Accident and Health Insurance Electronic Application Guidance
This guidance applies to all electronic applications for accident and health insurance contracts, policies, and certificates delivered or issued for delivery in New York pursuant to Insurance Law § 3201(b). An electronic application is any electronic form signed by an applicant that is used to obtain information from the applicant for use in determining acceptance or rejection of the applicant for insurance. Insurance Circular Letter No. 2 (1975).
2. Types of Electronic Filings
- No Filing Required
A filing to obtain electronic approval is not required when a previously approved paper application will be filled out electronically by an agent based on an applicant’s answers, the application is subsequently printed out in a format identical to the previously approved paper application, and the applicant signs the application in paper form with a “wet” signature. Under these circumstances, the applicant does not use an electronic system for any part of the application process. If the applicant will view, complete, or sign an electronic form, then a new filing seeking approval of the electronic form is required.
- Electronic Approval Extended Filing
If an insurer is seeking approval to use a previously approved paper application in electronic format, and the electronic format is identical to the previously approved paper application (e.g., a fillable PDF version of the paper application), then an extension of approval filing should be submitted under the filing type “Approval Extended.” An extension of approval is only available when there are no changes to the approved form. The General Information tab in SERFF should provide the State and/or SERFF tracking number, form number, and date of approval of the approved paper application form. The filing should also contain a description of the electronic application process. Screen shots of the previously approved paper application should be uploaded to the Supporting Documentation tab in SERFF. An extension of approval does not require a new form number. The screen shots of the electronic application process, including any drop downs, pop-ups, FAQs, or linked material, should be uploaded to the Supporting Documentation tab in SERFF. Following review of an acceptable “Approval Extended” submission, the form will be granted an extension of approval.
- Electronic Application Form Filing
If an insurer is seeking approval of an electronic application that is not identical to a previously approved paper application or a paper application currently pending approval, screenshots should be submitted for approval as the application policy form using the filing type “Normal Pre-Approval.” In this case, the screenshots should contain a distinct form number in the lower left corner of the first screen shot and should comply with all applicable paper and electronic application requirements. Reflexive material, including drop down options, should be submitted for approval in a corresponding Explanation of Variable Material. Any pop-ups, FAQs, or linked material that could appear in the application process should be uploaded to the Supporting Documentation tab in SERFF.
3. Type of Electronic Format
Application forms submitted for approval should be submitted in the form intended for actual use.
- The Filing Description in SERFF should state the type of electronic format being requested (e.g., internet, telephone, agent’s laptop), and whether the application will employ wet signatures, telephonic voice signatures, or other electronic signatures. The exact use should be described. General descriptions, such as use in “an electronic format” are not sufficient. The insurer’s procedure for collecting, transmitting, storing, and protecting electronic information should be provided.
- If electronic signatures, including telephonic voice signatures, will be used, the insurer should confirm compliance with New York’s Electronic Signatures and Records Act (“ESRA”), the federal Electronic Signatures in Global and National Commerce Act (“E-SIGN”), and Insurance Circular Letter No. 33 (1999).
4. Electronic Applications Supplemental Worksheet
All electronic application submissions should include a completed copy of the Electronic Application Supplemental Worksheet uploaded to the Supporting Documentation tab in SERFF.
5. Consent for Electronic Transactions, Signatures, and Delivery of Insurance Documents
- Transactions. An applicant must be able to choose between applying via a paper application or an electronic application. The insurer should provide clear language to the applicant prior to the start of the application process demonstrating that the applicant is consenting to do business electronically and that, alternatively, the applicant may request a paper copy of the application. This language should also explain how the applicant may obtain a paper copy of an application.
Prior to the applicant consenting to do business electronically, the applicant should be provided with a statement of the hardware and software requirements for access to and retention of the electronic records. When the applicant consents, it should be done in a manner that demonstrates they were able to access the information that was the subject of their consent. E-SIGN (15 U.S.C. § 7001(c)(1)(C)).
- Signatures. An electronic signature must be voluntary. The insurer should provide clear language within the application demonstrating that the applicant is consenting to sign the form electronically. If the applicant refuses to sign the form electronically, the insurer should provide the applicant with a paper copy of the application to complete.
- Delivery of Insurance Documents. Under both ESRA and E-SIGN (N.Y. State Technology Law § 309 and 15 U.S.C. § 7001(c), respectively), the insured’s acceptance of electronic delivery of insurance documents is voluntary. The applicant must opt-in to electronic delivery of insurance documents, including disclosures, notices, and policy forms. Before an insurer transmits insurance documents to an applicant electronically it should obtain the applicant’s consent. Insurers who require electronic delivery of insurance documents as a condition to applying electronically should present the applicant with clear disclosure language at the beginning of the electronic application process that demonstrates that the applicant is consenting to do business electronically and consenting to electronic delivery of insurance documents.
For telephonic and agent-assisted electronic applications, the telephonic script that is read to the applicant should include disclosure language that states that the applicant is consenting to do business electronically and consenting to electronic delivery of insurance documents. The insurer should upload the telephonic script to the Supporting Documentation tab in SERFF.
For applicants who do not consent to receiving insurance documents electronically, the applicant must have the option to complete a paper application and receive paper copies of insurance documents. Additionally, an insured who is enrolled in electronic delivery of policy forms or other insurance documents should be able to opt-out of electronic delivery and receive paper copies of insurance documents at any time. The electronic application process should identify the page number of the electronic application where the applicant is informed of the paper copy option and should also explain how an insured can withdraw their consent at any time and receive insurance documents only in paper format.
6. Miscellaneous Electronic Form Requirements
- The insurer should provide each applicant with the opportunity to print and retain all documents accessed during the electronic application process (including consents and disclosures) or provide future electronic access to the documents. This can be achieved either by notifying the applicant that they should print copies for their own record, providing the applicant with access to a “user account” on the insurer’s website where these documents can be accessed later, or providing the applicant an opportunity to receive copies in paper format (which an insurer shall provide upon request).
- The insurer should review and comply with the requirements imposed by E-SIGN, ESRA, and the Cybersecurity Requirements for Financial Services Companies in 23 NYCRR Part 500.
- The insurer should provide the applicant an opportunity to review all answers provided on the application prior to completing and signing the electronic application. For electronic applications, this may be achieved by allowing an applicant to review all answers provided prior to signing the application, or by displaying a PDF preview of the application that is populated with the answers the applicant provided. For telephonic applications, the insurer should email the applicant a copy, direct the applicant to a website where they can preview the completed application, or mail the applicant a physical copy of the completed application to review.
- The fraud warning for accident and health insurance applications shall be placed immediately above the space provided for the signature of the person executing the application or claim form and shall be printed in type which will produce a warning statement of conspicuous size. The fraud warning should be bolded or appear in a font size that is larger than the surrounding text. The fraud warning cannot appear in a pop-up or separate window.
7. Requirements for Telephonic Applications
- For telephonic applications, the insurer shall submit a transcript containing the application questions that will be asked by the licensed New York insurance agent or broker during the application process. Follow up questions that are asked during a “Part B” or underwriting interview need not be asked by a licensed New York insurance agent or broker. The telephone script should be uploaded to the Supporting Documentation tab in SERFF so that it can be filed for reference.
- The insurer should conduct the interview in the following manner:
- Any questions raised during the interview are limited to those questions appearing on the approved application (i.e., questions over the phone would be no different than those asked in the approved application).
- The applicant will have an opportunity to review and make corrections to those statements that were attributed to the applicant in the interview.
- Any information obtained in the interview that will be used in the underwriting process will be reduced to writing, signed by the applicant, and attached to the contract, policy, or certificate in compliance with Insurance Law § 3204.