(a) No person, including a member insurer or agent or affiliate of a member insurer shall 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 any newspaper, magazine, or other publication, or in the form of a notice, circular, pamphlet, letter, or poster, or over any radio or television broadcast, or in any other way, any advertisement, announcement, or statement, written or oral, that uses the existence of the Tennessee life and health insurance guaranty association for the purpose of sales, solicitation, or inducement to purchase any form of insurance or other coverage covered by this part. However, this section does not apply to the Tennessee life and health insurance guaranty association or any other entity that does not sell or solicit insurance or coverage by a health maintenance organization.
Terms Used In Tennessee Code 56-12-218
Association: means the Tennessee life and health insurance guaranty association created under §. See Tennessee Code 56-12-203
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.
Insurance: means life, annuity, and health benefits provided under a contract issued by a member insurer. See Tennessee Code 56-12-203
Member insurer: means an insurer, health maintenance organization, or nonprofit hospital and medical service organization licensed or that holds a certificate of authority to transact in this state any kind of insurance or health maintenance organization business for which coverage is provided under §. See Tennessee Code 56-12-203
Person: means an individual, corporation, limited liability company, partnership, association, governmental body or entity, or voluntary organization. See Tennessee Code 56-12-203
State: means a state, the District of Columbia, Puerto Rico, and a United States possession, territory, or protectorate. See Tennessee Code 56-12-203
written: includes printing, typewriting, engraving, lithography, and any other mode of representing words and letters. See Tennessee Code 1-3-105
(b) The association shall prepare a summary document that describes the general purposes and current limitations of this part and that complies with subsection (c). This document must be submitted to the commissioner for approval. At the expiration of the sixtieth day after the date on which the commissioner approves the document, a member insurer shall not deliver a policy or contract to a policy owner, contract owner, certificate holder, or enrollee unless the summary document is delivered to the policy owner, contract owner, certificate holder, or enrollee at the time of delivery of the policy or contract. The document must also be available upon request by a policy owner, contract owner, certificate holder, or enrollee. The distribution, delivery, or contents or interpretation of this document does not guarantee that either the policy or the contract, or the policy owner, contract owner, certificate holder, or enrollee is covered in the event of the impairment or insolvency of a member insurer. The association shall revise the document as amendments to this part require. Failure to receive the summary document does not give the policy owner, contract owner, certificate holder, enrollee, or insured any greater rights than those stated in this part.(c) The document prepared under subsection (b) must contain a clear and conspicuous disclaimer on its face. The commissioner shall establish the form and content of the disclaimer. The disclaimer must:
(1)State the name and address of the Tennessee life and health insurance guaranty association and department of commerce and insurance;(2) Prominently warn the policy owner, contract owner, certificate holder, or enrollee that the Tennessee life and health insurance guaranty association may not cover the policy or contract or, if coverage is available, it will be subject to substantial limitations and exclusions and conditioned on continued residence in this state;(3) State the types of policies or contracts for which guaranty funds will provide coverage;(4) State that the member insurer and its agents are prohibited by law from using the existence of the Tennessee life and health insurance guaranty association for the purpose of sales, solicitation, or inducement to purchase any form of insurance or health maintenance organization coverage;(5) State that the policy owner, contract owner, certificate holder, or enrollee should not rely on coverage under the Tennessee life and health insurance guaranty association when selecting an insurer or health maintenance organization;(6) Explain the rights available and procedures provided for filing a complaint to allege a violation of this part; and(7) Provide other information as directed by the commissioner, including, but not limited to, sources for information about the financial condition of insurers; provided, that the information is not proprietary or is not protected from disclosure under Tennessee’s public records law.(d) A member insurer shall retain evidence of compliance with subsection (b) for so long as the policy or contract for which the notice is given remains in effect.
