Oklahoma § 36-4429 - Suitability standards

§ 36-4429. Suitability standards

A. 1. This section shall not apply to life insurance policies

or riders containing accelerated long-term care benefits.

2. For certificates issued on or after the effective date of

this act, under a group long-term care insurance policy as defined

in Section 4424 of Title 36 of the Oklahoma Statutes, which policy

was in force at the time this act became effective, the provisions

of this section shall not apply.

B. Every provider of long-term care insurance shall:

1. Develop and use suitability standards to determine whether

the purchase or replacement of long-term care insurance is

appropriate for the needs of the applicant;

2. Train its agents in the use of its suitability standards;

and

3. Maintain a copy of its suitability standards and make them

available for inspection upon request by the Insurance Commissioner.

Oklahoma Statutes - Title 36. Insurance

C. 1. To determine whether the applicant meets the standards

developed by the provider, the agent and provider shall develop

procedures that take the following into consideration:

a.

the ability to pay for the proposed coverage and other

pertinent financial information related to the

purchase of the coverage,

b.

the applicant's goals or needs with respect to longterm care and the advantages and disadvantages of

insurance to meet these goals or needs, and

c.

the values, benefits and costs of the applicant's

existing insurance, if any, when compared to the

values, benefits and costs of the recommended purchase

or replacement.

2. The provider and, where an agent is involved, the agent

shall make reasonable efforts to obtain the information set out in

paragraph 1 of this subsection. The efforts shall include, at or

prior to application, providing the applicant with a personal

worksheet and a disclosure form which have been prescribed by the

Commissioner and are consistent with the National Association of

Insurance Commissioners (NAIC) Long-Term Care Insurance Model

Regulation.

3. A completed personal worksheet shall be returned to the

provider prior to the provider's consideration of the applicant for

coverage, except that the personal worksheet need not be returned

for sales of employer group long-term care insurance to employees

and their spouses.

4. The sale or dissemination outside the company or agency by

the provider or agent of information obtained through the personal

worksheet is prohibited.

D. The provider shall use the suitability standards it has

developed pursuant to this section and information furnished by the

applicant in determining whether issuing long-term care insurance

coverage to an applicant is appropriate.

Added by Laws 1995, c. 244, § 3, eff. Nov. 1, 1995.