SECTION 365:10-3-3. Definitions

  The following words or terms, when used in this Part, shall have the following meaning, unless the context clearly indicates otherwise:

"Advertisement" means:

(A)   Printed and published material, audio-visual material, and descriptive literature of an insurer used in direct mail, newspapers, magazines, radio scripts, TV scripts, social media, billboards and similar displays; and

(B)   Descriptive literature and sales aids of all kinds issued by an insurer, person, agent or broker for presentation to members of the insurance buying public, including, but not limited to circulars, leaflets, booklets, depictions, illustrations, and form letters and lead-generating devices of all kinds as herein defined; and

(C)   Prepared sales talks, presentations and material for use by agents, persons, brokers, solicitors, announcers, celebrities and other persons and representations made by agents, persons, brokers, announcers, celebrities and other persons in accordance therewith.

"Exception" means any provision in a policy whereby coverage for a specified hazard is entirely eliminated; it is a statement of a risk not assumed under the policy.

"Insurer" means any individual, corporation, association, partnership, reciprocal exchange, inter-insurer, Lloyds, fraternal benefit society, health maintenance organization, and any other legal entity which is defined as an "insurer" in the Insurance Code of this state and is engaged in the advertisement of a policy as "policy" is herein defined.

"Lead-Generating Device" means any communication directed to the public which, regardless of form, content or stated purpose, is intended to result in the compilation or qualification of a list containing names and other personal information to be used to solicit residents of this State for the purchase of accident and sickness insurance.

"Limitation" means any provision which restricts coverage under the policy other than an exception or a reduction.

"Policy" means any policy, plan, certificate, contract, agreement, statement of coverage, rider or endorsement which provides accident, disability or sickness benefits, or medical, surgical or hospital expense benefits, whether or an indemnity reimbursement, service or prepaid basis, except when issued in connection with another kind of insurance other than life, and except disability, waiver of premium and double indemnity benefits included in life insurance and annuity contracts.

"Reduction" means any provision which reduces the amount of the benefit; a risk of loss is assumed but payment upon the occurrence of such loss is limited to some amount or period less than would be otherwise payable had such reduction not been used.

[Source: Amended at 10 Ok Reg 1471, eff 5-1-93; Amended at 32 Ok Reg 1930, eff 9-15-15]