Contact Person: Illinois Department 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

Line(s) of   Line(s) of  
Business   Insurance  

Credit Accident/Health Insurance

 

Credit Accident/Health Policies

 
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Word Document - Alteration of this document will result in rejection of the filing

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 REVIEW

STANDARDS 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 Department's web site for the Universal Transmittal Document (Etrans) by clicking this link.
Scroll down to "Universal Transmittal Document Software (Etrans)"
 
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.

 
Cover Letter and Letter of Submission

50 IL Adm. Code 1405.20 (e)
50 IL Adm. Code 2001.30 (a) (3)

50 IL Adm. Code 916.40 (b)

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).
 
Rates 215 ILCS 5/155.58(a)
50 IL Adm. Code 916.40 f)
Rates must be submitted with a uniform transmittal document and contain a unique filing number.  
GENERAL REQUIREMENTS FOR ALL FILINGS REFERENCE DESCRIPTION OF REVIEW STANDARDS REQUIREMENTS   
Credit Accident and Health Required Provisions 215 ILCS 5/155.51(b)
215 ILCS 5/155.52(b)

All accident and health insurance sold in connection with loans or otherwise made effective in connection with loans or other credit transactions of less than 10 years duration are subject to Article IX ½ of the Illinois Insurance Code.

Credit accident and health insurance means insurance on a debtor to provide indemnity for payments becoming due on a loan or other credit transaction while the debtor is disabled as defined in the policy.

 
Policy or Certificate Required 215 ILCS 5/155.56(a) All credit accident and health insurance must be provided in the form of an individual policy or certificate delivered to the debtor.  
Contents of Policy or Certificate 215 ILCS 5/155.56(b)

Each policy or certificate must include:

1.) the name and home office address of the insurer;

2.) the name or identify of the insured debtor;

3.) the rate or amount of payment;

4.) a description of the amount and the term of coverage;

5.) a description of any exceptions, limitations or restrictions;

6.) a statement that the benefits shall be paid to the creditor to reduce or extinguish the unpaid indebtedness; and,

7.) that any excess shall be payable to the beneficiary, other than the creditor, named by the debtor or to his/her estate.

 
Delivery of Policy or Certificate 215 ILCS 5/155.56(c)(d)

The individual policy or group certificate must be delivered to the debtor at the time the indebtedness is incurred.

In lieu thereof, the insured debtor must receive a copy of the signed application or a notice of the proposed insurance. The insured debtor must then receive the policy or certificate within 30 days of the date the indebtedness is incurred.

 
Termination of Insurance Prior to Scheduled Maturity Date 215 ILCS 5/155.58(b) The individual policy or group certificate must include a provision that in the event of termination prior to the scheduled maturity date of the indebtedness, any refund of an amount paid by the debtor for coverage shall be paid or credited promptly to the person entitled.  
Payments Made Prior to Issuance of Policy or Certificate 215 ILCS 5/155.58(c) If an insured debtor is required to make a payment prior to the time the policy or certificate is issued the creditor must provide a written notice of such and make the appropriate credit to the account.  
Existing Insurance 215 ILCS 5/155.61 If credit accident and health insurance is required as additional security for any indebtedness, the debtor may request of the creditor to be able to use existing policies owned or controlled by him/her, or of procuring the required coverage through any authorized insurer.  
ADMINISTRATIVE CODE PROVISIONS      
Minimum Hours Worked 50 IL Adm. Code 952.30

If the coverage is contingent upon the insured working a minimum number of hours per week there must be a question on the application asking whether the insured works the minimum number of hours.

If the coverage is guaranteed issue, then the policy or certificate must include a clear statement regarding the minimum number of hours that must be worked per week.

 
Required loss ratio standards 50 IL Adm. Code 952.40 The Department requires a fifty (50%) loss ratio for benefits to be deemed reasonable in relation to the premium.  
DEPARTMENT POSITIONS      
Truncated or Critical Period Disability Rates 215 ILCS 5/143(1) Truncated or critical period disability rates must be adjusted down for the shorter period of coverage.  
Truncated or Critical Period Disability 215 ILCS 5/143(1) There must be a prominent disclosure on the schedule page indicating that the disability coverage is not for the full period of the loan.  
Pre-Existing Conditions 215 ILCS 5/143(1) Benefits for loss due to pre-existing conditions during a period of 6 months before the effective date of coverage can only be denied for a period up to 6 months after the date of issue.