NDAC 45-06-04-03
Definitions
Cite as N.D. Admin. Code ยง 45-06-04-03
1.
An "advertisement" for the purpose of this chapter includes:
a.
Printed and published material, audio visual material, and descriptive literature of an
insurer, agent, or broker used in direct mail, newspapers, magazines, radio scripts,
television scripts, billboards, and similar displays;
b.
Descriptive literature, identification cards, and sales aids of all kinds used by an insurer,
agent, or broker for presentation to members of the insurance buying public, including,
but not limited to, circulars, business calling cards, lead cards, surveys, leaflets, booklets,
depictions, illustrations, and form letters; and
c.
Prepared sales talks, presentations, and material for use by agents, brokers, and
solicitors.
2.
"Exception" for the purpose of this chapter means any provision in a policy whereby coverage
for a specified hazard is entirely eliminated; it is a statement or a risk not assumed under the
policy.
3.
"Institutional advertisement" for the purpose of this chapter means an advertisement having as
its sole purpose the promotion of the reader's or viewer's interest in the concept of accident
and sickness insurance, or the promotion of the insurer.
4.
"Insurer" for the purposes of this chapter includes any individual, corporation, association,
partnership, reciprocal exchange, interinsurer, Lloyds, fraternal benefit society, nonprofit health
service corporation, health maintenance organization, and any other legal entity which is
defined as an "insurer" in the insurance code of this state and is engaged in the advertisement
of an insurance policy as "policy" is defined in this section.
5.
"Invitation to contract" for the purpose of this chapter means an advertisement which is neither
an invitation to inquire nor an institutional advertisement.
6.
"Invitation to inquire" for the purpose of this chapter means an advertisement having as its
objective the creation of a desire to inquire further about the product and which is limited to a
brief description of the loss for which the benefit is payable, and which may contain:
a.
The dollar amount of benefit payable, and/or
b.
The period of time during which the benefit is payable; provided the advertisement does
not refer to cost. An advertisement which specifies either the dollar amount of benefit
payable or the period of time during which the benefit is payable must contain a provision
in effect as follows:
"For costs and further details of the coverage, including exclusions, any reductions
or limitations and the terms under which the policy may be continued in force, see
your agent or write to the company."
7.
"Limitation" for the purpose of this chapter means any provision which restricts coverage
under the policy other than an exception or a reduction.
8.
"Policy" for the purpose of this chapter includes any policy, plan, certificate, contract,
agreement, statement of coverage, rider, or endorsement which provides disability benefits, or
medical, surgical, or hospital expense benefits, whether on an indemnity, reimbursement,
service, or prepaid basis, nursing home benefits, long-term care insurance benefits, and
Medicare supplement benefits.
9.
"Reduction" for the purpose of this chapter means any provision which reduces the amount of
the benefit; a risk of loss is assumed but payment upon the occurrence of such loss is limited
to some amount or period less than would be otherwise payable had such reduction not been
used.