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INTRODUCTIONIn 1965, 52 million accidental injuries killed 107,000, temporarilydisabled over 10 million and permanently impaired 400,000American citizens at a cost of approximately $18 billion. Thisneglected epidemic of modern society is the nation's most impor-tant environmental health problem. It is the leading cause of deathin the first half of life's span.Although 49,000 deaths in 1965 were due to motor-vehicleaccidents, more than this number died from accidents at work, inthe home, in other forms of transportation, in public buildings,in recreational activities, etc.Public apathy to the mounting toll from accidents must betransformed into an action program under strong leadership. Thiscan be accomplished by the methods employed to bring poliomye-litis and other epidemics under control, and to make frontal attacksto conquer cancer, heart disease, and mental disease. Federal andvoluntary agencies have mobilized to prevent and treat birthdefects, muscular dystrophy, sclerosis, and palsy. Such concertedattacks have been mounted by conduct of national conferences atthe Executive level, appropriation of funds by the Congress, pool-ing of resources by lay and professional groups through voluntaryhealth agencies, expansion of research, and implementation ofprograms at regional and community levels. Basic to this unifiedapproach is identification of the individual citizen with a meansby which he can satisfy the inherent desire to serve his fellow man.Accidental death and disability too, can be attacked by suchconcerted actions.This report summarizes current practices and deficiencies atvarious levels of emergency care. Salient factors which requireearly solutions are:The general public is insensitive to the magnitude of the problemof accidental death and injury.Millions lack instruction in basic first aid.Few are adequately trained in the advanced techniques of cardio-pulmonary resuscitation, childbirth, or other lifesaving measures,yet every ambulance and rescue squad attendant, policeman, fire-
fighter, paramedical worker and worker in high-risk industry shouldbe trained.Local political authorities have neglected their responsibility toprovide optimal emergency medical services.Research on trauma has not been supported or identified at theNational Institutes of Health on a level consistent with its impor-tance as the fourth leading cause of death and the primary causeof disability.Potentials of the U. S. Public Health Service programs in accidentprevention and emergency medical services have not been fullyexploited.Data are lacking on which to determine the number of individualswhose lives are lost or injuries are compounded by misguidedattempts at rescue or first aid, absence of physicians at the scene ofinjury, unsuitable ambulances with inadequate equipment anduntrained attendants, lack of traffic control, or the lack of voicecommunication facilities.Helicopter ambulances have not been adapted to civilian peace-time needs.Emergency departments of hospitals are overcrowded, some arearchaic, and there are no systematic surveys on which to baserequirements for space, equipment, or staffing for present, let alonefuture, needs.Fundamental research in shock and trauma is inadequatelysupported.Medical and health-related organizations have failed to joinforces to apply knowledge already available to advance the treat-ment of trauma, or to educate the public and inform the Congress.Specific recommendations follow discussions of the various levelsof emergency care. Major steps toward a total national effortinclude:Conduct of National Conferences on Emergency Medical ServicesUnder medical leadership, national forums should be conducted atthe highest levels on all subjects important to total emergency carefrom the time of receipt of an injury through rehabilitation. Thepublic must be aroused and full, informed of present practices,shortcomings in emergency services, and wave in which optimal carecan be assured.Establishment of a 'national Trauma AssociationResponsible professional and lay organizations should pool theirefforts through a voluntary National Trauma Association as a meansof stimulating public demand for accident prevention and emergencymedical services and satisfying these needs through research, publicand professional education, and community services.6
Organization of Community Councils on Emergency Medical ServicesIn each community, coordination of lay and professional responsi-bilities for emergency medical care should be centralized in acouncil on emergency services. A council would serve to coordinateteaching programs on basic and advanced first aid of the Red Cross,the Medical Self-Help Program of the Public Health Service, cardio-pulmonary resuscitation of the American Heart Association, andothers. It would bring together the resources of chapters of theRed Cross and the National Safety Council, committees on traumaof the American College of Surgeons, local and county medicalsocieties of the American Medical Association, health departments,civic bodies, scouts, and others, to procure equipment, constructfacilities and ensure optimal emergency care on a day-to-day basisas well as in disaster or national emergency. Councils could serve asactive units to implement measures and to share in the contributionsand benefits of nationwide programs of a National Trauma Associ-ation and other voluntary health and allied agencies devoted toemergency medical services.Formation of a National Council on Accident PreventionThis report is concerned primarily with emergency care indicatedafter receipt of an injury and deals only briefly with problems ofaccident prevention. All pertinent research in this field should bereviewed. An analysis is in order of the several safety acts pertainingto government departments with administrative responsibility inaccident prevention. The newly established Department of Trans-portation deals not only with motor vehicles but also with aviation,railroads, and other forms of transport. Other departments deal withmining, industry, flammable clothing, foods, and drugs. There aremany common denominators of human behavior, environment, andmechanization applicable to each of these areas and their identifi-cation is essential to a systematic attack on this vital problem.Creation of a National Institute of TraumaAppropriated funds should be earmarked in support of the programof research in the therapy of trauma recently announced by theNational Institute of General Medical Sciences. This would includeprocessing of grant requests for research related to shock andtrauma which are now considered by numerous Institutes. Trainingfor academic careers and fellowships in traumatology should besupported. These combined activities call for establishment underthe U. S. Public Health Service of a National Institute of Trauma.7Next: The Magnitude of the Problem »
NEW YORK STATE DEPARTMENT OF FINANCIAL SERVICESReview Standards for Individual Accident Insurance or Accidental Death & Dismemberment InsuranceIndividual Accident/Accidental Death & Dismemberment Insurance Checklistfor SERFF Filings (As of 9.20.19)Instructions for SERFF ChecklistA. For ALL filings, the “General Requirements for All Filings” section in this checklist MUST be completed.B. For a FORM filing, completion of additional sections of this checklist may be required as follows depending on the type of form being submitted: Policy: Complete the “Policy Forms” section.Rider or Endorsement: Complete all items in the “Policy Form” section relevant to the form being submitted.Application: Complete the “Application Forms” section.C. For filing of initial rates, complete the section entitled “Actuarial Section For New Product Rate Requirements” in addition to completion of the applicableform sections identified above. For filing of rate changes to existing products (increases, decreases, or change in rate calculation rules or procedures),complete the “Actuarial Section for Existing Product Rate Requirements” section. For filing of any other changes to rate or underwriting manuals (e.g.,changes in commissions or underwriting), complete the “Actuarial Section for Existing Product Rate Requirements” section.D. For each item, enter in the last column the form number(s) and page number(s) where the requirement is met in the filing.E. Instructions for Citations. All citations to Insurance regulations link to the Department of State website and an unofficial copy of the NYCRR. Pleaseselect title 11 for Department regulations. Most of the pertinent form and rate regulations are located in Chapter III Policy and Certificate Provisions,Subchapter A Life, Accident and Health Insurance. All citations to New York Laws (Insurance Laws or other New York laws) link to the public LRSwebsite. To locate the Insurance Laws, please select the link labeled “ISC.”https://www.dfs.ny.gov/1 OF 27Individual Accident/Accidental Death & Dismemberment Insurance (as of 9.20.19)
Accidental Death Definition
NEW YORK STATE DEPARTMENT OF FINANCIAL SERVICESReview Standards for Individual Accident Insurance or Accidental Death & Dismemberment InsuranceLINE OF BUSINESS:CODE:Individual Accident/Accidental Death & Dismemberment InsuranceLINE(S) OF INSURANCECODESH02IH03IHealth-Accident OnlyHealth-Accidental Death & ENERALREQUIREMENTS FORALL FILINGSFILING SUBMISSIONFiling Description in SERFFhttps://www.dfs.ny.gov/REFERENCEDESCRIPTION OF REVIEW STANDARD REQUIREMENTSNote: Unless otherwisenoted, all references areto Insurance Law,Insurance Regulations,and DepartmentInsurance CircularLetters and Office ofGeneral Counsel(“OGC”) opinionsNote: This checklist is intended to provide guidance in the preparation of policy forms forsubmission and is not intended as a substitute for statute or regulation.11 NYCRR 52.33Circular Letter No. 33(1999)Supplement 1 to CL No.33 (1999)The SERFF filing description must contain the following: The identifying form number of each form submitted. § 52.33(a) If the form being submitted is a policy, the filing description must indicate that the policy issubmitted pursuant to 11 NYCRR 52.9. § 52.33(b) Whether the form is new or supersedes an approved or filed form. § 52.33(c) If the form supersedes an approved or filed form, the filing description must state the formnumber and date of approval or filing of the superseded form and any material differencesfrom the superseded form. § 52.33(d) If the approval of the superseded form is still pending, the filing description must includethe state tracking number, form number, and the submission date. § 52.33(d) If the form had previously been submitted for preliminary review, the filing descriptionmust include a reference to the previous submission and a statement setting out either thatthe form agrees precisely with the previous submission or the differences from the formsubmitted for preliminary review. § 52.33(e) If the form is other than a policy, the filing description must identify the form number andapproval date of the policy or policies with which it will be used. If the form is for generaluse, the Department may accept a description of the type of policy with which it may beused in lieu of the form number and approval date. § 52.33(g) If the form is a policy, the filing description must identify the form numbers and dates ofapproval of any applications previously approved to be used with the policy unless theapplication is required to be attached to the policy upon submission. § 52.33(h) If the policy is designed to be used with insert pages, the filing description must contain astatement of the insert page forms which must always be included in the policy and a list ofall optional pages, together with an explanation of their use. § 52.33(i)2 OF 27LOCATION OFSTANDARD INFILINGIndividual Accident/Accidental Death & Dismemberment Insurance (as of 9.20.19)
NEW YORK STATE DEPARTMENT OF FINANCIAL SERVICESReview Standards for Individual Accident Insurance or Accidental Death & Dismemberment InsuranceForm Requirements§ 3201(c)§ 3217(b)11 NYCRR 52.1(c)11 NYCRR 52.31Flesch Score§ 3102(c)Fraternal Benefit Society§ 4501(p)§ 4504(g)§ 4512(a)§ 4527(b)Individual Insurance Type§ 321611 NYCRR 52.2(k)11 NYCRR 52.1911 NYCRR 52.70https://www.dfs.ny.gov/Note: SERFF filing descriptions should advise as to whether the policy is intended for internetsales and should describe any proposed electronic procedures, and/or the proposed use ofelectronic signatures associated with the sale of the policy.Each form in the filing must meet the following requirements: The provisions of the form are NOT misleading or unreasonably confusing. § 3217(b)(2),§ 52.1(c) The provisions of the form provide substantial economic value to the policyholder. §3217(b)(5), § 52.1(c) The provisions of the form are NOT unjust, unfair, inequitable, misleading, or deceptive tothe policyholder. §§ 3201(c)(3), 3217(b) The form contains no strikeouts. § 52.31(b) The form is designated by a form number made up of numerical digits and/or letters in thelower left-hand corner of the first page. § 52.31(d) The form is submitted in the form intended for actual use. § 52.31(e) All blank spaces are filled in with hypothetical data. § 52.31(f) If the form contains illustrative material, it is only used for items which may vary from caseto case, such as names, dates, eligibility requirements, and premiums and schedules fordetermining the amount of insurance for each insured person. A full explanation of thenature and scope of the variable material, contained in an Explanation or Memorandum ofVariable Material, should be uploaded to the Supporting Documentation tab in SERFF. §52.31(l) If the form is available to spouses or dependents, select only one:The spouse/dependent receives their own individually issued policy; ORThe spouse/dependent is covered under the one policy issued to the primary insured.Provide Flesch score certification (the Flesch score should be at least 45). The number of words,sentences and syllables in the policy form should be set forth as part of the certification, whichmust be signed by an officer of the company.If the insurer is a Fraternal Benefit Society, the policy includes a provision that states that if itsreserves as to any class of certificates, other than those portions of any certificate that providevariable benefits based on the experience of a separate account, become impaired, its board ofdirectors may require that there shall be paid by the member to the society the amount of themember’s equitable proportion of such deficiency as ascertained by its board. If the payment isnot made it shall stand as an indebtedness against the certificate and draw interest not to exceedfive percent per annum compounded annually, or the equivalent effective rate of interest ifpayable in advance, or in lieu thereof, or in combination therewith, the member may consent toa reduction of the corresponding insurance benefit proportionate to the value of the additionalcontributions.The maximum accident disability benefits may not exceed 1,250 a month.Select only one of the types of insurance listed below:INDIVIDUAL. Insurance qualifies as Individual coverage when it meets the followingrequirements:3 OF 27Individual Accident/Accidental Death & Dismemberment Insurance (as of 9.20.19)
NEW YORK STATE DEPARTMENT OF FINANCIAL SERVICESReview Standards for Individual Accident Insurance or Accidental Death & Dismemberment Insurance NO premium discount for the policy for group or quasi-group market methods. Note:An individual filing may have a premium discount for factors such as spousal/domesticpartner status, preferred risk, etc.; Individual minimum loss ratio; Available to any individual in the general public; No exclusivity granted to the insurer by the employer or association if sold at aworksite; No sponsorship; No mass marketing; Regular sales method on a one-to-one basis; No employer or association contributions toward premium; and Insurer may have a premium remittance agreement with an employer or association thatis willing to participate in a payroll deduction arrangement, but the agreement isirrelevant to how the coverage is being sold.LIST BILL. Insurance qualifies as List Bill coverage when it meets the followingrequirements: Very few of the individual policies are sold at a common site or address (employer orassociation); No exclusivity granted to the insurer by the employer or association; No mass marketing; No employer or association funds are contributed toward premium, but employer orassociation does/does not remit insured’s premium payment. The individualpolicyholder pays the entire premium; When the “list bill” arrangement ceases for any reason, the premium discount for “listbill,” if any, increases to the regular individual rate. The increase in rate upon cessationof the arrangement is disclosed prominently on the cover page of the policy or the policyschedule AND in the application; and The premium discount for “list bill,” if any, is no greater than 10%.Rider or Endorsementhttps://www.dfs.ny.gov/11 NYCRR 52.16(e)(2)11 NYCRR 52.17 (a)(5),(6), (12), (14)11 NYCRR 52.31(a)FRANCHISE. Insurance qualifies as Franchise coverage when it meets the followingrequirements: Franchise definition per 11 NYCRR 52.2(k); All form content requirements for franchise per 11 NYCRR 52.19; Class and participation requirements per 11 NYCRR 52.70(b) and (c); and Policy states whether rates will increase when franchise relationship ends. If the rateswill increase, the increase in rate upon cessation of the arrangement is disclosedprominently on the cover page of policy or the policy schedule AND in the application.If the rider or endorsement provides a benefit for which a specific premium is charged, thepremium is shown on the application, rider or elsewhere in the policy. § 52.17(a)(14)If the rider or endorsement will be issued with an existing “guaranteed renewable” policy, suchrider will be made available at the option of the insured. §§ 52.17(a)(5), (6)4 OF 27Individual Accident/Accidental Death & Dismemberment Insurance (as of 9.20.19)
What Is Accidental Death Insurance
NEW YORK STATE DEPARTMENT OF FINANCIAL SERVICESReview Standards for Individual Accident Insurance or Accidental Death & Dismemberment InsuranceIf the rider or endorsement reduces or eliminates coverage after policy issuance, it provides forsigned acceptance by the insured. § 52.17(a)(12)New policy forms must comply with any statutory requirements without the use of amendatoryriders or endorsements except for minor changes. Previously approved policies may have ridersattached to comply with New York law, but only if it does not cause the policy in its entirety tomislead or confuse the policyholder. § 52.31(a)Table of Contents§ 3102(c)(1)(G)Vending Machine11 NYCRR 52.17(b)(2)APPLICATION FORMSAttestation of UnderlyingComprehensive MedicalInsurance§ 3201(c)(3)§ 3217(b)(5)11 NYCRR 52.1(c)Authorization11 NYCRR 420.18(b)Discrimination§ 2606§ 2607§ 2608Circular Letter No. 3(2016)Electronic ApplicationNote: For waivers issued as a condition of insurance, renewal or reinstatement, see 11 NYCRR52.16(e)(2).A table of contents is required for policies that are over 3,000 words or more than three pagesregardless of the number of words.If the policy form will be sold by a vending machine, the insurer must attach information andthe directions used in connection with the vending machine.Form & Page Number§ 3201(c)(1)11 NYCRR 52.31(e)The application policy form to be completed by a prospective insured should include thefollowing acknowledgment: I ACKNOWLEDGE THAT I HAVE MAJOR MEDICALINSURANCE OR SIMILAR COMPREHENSIVE HEALTH INSURANCE COVERAGE. Yes NoIf the application includes an authorization to disclose non-public personal health information,the authorization specifies the length of time the authorization will remain valid. The maximumallowable period is 24 months.No insurer or entity shall refuse to issue any insurance policy, or cancel or decline to renew thepolicy or otherwise unfairly discriminate because of race, color, creed, national origin, disability,sex, and marital status, or engage in sexual stereotyping. “Sex” includes sexual orientation,gender identity or expression and transgender status.No insurer or entity shall refuse to issue or renew, or shall cancel any insurance policy becauseof any past treatment for a mental disability of the insured. An issuer may refuse to issue, renew,or cancel a policy if the issuer relies on sound underwriting and actuarial principles reasonablyrelated to actual or anticipated loss experience.If an insurer is seeking approval to use a previously approved paper application in electronicformat, screen shots of the previously approved paper application must be filed for reference forinformational purposes. Any drop downs, pop-ups, FAQs, or linked material that could appearin the application process must be included either within the screen shots or as a supportingdocument provided for informational purposes.If an insurer is seeking approval of an application not previously approved that will only beavailable in an electronic format (i.e., will be completed and signed electronically) and there isno corresponding paper application, then screen shots must be submitted for approval as theapplication form. In this case, the screen shots must contain a distinct form number in the lowerleft corner and must comply with all applicable application requirements. Reflexive material,including drop down options, must be submitted for approval in a corresponding Explanation ofVariable Material. Include any pop-ups, FAQs, or linked material that could appear in theapplication process as a supporting document provided for informational purposes.https://www.dfs.ny.gov/5 OF 27Individual Accident/Accidental Death & Dismemberment Insurance (as of 9.20.19)
Examples Of Accidental Death
NEW YORK STATE DEPARTMENT OF FINANCIAL SERVICESElectronic Delivery ofDocumentsExtra-hazardous ActivitiesReview Standards for Individual Accident Insurance or Accidental Death & Dismemberment InsuranceNY Technology LawBefore an insurer transmits policy forms or any other documents to an insured electronically, itmust obtain the insured’s consent. If the insured refuses to consent to receiving documentsArticle IIIOGC Opinion No. 09-01- electronically, the insurer must send a hard copy of the policy forms or other documents to thatinsured.01OGC Opinion No. 05-1128§ 1113(a)(17)(E)If the application contains questions as to whether the applicant has engaged in or contemplatesparticipation in a number of specified activities, the insurer will adhere to the following11 NYCRR 52.2(i)Regulation 62 guidelines regarding “extra-hazardous” activities, defined by 11 NYCRR 52.2(i)11 NYCRR 52.16(e)(2)as aviation and related activities, such as sky diving and parachuting, and participation as aprofessional in athletics or sports. Participation as a professional in athletics or sports means anindividual who would qualify for insurance under Insurance Law § 1113(a)(17)(E).An insurer may exercise the following options depending upon whether the activity engaged inby the applicant is an extra-hazardous activity as defined by 11 NYCRR 52.2(i). If the activityengaged in by the applicant is within the definition of an extra-hazardous activity, the insurermay elect one of four options:a. The insurer may issue a standard risk policy;b. The insurer may decline to issue any policy at all;c. The insurer may place a waiver, approved by the Department, on the policy decliningcoverage for accidents arising out of such activities; ord. The insurer may charge additional premiums for providing coverage for such activities.If the activity engaged in is not within the definition of an extra-hazardous activity, the insurermust issue a standard risk policy or decline to issue any policy at all.Fraternal Benefit SocietyFraud Warning Statement§ 4501(a)§ 4505§ 4512§ 403(d)11 NYCRR 86.4(d)Future Activities11 NYCRR 52.1(c)Health Questions11 NYCRR 52.51(b)Note: Where waivers are required as a condition of issuance, renewal or reinstatement, signedacceptance by the insured is required unless on initial issuance the full text of the extrahazardous activity exclusion is contained either on the first page or specification page of thepolicy. For additional information, see the “Extra-hazardous Activities” section under“Permissible Exclusions and Limitations.”If the insurer is a fraternal benefit society, the application asks if the applicant is a member and,if the applicant is not a member, the application requires the person to apply for membership.All applications must contain the prescribed fraud warning statement. The fraud warningstatement must be placed directly above the signature line and printed in such a way that it isconspicuous to the insured such as by using bold font or larger font size.Applications should not inquire about open ended future activities or the future intent of theapplicant (such as asking if the insured ever plans on leaving the country) as these are undulyspeculative. Questions should be limited to present intent or present plans.Any question of past or present health of any person that refers to a specific disease or generalhealth must be asked “to the best of the applicant’s knowledge and belief.”Note: This does not apply to questions about factual information such as doctor visits or hospitalconfinements.https://www.dfs.ny.gov/6 OF 27Individual Accident/Accidental Death & Dismemberment Insurance (as of 9.20.19)
NEW YORK STATE DEPARTMENT OF FINANCIAL SERVICESInsurance with Other InsurersInvestigative Consumer ReportMedical Information ExchangeCenterMultiple Levels of Applicationsand/or UnderwritingOther Insurance in This InsurerPre-Existing ConditionsProhibited Questions andProvisionsRepresentations not WarrantiesTelephone or In-PersonInterviewhttps://www.dfs.ny.gov/Review Standards for Individual Accident Insurance or Accidental Death & Dismemberment Insurance§ 3216(d)(2)(D)If the application is used with a policy subject to Insurance Law §§ 3216(d)(2)(D) or3216(d)(2)(E), “Insurance with Other Insurers,” the application contains a question requiring§ 3216(d)(2)(E)information with respect to other insurance.11 NYCRR 52.51(h)General Business Law §If an Investigative Consumer Report will be prepared or procured, a notice complying withGeneral Business Law § 380-c is included in the application OR in a separate form.380-cIf a Medical Information Exchange Center (such as a Medical Information Bureau) will be used,§ 321the insurer complies with Insurance Law § 321.§ 4224(b)If more than one level of medical and financial underwriting (e.g., full underwriting, simplifiedunderwriting, or guaranteed issue) is used for a policy, or multiple applications are used, attacha full explanation of:a.
Individual Accident/Accidental Death & Dismemberment Insurance Checklist for SERFF Filings (As of 9.20.19) Instructions for SERFF Checklist A. For ALL filings, the “General Requirements for All Filings” section in this checklist MUST be completed. B. For a FORM filing, completion of additional sections of this checklist may be required as .