Accidental death and dismemberment, disability income filing requirements
File the following:
Title of insurance, form number location, etc, see RCW 48.20.012 (www.leg.wa.gov)
- John Doe schedule page,
- John Doe application,
- Rates - fill out rates section of the Uniform Transmittal form.
- Actuarial memo, see WAC 284-60-050 (www.leg.wa.gov) and RCW 48.70 (www.leg.wa.gov) - Specified disease insurance act.
- General rules and minimum standards, see WAC 284-50-330 (www.leg.wa.gov) and WAC 284-50-335 (www.leg.wa.gov).
- Cannot combine limited benefit, specified disease, specified accident and Medicare supplemental coverage with other types of insurance, see RCW 48.20.460 (www.leg.wa.gov).
Subrogation, insured made whole (Thiringer - Bulleting 79-4)
WAC 284-30-620 (www.leg.wa.gov) - Permissible time limit for benefits payable because of accidental injury or death.
WAC 284-50-315 (www.leg.wa.gov) - Policy definitions.
WAC 284-50-320 (www.leg.wa.gov) - Prohibited policy provisions.
WAC 284-50-330 (www.leg.wa.gov) - General rules as to minimum standards.
WAC 284-50-365 (www.leg.wa.gov) - Specified disease and specified accident coverage.
WAC 284-50-377 (www.leg.wa.gov) - Experimental and investigational prescriptions, treatments, procedures, or service - Definition required - Standard for definition - Written notice of denial required - Appeal process required.
RCW 48.18.190 (www.leg.wa.gov) - Policy must contain entire contract.
RCW 48.20.042 through .152 (www.leg.wa.gov) - Standard provisions.
RCW 48.20.172 through .272 (www.leg.wa.gov)- Optional provisions.
RCW 48.20.420 (www.leg.wa.gov) - Dependent child coverage - Continuation for incapacity.
RCW 48.20.490 (www.leg.wa.gov) - Continuation of coverage by former spouse and dependents.
Waiver, rider, endorsements
- Signed acceptance by insured when limiting, excluding or reducing benefits, see WAC 284-50-320(7) (www.leg.wa.gov) - Prohibited policy provisions, WAC 284-50-375(2) (www.leg.wa.gov) - Required disclosure provisions, general rules, and RCW 48.20.015 (www.leg.wa.gov) - Endorsements.
- Option to cancel after five years when excluding, limiting or reducing benefits, see:
RCW 48.20.510 (www.leg.wa.gov) - Cancellation of rider.
File the following for in-state and out-of-state.
- Actuarial memorandum, see WAC 284-60-060 (www.leg.wa.gov) and RCW 48.70 (www.leg.wa.gov) - Specified disease insurance act.
- John Doe schedule of benefits page,
- Time limit for benefits, see WAC 284-30-620 (www.leg.wa.gov):
- WAC 284-96-015 (www.leg.wa.gov) - Experimental and investigational prescriptions, treatments, procedures, or services - Definition required - Standard for definition - Written notice of denial required - Appeal process required.
- RCW 48.21.050 through .090 (www.leg.wa.gov) - Standard provisions.
- RCW 48.21.110 (www.leg.wa.gov) - Payment of benefits.