Ins 6.85 Ins 6.85 Notification of a person’s right to file a complaint with the commissioner.

Ins 6.85(1) (1) Purpose. This section interprets and implements s. 631.28, Stats., by specifying the contents of a notice insurers must provide to insureds about their right to file a complaint with the office of the commissioner of insurance. This section also describes when and the manner in which such notice must be provided.

Ins 6.85(2) (2) Scope. This section applies to all policies or certificates in force, issued or renewed in Wisconsin on or after the effective date of this section.

Ins 6.85(3) (3) Definitions. For purposes of this section, “insured” means the policyholder for individual policies and both the group policyholder and certificate holder for group policies.

Ins 6.85(4) (4) Notice format. Every insurer shall disclose the insured’s right to contact the office of the commissioner of insurance regarding an insurance problem by providing a notice which shall:

Ins 6.85(4)(a) (a) Be in the form as prescribed in Appendix I or for policies subject to sub. (5) (d) in form as prescribed in Appendix 2;

Ins 6.85(4)(b) (b) Include the issuer’s address, toll free phone number, if available, and phone number in no less than 12-point type and bold print.

Ins 6.85 Note Note: The language in sub. (4) (b) applies to notices sent on or after March 1, 1995.

Ins 6.85(4)(c) (c) Be in no less than 10-point type; and

Ins 6.85(4)(d) (d) Have the phrase “KEEP THIS NOTICE WITH YOUR INSURANCE PAPERS,” “PROBLEMS WITH YOUR INSURANCE?” in Appendix I and the “OFFICE OF THE COMMISSIONER OF INSURANCE” in Appendices I and 2 capitalized and in bold lettering.

Ins 6.85(5) (5) Notice delivery.

Ins 6.85(5)(a) (a) For policies issued prior to the effective date of this section, except for policies included under pars. (c) and (d):

Ins 6.85(5)(a)1. 1. The notice shall be provided on or before the insured’s first renewal date after the effective date of this section or within one year after the effective date of this section, whichever is earlier, with a separate notice to the insured; or

Ins 6.85(5)(a)2. 2. For single premium policies, a separate notice shall be provided on or before the insured’s next anniversary date or within one year after the effective date of this section, whichever is earlier.

Ins 6.85(5)(b) (b) For policies or certificates issued on or after the effective date of this section, except for policies included under pars. (c) and (d), a separate notice shall be provided at the time the policy or certificate is issued.

Ins 6.85(5)(c) (c) For surety and title insurance policies the notice must be given as a separate notice to each claimant at the time a claim is denied.

Ins 6.85(5)(d) (d) For policies subject to s. 632.83, Stats., the insurer shall either give notice in the form as prescribed in Appendix 2 and as specified in pars. (a) and (b) or may include the language in Appendix 2 as part of the grievance procedure language in the policy and certificates issued after the effective date and, for policies issued prior to the effective date, provide a policy or certificate amendment on or before the first renewal date after the effective date or within one year after the effective date of this section, whichever is earlier.

Ins 6.85 History History: Emerg. cr. eff. 2-1-93; cr. Register, February, 1993, No. 446, eff. 3-1-93; correction in (5) (d), Register, April, 1993, No. 448, eff. 5-1-93; am. (4) (b) and Appendix, Register, January, 1995, No. 469, eff. 2-1-95; correction in (5) (d) made under s. 13.93 (2m) (b) 7., Stats., Register January 2002 No. 553.

Ins 6.90 Ins 6.90 Prohibited uses of senior-specific designations.

Ins 6.90(1) (1) Purpose. The purpose of this rule is to set forth standards to protect consumers from advertising and trade practices that are deceptive, misleading, or restrain competition unreasonably, with respect to the use of senior-specific certifications and professional designations in the advertising, solicitation, sale or purchase of, or advice made in connection with, life or health insurance, or an annuity product.

Ins 6.90(2) (2) Authority.

Ins 6.90(2)(a) (a) This rule is adopted pursuant to the Office of the Commissioner of Insurance’s authority under ss. 601.42 (3) and 628.34 (12), Stats.

Ins 6.90(2)(b) (b) Nothing in this rule shall limit the commissioner’s authority to enforce existing provisions of law.

Ins 6.90(3) (3) Scope. This rule shall apply to any advertising, solicitation, or sale or purchase of, or advice made in connection with, a life or health insurance policy, or annuity product by an insurance producer.

Ins 6.90(4) (4) Definitions. In this section:

Ins 6.90(4)(a) (a) “Advertising” means all of the following:

Ins 6.90(4)(a)1. 1. Printed and published material, audio visual material and descriptive literature of an insurer or intermediary used in direct mail, newspapers, magazines, other periodicals, radio and television scripts, billboards and similar displays, excluding advertisements prepared for the sole purpose of recruiting employees, intermediaries or agencies.

Ins 6.90(4)(a)2. 2. Descriptive literature and sales aids of all kinds authored, issued, distributed or used by an insurer, intermediary or third party for presentation to members of the public, including circulars, leaflets, booklets, depictions, illustrations and form letters. Descriptive literature and sales aids do not include material in house organs of insurers, communications within an insurer’s own organization not intended for dissemination to the public, individual communications of a personal nature, and correspondence between a prospective group or blanket policyholder and an insurer in the course of negotiating a group or blanket policy, and general announcements from group or blanket policyholders to eligible individuals that a contract has been written.

Ins 6.90(4)(a)3. 3. Prepared sales talks, presentations and material for use by intermediaries and representations made by intermediaries in accordance therewith, excluding materials to be used solely by an insurer for the training and education of its employees or intermediaries; and