50 Ill. Adm. Code 1705.40
Construction of All Forms Issued by Fraternal Benefit Societies
Section 1705
Section 1705.40 Construction
of All Forms Issued by Fraternal Benefit Societies
a) Certificates issued under Section 288(2) of the Illinois
Insurance Code may be issued in connection with or separate from life
certificates issued under Section 288(1). Because such certificates must
conform, as far as practical, to Article XX and Department Rules and
Regulations pertaining to Accident and Health Benefits, (50 Ill. Adm. Code
Subchapter z) it is urged that they not be issued as a part of, supplemental
to, or attached to life certificates.
b)
1) Societies may provide for only one application to be made for
both the life and the accident and health insurance, a copy of the application
is made a part of each certificate. This procedure may be used only when the
life and the accident and health certificates are to be issued concurrently.
2) A combined application must set forth the amount of life
insurance and the amount of the accident and health insurance in addition to
the contribution for each class of insurance.
c) Societies must state on the face of the certificate, in
addition to the name of the Society, "Fraternal Benefit Society".
d)
1) Riders, endorsements or supplemental agreements, must contain
the name of the Society, a descriptive title, the date of execution, the
signature of at least one officer of the Society, and a statement indicating
the form is attached to and made a part of certificate number _______, issued
on the life of ___________________.
2) Endorsements printed or rubber stamped on the policy do not
require the name of the Society or a statement with reference to the
endorsement being attached to and made a part of the policy. Such imprinted or
stamped endorsements must receive approval by this Department.
e) Application questions:
1) Applications must be composed of questions by the Society in
the form of clear and direct interrogatories permitting the answers by the
applicant only in the form of direct statements and may not contain any
questions or representations based upon indefinite or ambiguous terms.
2) Questions in the application must be broken down so that each
answer thereto pertains to related disease or conditions.
f) All forms submitted to the Department for approval must be
submitted in duplicate with illustrative data filled in as when prepared for
issue and must be accompanied by a "Certificate of Compliance" in
substantially the form appended hereto as Exhibit A.
g) The Certificate must have a copy of the application, including
evidence of insurability, attached to the form when submitted. Where
provisions of the constitution or by-laws will affect the status of the
members, in respect to his insurance, and those provisions are not contained in
the certificate, reference to the constitution and/or by-laws must be made in
the letter of transmittal in order that the Department may properly determine
the effect of those provisions on the certificate.
h) Each form submitted to the Department must contain a form
number which is to appear in the lower left corner of the first page and the
filing back in addition to a descriptive title to be imprinted thereon. The
form number may appear in as many additional places on the form as the Society
may desire.
i) The letter of submission for new forms should include the
form number and approval date of any form being discontinued or being replaced.
j) All copies of forms submitted to the Department will be
retained by the Department. Under no circumstances will copies of forms be
returned to Societies with the Department stamp of approval thereon. Notice of
approval will be given by letter only.