CLHIA GuidelinesOne of the CLHIA's strategic objectives is to foster sound and equitable principles in the conduct of the business of member life and health insurers that carry on business in Canada.
CLHIA Guidelines are designed to promote consistent practices and standards for the life and health insurance industry and to reinforce the best interests of consumers and the industry.
The purpose of this Guideline is to set out practices for printed disclosure (i.e. hard copy or electronic) by life and health insurance companies about their products, and thereby promote the ability of consumers to make informed decisions about the products for which they apply.
Individual Variable Insurance Contracts (IVICs) Relating to Segregated Funds
This Guideline establishes industry standards for disclosure in point-of-sale IVIC documents and contracts, advertising disclosure, audit and accounting requirements, and minimum investment standards.
Group Life and Group Health Insurance
This Guideline is intended to help ensure consistent practices amongst member companies in the administration of a Group Insurance contract.
Coordination of Benefits-Group Health and Dental
This Guideline is intended to help foster consistency within the industry in situations where a Covered Individual can submit a Group Health or Group Dental claim to more than one plan.
This Guideline describes practices for providing consumers with information reasonably sufficient to make an informed decision about the insurance being made available. This Guideline also helps explain the applicability of more general CLHIA Guidelines to travel insurance.
This Guideline recommends practices for the preparation and distribution of illustrations, both at point-of-sale and for in-force policies.
Creditor's Group Insurance
This Guideline protects the interests of Debtors by promoting consistent practices for insurers and by providing operating and disclosure standards for the transaction of Creditor's Group Insurance.
Screening Agents for Suitability and Reporting Unsuitable Agents
This Guideline sets out a framework and describes practices to assist companies in establishing and maintaining a system for screening and monitoring agents.
The purpose of this Guideline is to set out practices for disclosure of information to consumers in the direct marketing channel.
10-Day Insurance Contract Rescission Right
This Guideline calls for a 10-day “free look” in the case of individual life insurance contracts and individual accident and sickness insurance contracts. More specifically, and subject to section 7 below, this Guideline calls on insurers to provide a 10-day “free look” for a purchaser of an individual life insurance or accident and sickness insurance contract to allow him or her time to review the policy to confirm that it is consistent with what was expected when he or she applied for the policy. If the purchaser is not satisfied, this Guideline calls on insurers to allow the purchaser to cancel the contract within the time provided for a refund of premiums paid.
Policyowner Statements And Notices
The purpose of this Guideline is to establish consistent practices for disclosure of policy details for policyowner statements and notices.
Capital Accumulation Plans
This Guideline sets out regulators' expectations regarding the rights and duties of plan members, sponsors and service providers relating to employer-sponsored, tax assisted, savings plans known as Capital Accumulation Plans ("CAPs"). The Guideline also recommends comparable practices for non-tax-assisted plans.
Compensation Structures: Managing Conflicts of Interest
This Guideline supports the broader objective of managing conflicts of interest that could arise due to sales-related compensation. “Sales-related compensation” refers to remuneration paid by an insurer, directly or indirectly, of either a monetary or non-monetary nature, with respect to the placement and/or ongoing servicing of a contract of insurance.
Confirming Advisor Disclosure
The regulators' principles clearly oblige advisors to make appropriate disclosure at point-of-sale. This Guideline recommends practices that member companies can adopt to confirm that all advisors make disclosure consistent with that set out in the industry’s Reference Document, Advisor Disclosure.
Guaranteed Withdrawl Benefit (GWB) Illustrations
The purpose of this Guideline is to describe the information that should be included in illustrations of IVICs offering guaranteed withdrawal benefits. In particular, the Guideline identifies features that could be misunderstood by consumers or which are affected by consumer decisions and recommends practices to assist in explaining these.
Quebec Drug Insurance Eligible Persons in Public and Private Plans
This Guideline is intended to set out a standard of practice for insurers and ensure that industry practices are administered and applied in a consistent manner for all persons with drug coverage in Quebec under Group Insurance Contracts and Employee Benefit Plans underwritten or administered by insurers.
Out-of-Country/Out-of-Province/Territory Coordination of Benefits
This Guideline describes the coordination of payments from plans under which an individual is covered for out-of-country/out-of-province/territory medical expenses. Many of the processes outlined in the Guideline occur between insurers or plan administrators. The primary responsibility of the Covered Individual, once initial contact has been made with their insurer or plan administrator, is to disclose all sources of available coverage to facilitate the process between all potential payment sources.
Consistent with the CCIR recommendations, this Guideline is intended to bring greater clarity to the roles, responsibilities and accountabilities within insurer-MGA relationships.