{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-3611","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-3611","heading":"Grounds for disapproval of forms - Prevention of delivery","body":"of certain policies - Exemptions.\n\nA. The Insurance Commissioner shall disapprove any form of\n\npolicy, application, rider or endorsement or withdraw any previous\n\napproval thereof only:\n\n1. If it is in any respect in violation of or does not comply\n\nwith this code, including Section 4509 of this title or any other\n\napplicable statute in the State of Oklahoma;\n\n2. If it contains or incorporates by reference any\n\ninconsistent, ambiguous, or misleading clauses, or exceptions and\n\nconditions which deceptively affect the risks purported to be\n\nassumed in the general coverage of the contract; and\n\n3. If it has any title, heading, or other indication of its\n\nprovisions which is misleading.\n\nB. 1. No individual or family accident and health insurance\n\npolicy, shall be delivered, or issued for delivery, in this state\n\nunless:\n\na. accompanied by an appropriate outline of coverages in\n\nplain and simple language, in no less than 10-point\n\ntype, and provided further, at the top of the front\n\npage of the outline of coverage, in no less than 14-\n\npoint type, shall state the policy described herein is\n\na limited policy or a substandard policy or other\n\nappropriate information, as prescribed by the\n\nInsurance Commissioner, and\n\nb. an appropriate outline of coverage is completed and\n\ndelivered to the applicant at the time application is\n\nmade, and an acknowledgment of receipt or certificate\n\nof delivery of such outline is provided to the insurer\n\nwith the application.\n\nIn the case of a direct response, such as a written application\n\nto the insurance company from an applicant, the outline of coverage\n\nshall accompany the policy when issued.\n\n2. Such outline of coverage shall contain:\n\na. a statement identifying the applicable category of\n\ncoverage afforded by the policy as based on the\n\nminimum basic standards set forth in the rules and\n\nregulations issued to effect compliance with paragraph\n\n3 of this section and Title 36 of the Oklahoma\n\nStatutes,\n\nb. a brief description of the principal benefits and\n\ncoverage provided in the policy,\n\nc. a summary statement of the principal exclusions and\n\nlimitations or reductions contained in the policy,\n\nincluding, but not limited to, pre-existing\n\nconditions, probationary periods, elimination periods,\n\nand any age limitations or reductions,\n\nd. a summary statement of the renewal provision,\n\nincluding any reservation of the insurer of a right to\n\nchange premiums, and\n\ne. a statement that the outline contains a summary only\n\nof the details of the policy as issued or of the\n\npolicy as applied for and that the issued policy\n\nshould be referred to for the actual contractual\n\ngoverning provisions.\n\n3. The department shall adopt rules and regulations which\n\nestablish minimum standards for the general content of forms of\n\nindividual and family health policies, which shall be inclusive of\n\nterms of renewability, initial and subsequent conditions of\n\neligibility, termination of insurance, probationary periods,\n\nexclusions, limitations, and reductions. The minimum standards\n\nexpressed in such rules and regulations shall be in addition to, and\n\nin accordance with, individual accident and sickness policy\n\nprovisions as provided in this title.\n\n4. The department shall adopt rules and regulations which\n\nestablish minimum standards of benefits and identification for each\n\nof the following categories of coverage in individual and family\n\nforms, other than conversion policies, of accident and health\n\ninsurance:\n\na. basic hospital expense insurance,\n\nb. basic medical expense insurance,\n\nc. basic surgical expense insurance,\n\nd. hospital confinement indemnity insurance,\n\ne. major medical expense insurance,\n\nf. disability income protection insurance,\n\ng. accident-only insurance, and\n\nh. limited benefit insurance.\n\nNothing in this section shall preclude the issuance of any\n, of accident and health\n\ninsurance:\n\na. basic hospital expense insurance,\n\nb. basic medical expense insurance,\n\nc. basic surgical expense insurance,\n\nd. hospital confinement indemnity insurance,\n\ne. major medical expense insurance,\n\nf. disability income protection insurance,\n\ng. accident-only insurance, and\n\nh. limited benefit insurance.\n\nNothing in this section shall preclude the issuance of any\n\npolicy which combines two or more of the categories of coverage\n\nenumerated in subparagraphs a through e, or any policy which does\n\nnot meet the prescribed minimum standards for categories of coverage\n\nin subparagraphs a through g when such policy is, in the opinion of\n\nthe department, either experimental in nature or is demonstrated to\n\nbe a type of coverage that will fulfill a reasonable need of the\n\nperson or persons to be insured. Any policy so approved will be\n\nidentified as to category only as prescribed by the department.\n\n5. The department may, within such time as provided by law for\n\nthe disapproval of an individual or family form of accident or\n\nhealth insurance, group accident and health insurance, or life and\n\nannuity insurance, disapprove any such form if it finds that it does\n\nnot comply with applicable law in this state or it finds that such\n\nform is unjust, unfair, or inequitable to the policyholder, any\n\nperson insured thereunder, or any beneficiary. In acting upon any\n\nsuch submission, the Commissioner shall, under this section,\n\nconsider whether the benefits afforded under the submitted policy or\n\nbenefit form would fulfill a reasonable need of a policyholder.","path":["OK Code","Title 36"],"source_url":"https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os36.pdf","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:36Z","sha256":"b4a504d5d981b66284806e54683b565cf88e612cfcc08aa6e7ecbf9b803028ac","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-3610","next":"us-ok/okla.-stat.-tit.-36-36-3611.1"},"notice":"GroundRules: Original legal text. Not legal advice."}