a. Complete a good faith effort, which shall be documented by the insurer, to confirm the death of the insured or retained asset account holder against other available records and information.
b. Determine whether benefits are due in accordance with the applicable policy or contract.
2. If benefits are due in accordance with the applicable policy or contract:
a. Use good faith efforts, which shall be documented by the insurer, to locate the beneficiary or beneficiaries.
b. Provide the appropriate claims forms or instructions to the beneficiary or beneficiaries to make a claim, including the need to provide an official death certificate, if applicable under the policy or contract.
(b) With respect to group life insurance, insurers are required to confirm the possible death of an insured when the insurers maintain at least the following information of those covered under a policy or certificate:
1. Social security number or name and date of birth.
2. Beneficiary designation information.
3. Coverage eligibility.
4. Benefit amount.
5. Premium payment status.
(c) Every insurer shall implement procedures to account for all of the following:
1. Initials used in lieu of a first or middle name, use of a middle name, compound first and middle names, and interchanged first and middle names.
2. Compound last names; maiden or married names; and hyphens, blank spaces, or apostrophes in last names.
3. Transposition of the month and date portions of the date of birth.
(d) To the extent permitted by law, the insurer may disclose minimum necessary personal information about the insured or beneficiary to a person who the insurer reasonably believes may be able to assist the insurer to locate the beneficiary or a person otherwise entitled to payment of the claims proceeds.
(e) The insurer comparison of in-force policies, contracts, and retained asset accounts shall be conducted first to the extent that such records are available electronically and then using the most easily accessible insurer records for records that are not available electronically.
(f) Nothing in this section shall limit the insurer from requesting a valid death certificate as part of any claims validation process.
(3) Fees and costs. An insurer or its service provider shall not charge any beneficiary or other authorized representative for any fees or costs associated with a death master file search or verification of a death master file match conducted pursuant to this section.
(4) Payment of benefits. The benefits from a policy, contract, or a retained asset account, plus any applicable accrued contractual interest, shall first be payable to the designated beneficiaries or owners and, in the event said beneficiaries or owners cannot be found, shall escheat to the state as unclaimed property under ch. 177. Interest payable under s. 628.46 shall not be payable as unclaimed property under s. 177.07.
(5) Unclaimed proceeds. An insurer shall report and remit unclaimed insurance proceeds in accordance with the requirements of ch. 177.
(6) Unfair marketing practices. Failure to meet any requirement of this section with such frequency as to constitute a general business practice is a violation of s. 628.34. Nothing in this section shall be construed to create or imply a private cause of action for a violation of this section.
(7) Orders. The commissioner may make an order regarding any of the following:
(a) Limiting an insurer's death master file comparisons required under sub. (2) (a) to the insurer's electronic searchable files or approving a plan and timeline for conversion of the insurer's files to electronic searchable files.
(b) Exempting an insurer from the death master file comparisons required under sub. (2) (a) or permitting an insurer to perform such comparisons less frequently than semi-annually upon a demonstration of hardship by the insurer.
(c) Phasing in compliance with this section according to a plan and timeline approved by the commissioner.
(8) Rules. The commissioner may adopt rules implementing and administering this section.
192,2
Section
2.
Effective date.
(1) This act takes effect on the first day of the 13th month beginning after publication.
