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Long Term Insurance Act, 1998 (Act No. 52 of 1998)

Regulations

Regulations under the Long-term Insurance Act, 1998

Part 7 : Contracts Identified as Health Policies under Section 72(2A)(a) of the Act

7.6 Reporting requirements

 

(1) An insurer must, at least 1 month prior to marketing or offering a new product line, submit to the Authority and Authority of Medical Schemes a summary of the benefits, terms and conditions and marketing material of the health policy or policies forming part of the product line.

 

(2) The Authority may at any time request information on the benefits, terms, conditions and marketing material of a contract that, in the opinion of the Authority or the Authority of Medical Schemes, is or may be a contract referred to under regulation 7.2(1).

 

(3) The Authority of Medical Schemes may at any time advise the Authority that the Authority of Medical Schemes is of the opinion that the benefits, terms and conditions or marketing material relating to a contract under subregulation (1) or (2) is contrary to the objectives and purpose of the Medical Schemes Act and the principles referred to in sections 72(2A)(b)(i)(cc)(A) to (C) of the Act, and the reasons for this opinion.

 

(4) The Authority may at the Authority's own accord or after due consideration of an opinion of the Authority of Medical Schemes referred to under subregulation (3), by notice to an insurer, object to any of the benefits, terms and conditions and marketing material of a health policy under subregulation (1) and (2), and instruct the insurer to –
(a) stop marketing the health policy or policies;
(b) stop offering or renewing the health policy or policies to the public and within 90-days of the date determined by the Authority, terminate such health policy or policies; or
(c) by a date determined by the Authority, amend any of the benefits, terms and conditions and marketing material of a health policy or policies in accordance with the requirements of the Authority.