760 IAC 2-9-1 Reporting

Sec. 1. (a) Every insurer shall maintain records for each insurance producer of that insurance producer's amount of replacement sales as a percent of the insurance producer's total annual sales and the amount of lapses of long term care insurance policies sold by the insurance producer as a percent of the insurance producer's total annual sales. (b) Each insurer shall report annually by June 30 the ten percent (10%) of its insurance producers with the greatest percentages of lapses and replacements as measured by subsection (a). (c) Reported replacement and lapse rates do not alone constitute a violation of insurance laws or necessarily imply wrongdoing. The reports are for the purpose of reviewing more closely insurance producer activities regarding the sale of long term care insurance. (d) Every insurer shall report annually by June 30 the number of the following: (1) Lapsed policies as a percent of its total annual sales and as a percent of its total number of policies in force as of the end of the preceding calendar year. (2) Replacement policies sold as a percent of its total annual sales and as a percent of its total number of policies in force as of the preceding calendar year. (3) Claims denied for each class of business as a percentage of claims. (e) For purposes of this rule: (1) "claim" means a request for payment of benefits under a policy in force regardless of whether the benefit claimed is covered under the policy and any terms or conditions of the policy have been met; (2) "denied" means the insurer refuses to pay a claim for any reason other than for claims not paid for failure to meet the waiting period or because of an applicable preexisting condition; (3) "policy" means only long term care insurance; and (4) "report" means on a statewide basis. (f) Reports required under this section shall be filed with the commissioner.