ILLINOIS: The Director of the Illinois Department of Insurance issued a bulletin to all health insurance carriers and HMOs in late December regarding health coverage rescission documentation requirements. Illinois health carriers can rescind a health policy only “when an insured has provided a false statement in an application which materially affected the acceptance of a risk or hazard assumed.”  

The DOI indicates that when a consumer files a complaint about a rescission, it will measure the effect of the false statement by examining the insurer’s underwriting guidelines. Thus, the carrier will be required to respond to rescission complaints by providing a “full and complete copy of its underwriting guidelines,” including any supplements, appendices, or exhibits. 

The underwriting guidelines must be submitted free from redactions, deletions, or exclusions.  Clarifications on the bulletin are being sought because of the potential for requiring release of proprietary information.

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