(a) All certificates and contracts covered by G.S. 58-66-35 must be printed in a type face at least as large as 10 point modern type, one point leaded, be written in a logical and clear order and form, and contain the following items:
(1) On the cover, first, or insert page of the certificate a statement that the certificate is a legal contract between the certificate owner and the insurer, and the statement, printed in larger or other contrasting type or color, "Read your certificate carefully";
(2) An index of the major provisions of the certificate, which may include the following items:
a. The person or persons insured by the certificate;
b. The applicable events, occurrences, conditions, losses, or damages covered by the certificate;
c. The limitations or conditions on the coverage of the certificate;
d. Definitional sections of the certificate;
e. Provisions governing the procedure for filing a claim under the certificate;
f. Provisions governing cancellation, renewal, or amendment of the certificate by either the insurer or the subscriber;
g. Any options under the certificate; and
h. Provisions governing the insurer's duties and powers in the event that suit is filed against the subscriber.
(b) In determining whether or not a certificate is written in a logical and clear order and form the Commissioner must consider the following factors:
(1) The extent to which sections or provisions are set off and clearly identified by titles, headings, or margin notations;
(2) The use of a more readable format, such as narrative or outline forms;
(3) Margin size and the amount and use of space to separate sections of the policy; and
(4) Contrast and legibility of the colors of the ink and paper, and the use of contrasting titles or headings for sections. (1979, 2nd Sess., c. 1161, s. 1.)
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Last modified: March 23, 2014