Iowa Administrative Code

under Iowa Code section 507B.4. [ARC 7733C, IAB 3/20/24, effective 4/24/24]

policies and certificates except: 1. Variable life insurance; 2. Individual and group annuity contracts; 3. Credit life insurance; or 4. Life insurance policies or certificates with initial face amounts of $10,000 or less. [ARC 7733C, IAB 3/20/24, effective 4/24/24]…

“Actuarial Standards Board” means the board established by the American Academy of Actuaries to develop and promulgate standards of actuarial practice. “Contract premium” means the gross premium that is required to be paid under a fixed premium policy, including the premium for a…

14.5(1) Each insurer marketing policies to which these rules are applicable shall notify the commissioner whether a policy form is to be marketed with or without an illustration. For policy forms filed after February 1, 1997, the illustration identification shall be made at the t…

14.6(1) An illustration used in the sale of a life insurance policy shall satisfy the applicable requirements of these rules, be clearly labeled “life insurance illustration” and contain the following basic information: a. Name of insurer; b. Name and business address of producer…

14.7(1) Format. A basic illustration shall conform with the following requirements: a. The illustration shall be labeled with the date on which it was prepared. b. Each page, including any explanatory notes or pages, shall be numbered and show its relationship to the total number…

14.8(1) A supplemental illustration may be provided so long as: a. It is appended to, accompanied by or preceded by a basic illustration that complies with these rules; b. The nonguaranteed elements shown are not more favorable to the policyowner than the corresponding elements b…

14.9(1) If a basic illustration is used by an insurance producer or other authorized representative of the insurer in the sale of a life insurance policy and the policy is applied for as illustrated, a copy of that illustration, signed in accordance with these rules, shall be sub…

of conduct by identifying unfair methods of competition and unfair or deceptive acts or practices in the business of insurance, as prohibited by Iowa Code chapter 507B. [ARC 7734C, IAB 3/20/24, effective 4/24/24]

15.10(1) Contents of notice. Automobile insurance policies delivered in this state shall include a notice that contains and is limited to the following language: NOTICE REGARDING UNINSURED/UNDERINSURED COVERAGE Uninsured/underinsured coverage does not cover damage done to your ve…

15.11(1) Sex discrimination. a. A contract shall not be denied to an individual based solely on that individual’s sex or marital status. No benefits, terms, conditions or type of coverage shall be restricted, modified, excluded, or reduced on the basis of the sex or marital statu…

virus. 15.12(1) Written release. No insurer shall obtain a test of any individual in connection with an application for insurance for the presence of an antibody to the human immunodeficiency virus unless the individual to be tested provides a written release on a form that conta…

15.13(1) Complaint and business records. a. An insurer shall maintain its books, records, documents and other business records in such an order that data regarding complaints, claims, rating, underwriting and marketing are accessible and retrievable for examination by the insuran…

15.14(1) If, after hearing, the commissioner determines that a person has engaged in an unfair trade practice in violation of these rules, an unfair method of competition, or an unfair or deceptive act or practice in violation of Iowa Code chapter 507B, the commissioner shall red…

DIVISION II CLAIMS

“Advertisement” for the purpose of these rules means material designed to create public interest in insurance or an insurer, or to induce the public to purchase, increase, modify, reinstate or retain a policy including: 1. Printed and published material, audio and visual material…

15.3(1) Form and content of advertisements. The format and content of an advertisement shall be truthful and sufficiently complete and clear to avoid deception or the capacity or tendency to misrepresent or deceive. Whether an advertisement has a capacity or tendency to misrepres…

settlement of a loss or claim under a specific coverage that contains language purporting to release the insurer or its insured from total liability. [ARC 7734C, IAB 3/20/24, effective 4/24/24]

provisions apply: 15.32(1) Definitions and scope. a. For purposes of this rule, the following definitions apply: “Circumstance requiring special treatment” means: 1. A claim that an insurer has a reasonable basis to suspect may be fraudulent or that fraud or a material misreprese…

15.33(1) Prohibitions. This rule applies to all claims paid on or after January 1, 2002: a. Absent a reasonable basis to suspect fraud, an insurer may not audit a claim more than two years after the submission of the claim to the insurer. Nothing in this rule prohibits an insurer…

15.4(1) The definition of terms applicable to this rule and its appendices will be found in Appendix I. 15.4(2) Except as hereafter exempted, this rule shall apply to any solicitation, negotiation or procurement of life insurance occurring within this state. This rule shall apply…

this rule, “insurer” means property and casualty insurers. 15.41(1) An insurer shall fully disclose to first-party claimants all pertinent benefits, coverages or other provisions of a policy or contract under which a claim is presented. 15.41(2) Within 30 days after receipt by th…

purposes of this rule, “insurer” means property and casualty insurers. 15.42(1) Upon receiving notification of a claim, an insurer shall, within 15 days, acknowledge the receipt of such notice unless payment is made within that period of time. If an acknowledgment is made by mean…

15.43(1) Loss calculation and deviation guidelines. a. Loss calculation. When the insurance policy provides for the adjustment and settlement of first- party automobile total losses on the basis of actual cash value or replacement with another automobile of like kind and quality,…

15.44(1) Replacement cost. When the policy provides for the adjustment and settlement of first-party losses based on replacement cost, the following shall apply: a. When a loss requires repair or replacement of an item or part, any consequential physical damage incurred in making…

15.45(1) Identification. All aftermarket crash parts supplied for use in this state shall comply with the identification requirements of Iowa Code section 537B.4. 15.45(2) Like kind and quality. An insurer shall not require the use of aftermarket crash parts in the repair of an a…

DIVISION III DISCLOSURE FOR SMALL FACE AMOUNT LIFE INSURANCE POLICIES

Medicare supplement insurance is prohibited. [ARC 7734C, IAB 3/20/24, effective 4/24/24]

information to the purchasers of small face amount life insurance policies. The rules in this division apply to all small face amount policies not exempted under rule 191—15.53(507B) that are issued on or after July 1, 2004. [ARC 7734C, IAB 3/20/24, effective 4/24/24]

an initial face amount of $15,000 or less. [ARC 7734C, IAB 3/20/24, effective 4/24/24]

certificates except: 1. Variable life insurance; 2. Individual and group annuity contracts; 3. Credit life insurance; 4. Group or individual policies of life insurance issued to members of an employer group or other permitted group when: • Every plan of coverage was selected by t…

15.54(1) An insurer issuing a small face amount policy shall provide the disclosure included in Appendix IV if at any point in time over the term of the policy the cumulative premiums paid may exceed the face amount of the policy at that point in time. The required disclosure sha…

to policyholders or certificate holders that ask questions about the disclosure statement. [ARC 7734C, IAB 3/20/24, effective 4/24/24]

DIVISION IV ANNUITY DISCLOSURE REQUIREMENTS

for the disclosure of certain minimum information about annuity contracts to protect consumers and to foster consumer education. The rules specify the minimum information that must be disclosed, the method for disclosing it and the use and content of illustrations, if used, in co…

rule for which applications are taken on or after January 1, 2013, except that rule 191—15.66(507B) applies to all annuities not exempted under this rule that are in effect or for which applications are taken on or after January 1, 2013, and except that rule 191—15.67(507B) appli…

“Buyer’s Guide” means the National Association of Insurance Commissioners’ approved Annuity Buyer’s Guide. “Contract owner” means the owner named in the annuity contract or the certificate holder in the case of a group annuity contract. “Determinable elements” means elements that…

15.64(1) Delivery methods. The documents required under this rule may be delivered as follows: a. When an application for an annuity contract is taken in a face-to-face meeting, the applicant shall be given at or before the time of application both the disclosure document describ…

b. When an application for an annuity contract is taken by means other than a face-to-face meeting, the applicant shall be sent both the disclosure document and the Buyer’s Guide no later than five business days after the completed application is received by the insurer. c. When …

15.66(1) An insurer or producer may elect to provide a consumer an illustration at any time, provided that the illustration is in compliance with this rule and: a. Is clearly labeled as an illustration; b. Includes a statement referring consumers to the disclosure document and Bu…

nonguaranteed elements and for deferred annuities in the accumulation period, the insurer shall provide each contract owner with a report, at least annually, on the status of the contract that contains at least the following information: 15.67(1) The beginning and ending date of …

insurer or producer that violates a requirement of these rules shall be guilty of a violation of Iowa Code chapter 507B. [ARC 7734C, IAB 3/20/24, effective 4/24/24]

person or circumstance is for any reason held to be invalid by any court of law, the remainder of the rule and its application to other persons or circumstances shall not be affected. [ARC 7734C, IAB 3/20/24, effective 4/24/24]

DIVISION V SUITABILITY IN ANNUITY TRANSACTIONS

191—15.74(507B), to act in the best interest of the consumer when making a recommendation of an annuity and to require insurers to establish and maintain a system to supervise recommendations so that the insurance needs and financial objectives of consumers at the times of the tr…