Accidental death and dismemberment, disability income filing requirements

For individuals

File the following:

Policy:

• Renewal provision, see WAC 284-50-375(1) and RCW 48.18.298
• "Free look", minimum 10 days, see WAC 284-50-375(7) and RCW 48.20.013
• Title of insurance, form number location, etc, see RCW 48.20.012
• John Doe schedule page
• John Doe application
• Rates - fill out rates section of the Uniform Transmittal form
• Actuarial memo, see WAC 284-60-050 and RCW 48.70 - Specified disease insurance act
• General rules and minimum standards, see WAC 284-50-330 and WAC 284-50-335
• Cannot combine limited benefit, specified disease, specified accident and Medicare supplemental coverage with other types of insurance, see RCW 48.20.460

Standard provisions

Subrogation, insured made whole (Thiringer - Bulleting 79-4)

WAC 284-30-620 - Permissible time limit for benefits payable because of accidental injury or death

WAC 284-50-315 - Policy definitions

WAC 284-50-320 - Prohibited policy provisions

WAC 284-50-330 - General rules as to minimum standards

WAC 284-50-365 - Specified disease and specified accident coverage

WAC 284-50-377 - 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 - Policy must contain entire contract

RCW 48.20.042 through .152- Standard provisions

RCW 48.20.172 through .272- Optional provisions

RCW 48.20.420 - Dependent child coverage - Continuation for incapacity

RCW 48.20.490 - 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) - Prohibited policy provisions, WAC 284-50-375(2) - Required disclosure provisions, general rules, and RCW 48.20.015 - Endorsements
• Option to cancel after five years when excluding, limiting or reducing benefits, see:
• RCW 48.20.510 - Cancellation of rider

For groups

File the following for in-state and out-of-state.

• Policy
• Certificate
• Rates
• Actuarial memorandum, see WAC 284-60-060 and RCW 48.70 - Specified disease insurance act
• John Doe schedule of benefits page
• Time limit for benefits, see WAC 284-30-620

Standard provisions

• WAC 284-96-015 - 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- Standard provisions
• RCW 48.21.110 - Payment of benefits