclusion.
(7) Waiting periods and the requirements applicable to them must be clearly and prominently disclosed to consumers prior to the policy purchase.
(8) The pet insurer shall include a summary of all policy provisions required in subsections (1) through (7) in a separate document titled "Insurer Disclosure of Important Policy Provisions".
(9) In connection with the issuance of a new pet insurance policy, the pet insurer shall provide the consumer with a copy of the "Insurer Disclosure of Important Policy Provisions" document required pursuant to subsection (8) in at least 12-point type when it delivers the policy.
(10) (a) At the time a pet insurance policy is issued or delivered to a policyholder, the pet insurer shall include a written disclosure with the following information, printed in at least 12-point boldface type:
(i) the commissioner's mailing address, toll-free telephone number, and website address; and
(ii) the address and customer service telephone number of the pet insurer and the agent or broker of record, if the policy was issued or delivered by an agent or broker.
(b) The disclosures required in this section are in addition to any other disclosure requirements required by law or rules promulgated by the commissioner.