Ga. Comp. R. & Regs. R. 120-2-16-.15 - Reporting Requirements
(1) Every insurer shall maintain records for
each agent of that agent's amount of replacement sales as a percent of the
agent's total annual sales and the amount of lapses of long-term care insurance
policies sold by the agent as a percent of the agent's total annual
sales.
(2) Every insurer shall
report annually by June 30 the 10 percent of its agents with the greatest
percentages of lapses and replacements as measured by subsection (1) above.
(Appendix G)
(3) Reported
replacement and lapse rates do not alone constitute a violation of insurance
laws or necessarily imply wrongdoing. The reports are for the purpose of
reviewing more closely agent activities regarding the sale of long-term care
insurance.
(4) Every insurer shall
report annually by June 30 the number of lapsed policies as a percent of its
total annual sales and as a percent of its total number of policies in force as
of the end of the preceding calendar year. (Appendix G)
(5) Every insurer shall report annually by
June 30 the number of replacement policies sold as a percent of its total
annual sales and as a percent of its total number of policies in force as of
the preceding calendar year. (Appendix G)
(6) Every insurer shall report annually by
June 30, for qualified long-term care insurance contracts, the number of claims
denied for each class of business, expressed as a percentage of claims denied.
(Appendix E)
(7) For purposes of
this section:
(a) "Policy" means only
long-term care insurance;
(b)
Subject to paragraph (c), "claim" means a request for payment of benefits under
an in force policy regardless of whether the benefit claimed is covered under
the policy or any terms or conditions of the policy have been met;
(c) "Denied" means the insurer refuses to pay
a claim for any reason other than for claims not paid for failure to meet the
waiting period or because of an applicable preexisting condition; and
(d) "Report" means on a statewide
basis.
(8) Reports
required under this section shall be filed with the Commissioner.
Notes
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