| Contact Person: | Illinois Division of Insurance | 320 West Washington Street | ||
| Cindy Colonius | Review Requirements Checklist | Springfield, IL 62767-0001 | ||
| 217-782-4572 | ||||
| Cindy.Colonius@Illinois.gov |
Effective 1/01/08 |
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| Line(s) of | Filing | Line(s) of | Filing | |
| Business | Code(s) | Insurance | Code(s) | |
Accidental Death Benefits - Individual and Group Products (Riders) |
LO8
|
Individual and Group Policy Riders. |
LO8.000 |
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| Illinois Insurance Code Link | Illinois Compiled Statutes Online | |||
| Illinois Administrative Code Link | Administrative Regulations Online | |||
| Product Coding Matrix | Product Coding Matrix | |||
| REVIEW REQUIREMENTS | REFERENCE |
DESCRIPTION OF REVIEWSTANDARDS REQUIREMENTS |
LOCATION OF STANDARD IN FILING |
| NOTE: These brief summaries do not include all requirements of all laws, regulations, bulletins, or requirements, so review actual law, regulation, bulletin, or requirement for details to ensure that forms are fully compliant before filing with the Department of Insurance. | |||
| FORM FILING REQUIREMENTS | REFERENCE | DESCRIPTION OF REVIEW STANDARDS REQUIREMENTS | LOCATION OF STANDARD IN FILING |
| Uniform Transmittal Document (Etrans) | 50 IL Adm. Code 916 | Form filings must now be submitted either by SERFF or CD-ROM. Please visit the Division’s web site for the Universal Transmittal Document (Etrans) by clicking here. Scroll down to “Universal Transmittal Document Software (Etrans)” |
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| Review Requirements Checklist | Go to Review Requirements Checklists on DOI web site. See next column | Each filing must include a completed Review Requirements Checklist that must contain a completed “Location of Standard in Filing” column for each required element of the filing. Please indicate the proper page # and form # for each entry. The checklists may be found at this link. |
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| Cover Letter and Letter of Submission | 50 IL Adm. Code 1405.20 (e) |
In addition to referencing any previously approved form number(s) as required by 50 IL Adm. Code 1405.20(e), those references must also include the filing number and SERFF tracking number (if applicable and available) for the referenced forms. Letters of submission must generally describe the intent and use of the form being filed and, if applicable, how it will be used with any previously approved form(s). |
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| ADMINISTRATIVE CODE PROVISIONS | REFERENCE | DESCRIPTION OF REVIEW STANDARDS REQUIREMENTS | |
| Company Name | 50 IL Adm. Code 1405.20 c) 1) | The name of the company shall appear on the form. | |
| Appropriate Descriptive Title | 50 IL Adm. Code 1405.20 c) 5) | There must be an appropriate, unambiguous title describing the form. | |
| Accidental Cause | 50 IL Adm. Code 1405.40 p) 1) | Supplemental benefits may be added to a life policy, even though Accidental Death, Dismemberment and Loss of Eyesight Benefits are limited to accidental cause. | |
| Accidental Means | 50 IL Adm. Code 1405.40 p) 2) | Accidental means test requires that both the cause and result of the accident be an accident. | |
| Direct Result Language Requirement | 50 IL Adm. Code 1405.40 p) 2) | Only direct result language is permitted. Words such as "external", "violent" or "visible wound" are prohibited. | |
| Prohibited Language | 50 IL Adm. Code 1405.40 p) 3) | Provisions for loss due to accident or accidental injury shall not contain language limiting, reducing, or excluding liability for a loss resulting from purely accidental circumstances such as "involuntary", or "unintentional". | |
| Contributory Language Prohibited | 50 IL Adm. Code 1405.40 p) 2) | Contributory language such as "indirectly", "wholly or in part", or "contributed to by" is prohibited. | |
| GENERAL INFORMATION | |||
| Additional Benefits | 50 IL Adm. Code 1405.40 p) 1) |
Accidental Death Benefits are considered additional benefits. These benefits must be paid in addition to the basic policy death benefit. |
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| Schedule Page Requirement | 50 IL Adm. Code 1405.40 p) 1) | The schedule page or data page must indicate the amount of the basic death benefit in one column and the amount of the accidental death benefit in a separate column to make it clear that the accidental death benefit will be paid in addition to the basic death benefit. | |
| Prohibited Exclusions | 50 IL Adm. Code 1405.40 p) 3) | Exclusions such as "that results from or arises out of any past or present employment or occupation for compensation or profit" are prohibited. | |
| DEPARTMENT POSITIONS | |||
| Benefit Restrictions | 215 ILCS 5/143(1) | Surgical reattachment, coma, critical burn, exposure, loss of use or paralysis, loss of speech and/or hearing are not considered Accidental Death and Dismemberment benefits. | |
| Exclusion Limitations | 215 ILCS 5/143(1) | Benefits may not be excluded for loss that results from the actions of someone other than the insured's. |