Utah Code 31A-28-119. Prohibited advertisement of the association — Notice to owners of policies and contracts
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Terms Used In Utah Code 31A-28-119
- Affiliate: means a person who controls, is controlled by, or is under common control with, another person. See Utah Code 31A-1-301
- Association: means the Utah Life and Health Insurance Guaranty Association continued under Section 31A-28-106. See Utah Code 31A-28-105
- Certificate: means evidence of insurance given to:(23)(a) an insured under a group insurance policy; or(23)(b) a third party. See Utah Code 31A-1-301
- Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
- Contract: A legal written agreement that becomes binding when signed.
- contract owner: means a person who:
(16)(a)(i) is identified as the legal owner under the terms of the policy or contract; or(16)(a)(ii) is otherwise vested with legal title to the policy or contract through a valid assignment:(16)(a)(ii)(A) completed in accordance with the terms of the policy or contract; and(16)(a)(ii)(B) properly recorded as the owner on the books of the insurer. See Utah Code 31A-28-105- Department: means the Insurance Department. See Utah Code 31A-1-301
- Enrollee: includes an insured. See Utah Code 31A-1-301
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Filing: when used as a noun, means an item required to be filed with the department including:
(70)(a) a policy;(70)(b) a rate;(70)(c) a form;(70)(d) a document;(70)(e) a plan;(70)(f) a manual;(70)(g) an application;(70)(h) a report;(70)(i) a certificate;(70)(j) an endorsement;(70)(k) an actuarial certification;(70)(l) a licensee annual statement;(70)(m) a licensee renewal application;(70)(n) an advertisement;(70)(o) a binder; or(70)(p) an outline of coverage. See Utah Code 31A-1-301- Form: means one of the following prepared for general use:
(74)(a)(i) a policy;(74)(a)(ii) a certificate;(74)(a)(iii) an application;(74)(a)(iv) an outline of coverage; or(74)(a)(v) an endorsement. See Utah Code 31A-1-301- Insurance: includes :
(96)(b)(i) a risk distributing arrangement providing for compensation or replacement for damages or loss through the provision of a service or a benefit in kind;(96)(b)(ii) a contract of guaranty or suretyship entered into by the guarantor or surety as a business and not as merely incidental to a business transaction; and(96)(b)(iii) a plan in which the risk does not rest upon the person who makes an arrangement, but with a class of persons who have agreed to share the risk. See Utah Code 31A-1-301- Insured: means a person to whom or for whose benefit an insurer makes a promise in an insurance policy and includes:
(103)(a)(i) a policyholder;(103)(a)(ii) a subscriber;(103)(a)(iii) a member; and(103)(a)(iv) a beneficiary. See Utah Code 31A-1-301- Member: means a person having membership rights in an insurance corporation. See Utah Code 31A-1-301
- Member insurer: includes an insurer whose license or certificate of authority in this state may have been:
(14)(b)(i) suspended;(14)(b)(ii) revoked;(14)(b)(iii) not renewed; or(14)(b)(iv) voluntarily withdrawn. See Utah Code 31A-28-105- Person: includes :
(146)(a) an individual;(146)(b) a partnership;(146)(c) a corporation;(146)(d) an incorporated or unincorporated association;(146)(e) a joint stock company;(146)(f) a trust;(146)(g) a limited liability company;(146)(h) a reciprocal;(146)(i) a syndicate; or(146)(j) another similar entity or combination of entities acting in concert. See Utah Code 31A-1-301- Policy: includes a service contract issued by:
(150)(b)(i) a motor club under Chapter 11, Motor Clubs;(150)(b)(ii) a service contract provided under Chapter 6a, Service Contracts; and(150)(b)(iii) a corporation licensed under:(150)(b)(iii)(A) Chapter 7, Nonprofit Health Service Insurance Corporations; or(150)(b)(iii)(B) Chapter 8, Health Maintenance Organizations and Limited Health Plans. See Utah Code 31A-1-301- producer: means a person licensed or required to be licensed under the laws of this state to sell, solicit, or negotiate insurance. See Utah Code 31A-1-301
- Sell: means to exchange a contract of insurance:
(179)(a) by any means;(179)(b) for money or its equivalent; and(179)(c) on behalf of an insurance company. See Utah Code 31A-1-301- State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
(1)(a) Except as provided in Subsection (1)(b), a person, including a member insurer, producer, or affiliate of a member insurer may not make, publish, disseminate, circulate, or place before the public, or cause directly or indirectly to be made, published, disseminated, circulated, or placed before the public, in a newspaper, magazine, or other publication, or in the form of a notice, circular, pamphlet, letter, or poster, or over a radio station or television station, or in any other way, any advertisement, announcement, or statement written or oral, that uses the existence of the association for the purpose of sales, solicitation, or inducement to purchase any form of insurance or coverage for which the guaranty association provides coverage under this part.(1)(b) This section does not apply to:(1)(b)(i) the association; or(1)(b)(ii) another entity that does not sell or solicit insurance.(2)(2)(a) The association shall:(2)(a)(i) have a summary document describing the general purposes and current limitations of this part that complies with Subsection (3); and(2)(a)(ii) submit the summary document described in Subsection (2)(a)(i) to the commissioner for approval.(2)(b) A member insurer may not deliver a policy or contract to a policy owner, contract owner, certificate holder, or enrollee unless the summary document is also delivered to the policy owner, contract owner, certificate holder, or enrollee before, or at the time of, delivery of the policy or contract.(2)(c) The summary document shall be available upon request by a policy owner, contract owner, certificate holder, or enrollee.(2)(d) The distribution, delivery, or contents or interpretation of the summary document does not guarantee that:(2)(d)(i) the policy or the contract is covered in the event of the impairment or insolvency of a member insurer; or(2)(d)(ii) the policy owner, contract owner, certificate holder, or enrollee is covered in the event of the impairment or insolvency of a member insurer.(2)(e) The summary document shall be revised by the association as amendments to this part may require.(2)(f) Failure to receive the summary document as required in Subsection (2)(b) does not give the policy owner, contract owner, certificate holder, enrollee, or insured any greater rights than those stated in this part.(3)(3)(a) The summary document described in Subsection (2) shall contain a clear and conspicuous disclaimer on its face.(3)(b) The commissioner shall, by rule, establish the form and content of the disclaimer described in Subsection (3)(a), except that the disclaimer shall:(3)(b)(i) state the name and address of:(3)(b)(i)(A) the association; and(3)(b)(i)(B) the department;(3)(b)(ii) prominently warn a policy owner, contract owner, certificate holder, or enrollee that:(3)(b)(ii)(A) the association may not cover the policy or contract; or(3)(b)(ii)(B) if coverage is available, it is:(3)(b)(ii)(B)(I) subject to substantial limitations and exclusions; and(3)(b)(ii)(B)(II) conditioned on continued residence in the state;(3)(b)(iii) state the types of policies or contracts for which the association will provide coverage;(3)(b)(iv) state that the member insurer and the member insurer’s producers are prohibited by law from using the existence of the association for the purpose of sales, solicitation, or inducement to purchase any form of insurance;(3)(b)(v) state that the policy owner, contract owner, certificate holder, or enrollee should not rely on coverage under the association when selecting an insurer;(3)(b)(vi) explain the rights available and procedures for filing a complaint to allege a violation of this part; and(3)(b)(vii) provide other information as directed by the commissioner including sources for information about the financial condition of insurers provided that the information:(3)(b)(vii)(A) is not proprietary; and(3)(b)(vii)(B) is subject to disclosure under public records laws.(4)(4)(a) An insurer, or the insurer’s producer, may not deliver a policy or contract described in Subsection 31A-28-103(6) and wholly excluded under Subsection 31A-28-103(7)(a) from coverage under this part unless the insurer or the insurer’s producer, prior to or at the time of delivery, gives the policy owner, contract owner, certificate holder, or enrollee a separate written notice that clearly and conspicuously discloses that the policy or contract is not covered by the association.(4)(b) The commissioner shall by rule specify the form and content of the notice required by Subsection (4)(a).(5) A member insurer shall retain evidence of compliance with Subsection (2) for the later of:(5)(a) three years; or(5)(b) until the conclusion of the next market conduct examination by the department of insurance where the member insurer is domiciled.