§ 51.1. Definitions.
The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:
Advertisement—Printed and published material, audio visual material and descriptive literature of a company used in direct mail, newspapers, magazines, radio scripts, TV scripts, billboards and similar displays; descriptive literature and sales aids of all kinds issued by a company, 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 prepared sales talks, presentations and material for use by agents, brokers or solicitors, and any representations made in connection therewith.
Commissioner—The Commissioner of the Pennsylvania Insurance Department.
Company—An association, individual, corporation, partnership, reciprocal or interinsurance exchange, Lloyds, hospital plan corporation, professional health services plan corporation, fraternal benefit society, beneficial society, voluntary nonprofit health service plan and any other legal entity issuing to Commonwealth residents a contract of insurance as defined in this chapter and subject to appropriate regulation by the Department.
Compliance standards—The criteria by which an advertisement would be judged acceptable by the Department as not being deceptive, misleading or otherwise in violation of the Unfair Insurance Practices Act (40 P. S. § § 1171.1—1171.15) or other applicable law or regulation.
Contract—A policy, plan, certificate issued by a fraternal benefit society, agreement, statement of coverage, binder, rider or endorsement which provides insurance or service benefits.
Department—The Insurance Department of the Commonwealth.
Exception—A provision in a contract whereby coverage for a specified risk is entirely eliminated.
Invitation to inquire—An advertisement which is designed to attract the reader’s interest in the contract advertised so that he will inquire for further details and information.
Limitation—A provision other than an exception or reduction which restricts coverage or benefits under the contract.
Mail-order solicitation—An advertisement which is designed specifically to market a contract to a prospective insured where the application for the contract is made by mail. A mail-order solicitation does not include the following:(i) Material which relates to the renewal of an existing contract, when the renewal does not affect the benefits available, coverage included or rates payable under the contract.
(ii) An invitation to inquire.
Publication—The circulation of an advertisement by any means, whereby the advertisement may reasonably be expected to reach prospective or present policyholders in this Commonwealth.
Reduction—A provision which reduces the amount of the benefit which would otherwise be payable either by limitation as to dollar amount or by limitation as to period of time.
Source The provisions of this § 51.1 amended May 21, 1976, effective May 22, 1976, 6 Pa.B. 1135. Immediately preceding text appears at serial pages (15132) and (13286).
Cross References This section cited in 31 Pa. Code § 89.1 (relating to definitions); and 31 Pa. Code § 154.16 (relating to information for enrollees).
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