1. Purpose

The purpose of this rule is to define the term "total disability" for purposes of the extension of benefits required by Title 24 M.R.S.A. § 2348 and Title 24-A M.R.S.A. § 2849-A.

2. Authority

This rule is promulgated pursuant to the authority vested in the Superintendent of Insurance under Title 24 M.R.S.A. § 2348 and Title 24-A M.R.S.A. §§ 212 and 2849-A.

3. Applicability and scope

This rule shall apply to all group contracts and policies which are subject to the requirements of Title 24 M.R.S.A. § 2348 and Title 24-A M.R.S.A. § 2849-A.

4. Definition

For purposes of determining eligibility for extension of benefits, "total disability" shall be defined no more restrictively than:

A. in the case of an insured who was gainfully employed prior to disability, "the inability to engage in any gainful occupation for which he or she is reasonably suited by training, education, and experience;" or

B. in the case of an insured who was not gainfully employed prior to disability, "the inability to engage in most normal activities of a person of like age in good health."

5. Transition

Any insurer subject to this rule that does not have approved forms which comply with this rule may continue to issue previously approved forms until complying forms are approved, providing the following conditions are met:

A. The previously approved forms must be in compliance with Title 24 M.R.S.A. § 2348 or Title 24-A M.R.S.A. § 2849-A; and

B. Complying forms must be filed on or before July 1, 1991.

6. Effective date

This rule shall be effective July 1, 1991.

History. -- Effective. 7-1-91.

History. -- Statutory Authority.--24 M.R.S.A. § 2348; 24-A M.R.S.A. §§ 212 and 2849A.

EFFECTIVE DATE (ELECTRONIC CONVERSION): January 14, 1997