State RegulationsMA specificDifficulty 2/5
An insurer solicits an applicant for an individual accident and health policy. Under 211 CMR 42.09 and M.G.L. c. 175, § 110E, what must the solicitation include so the applicant can understand the coverage being offered?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
211 CMR 42.09 and M.G.L. c. 175, § 110E require an outline of coverage in the sale of individual accident and health insurance. The outline is a standardized summary of the policy's principal benefits, exclusions, and terms, giving the applicant a readable basis for comparing policies before purchase. Its purpose is informed comparison; materials that serve underwriting, marketing history, or producer compensation do not satisfy the requirement.
Why the other options are wrong
- A) A pre-signed blank records release serves the insurer's underwriting convenience, not the applicant's understanding; the outline-of-coverage requirement is what the advertising rules demand.
- C) Historical claim-denial lists are not part of the required solicitation materials under 211 CMR 42.09 and M.G.L. c. 175, § 110E.
- D) Commission schedules concern producer compensation and are not applicant disclosures required by the outline-of-coverage rules.
Memory hook
Sell the summary, not the mystery: the outline of coverage goes with the pitch.