1. (a) The Surrender Comparison Index Disclosure shall be given as a separate document upon delivery of the policy or earlier if requested by the life insurance applicant. If requested earlier, the index disclosure shall be provided as soon as reasonably possible.
2. (b) A disclosure that is minimally satisfactory to the Insurance Department is set forth in Appendix B. If the Appendix B disclosure will be used, a letter to that effect, prior to use, is adequate notification to the Department. However, if a disclosure different than Appendix B will be used, it must be filed with the Department for review prior to use.

3. (c) The Surrender Comparison Index Disclosure shall describe:

   1. (1) The name, age and sex of the insured.
   2. (2) The face amount of the policy.
   3. (3) The descriptive title of the policy, as ‘‘whole life, 20 year decreasing term, endowment at age 65,’’ and so forth.
   4. (4) The policy number of policy.
   5. (5) The 10-year Surrender Index and 20-year Surrender Index per $1,000 of face amount of basic insurance.
   6. (6) If applicable, the amount of the equivalent level annual dividend and termination dividend reflected in each Index.
   7. (7) If applicable, the dividend scale on which the reflected dividends are based.
   8. (8) An explanation of the purpose and use of the Surrender Comparison Index.
4. (d) Italicized material in the Appendix B disclosure statement has been included for explanatory purposes only and may not appear in copies of Appendix B used by insurers. Insurer’s Appendix B form should only indicate applicable terminology or designation in lieu of italicized material.

Source

The provisions of this § 83.55 amended through December 28, 1979, effective March 1, 1980, 9 Pa.B. 4251. Immediately preceding text appears at serial pages (42675) and (42676).

Cross References

This section cited in 31 Pa. Code § 90c.18 (relating to applications intended for use in mail order solicitations of life insurance).