NAC688C.210. Request for verification of coverage of insured.

     1. A provider of viatical settlements or a broker of viatical settlements may submit a request for a verification of coverage of an insured to an insurer. The request must be:

     (a) Except as otherwise provided in subsection 3, on a written form in the format developed by the National Association of Insurance Commissioners for the submission of a request for verification of coverage of an insured by an insurer; and

     (b) Accompanied by a signed statement from the viator authorizing the provider of viatical settlements or broker of viatical settlements to submit the request for the verification of coverage.

     2. If an insurer receives a request for a verification of coverage of an insured that complies with the provisions of subsection 1, the insurer shall:

     (a) Respond to the request not later than 30 days after the date of the receipt of the request.

     (b) If the policy covering the insured is a policy of individual life insurance, submit to the provider of viatical settlements the following information:

          (1) The face value of the policy;

          (2) The original effective date of the policy, including the month, day and year;

          (3) A list of any changes made in the face value of the policy since the original effective date;

          (4) Whether the policy is:

               (I) A policy of whole life insurance;

               (II) A policy of term life insurance;

               (III) A policy of universal life insurance; or

               (IV) A policy of variable life insurance;

          (5) Whether the policy is participating or nonparticipating;

          (6) The current net death benefit of the policy, including, without limitation, any additional benefits provided by the policy, any interest accumulated under the policy, any premiums paid towards the policy and any dividends earned under the policy;

          (7) Complete information on any loans that are outstanding against the policy;

          (8) Complete information on any accelerated death benefits paid under the policy;

          (9) Whether the policy has lapsed because of nonpayment of the premium due on the policy;

          (10) The amount of the next premium scheduled to be paid on the policy;

          (11) The date the next premium schedule to be paid on the policy is due;

          (12) The mode of payment for the premiums on the policy;

          (13) Whether premiums on the policy are being paid under a waiver of premium benefit provision of the policy;

          (14) If the premiums on the policy are being paid under a waiver of premium benefit provision of the policy:

               (I) The effective date of the waiver of premium benefit;

               (II) When the waiver of premium benefit is reviewed; and

               (III) The next date scheduled to review the waiver of premium benefit;

          (15) Information regarding accelerated death benefits available under the policy, including:

               (I) The method for calculating the accelerated death benefit;

               (II) If a lien method is used for calculating the accelerated death benefit, the interest rate applied to the accelerated death benefit;

               (III) Whether there is an accelerated death benefit available to be paid under the policy; and

               (IV) If there is an accelerated death benefit available under the policy, whether the accelerated death benefit is assignable;

          (16) The name and address of the person for whom any assignment is made under the policy;

          (17) The current listing of beneficiaries under the policy and if any beneficiaries are irrevocable;

          (18) A list of all past beneficiaries under the policy and if any past beneficiaries are irrevocable;

          (19) Any active riders on the policy;

          (20) The name and address of the insurer responding to the request for a verification of coverage; and

          (21) The printed name, title and signature of the person completing the response to the request for a verification of coverage.

     (c) If the policy covering the insured is a policy of group life insurance or a certificate issued under a policy of group life insurance, submit to the provider of viatical settlements the following information:

          (1) The face value of the policy;

          (2) The original effective date of the policy, including the month, day and year;

          (3) A list of any changes made in the face value of the policy since the original effective date;

          (4) Whether the policy is:

               (I) A policy of whole life insurance;

               (II) A policy of term life insurance;

               (III) A policy of universal life insurance; or

               (IV) A policy of variable life insurance;

          (5) Whether the policy is participating or nonparticipating;

          (6) The current net death benefit of the policy, including, without limitation, any additional benefits provided by the policy, any interest accumulated under the policy, any premiums paid towards the policy and any dividends earned under the policy;

          (7) Complete information on any loans that are outstanding against the policy;

          (8) Complete information on any accelerated death benefits paid under the policy;

          (9) Whether the policy has lapsed because of nonpayment of the premium due on the policy;

          (10) The amount of the next premium scheduled to be paid on the policy;

          (11) The date the next premium schedule to be paid on the policy is due;

          (12) The mode of payment for the premiums on the policy;

          (13) Whether premiums on the policy are being paid under a waiver of premium benefit provision of the policy;

          (14) If the premiums on the policy are being paid under a waiver of premium benefit provision of the policy:

               (I) The effective date of the waiver of premium benefit;

               (II) When the waiver of premium benefit is reviewed; and

               (III) The next date scheduled to review the waiver of premium benefit;

          (15) Information regarding accelerated death benefits available under the policy, including:

               (I) The method for calculating the accelerated death benefit;

               (II) If a lien method is used for calculating the accelerated death benefit, the interest rate applied to the accelerated death benefit;

               (III) Whether there is an accelerated death benefit available to be paid under the policy; and

               (IV) If there is an accelerated death benefit available under the policy, whether the accelerated death benefit is assignable;

          (16) The name and address of the person for whom any assignment is made under the policy;

          (17) The current listing of beneficiaries under the policy and if any beneficiaries are irrevocable;

          (18) A list of all past beneficiaries under the policy and if any past beneficiaries are irrevocable;

          (19) Any active riders on the policy;

          (20) Whether the policy is self-insured or fully funded;

          (21) The amount of the basic insurance offered under the policy;

          (22) The effective date of the basic insurance offered under the policy;

          (23) Information on the premium for the basic insurance offered under the policy, including:

               (I) The amount of the premium paid by the employer;

               (II) The amount of the premium paid by the insured; and

               (III) The date the next premium is due;

          (24) Information on any supplemental insurance available under the policy, including the name of the insurer offering the supplemental insurance;

          (25) Information on the premium for the supplemental insurance offered under the policy, including:

               (I) The amount of the premium paid by the employer;

               (II) The amount of the premium paid by the insured; and

               (III) The date the next premium is due;

          (26) The name and address of the insurer responding to the request for a verification of coverage; and

          (27) The printed name, title and signature of the person completing the response to the request for a verification of coverage.

     3. An insurer and a provider of viatical settlements or broker of viatical settlements may agree in writing to:

     (a) Use a form for the submission of a request for the verification of coverage other than a form in the format developed by the National Association of Insurance Commissioners and required pursuant to paragraph (a) of subsection 1; and

     (b) Use a process for responding to a request for the verification of coverage other than the process required pursuant to subsection 2.

     4. An insurer shall not charge a fee to a provider of viatical settlements or broker of viatical settlements for responding to a request for a verification of coverage that exceeds any usual and customary charges that are applicable to an owner of the policy for similar services.

     5. An insurer may notify the owner of a policy or the insured covered under a policy that a provider of viatical settlements has submitted a request for a verification of coverage.

     (Added to NAC by Comm’r of Insurance by R180-03, eff. 11-15-2004)