The Dark World of Healthcare Marketing – What You Should Know


Solicitation and  Marketing Requirements



The purpose of an advertising regulation is to give a complete and accurate description to the public, prevent unfair competition, and set a minimum standard of conduct. In most states, each insurer must provide the Department of Insurance a copy of any advertisement prior to its use.

Each insurer must maintain at its home or principal office, a complete file containing every printed, published or prepared advertisement of its individual, blanket, franchise and group policies.

Advertisements are printed or published material, audiovisual material and descriptive literature, to include newspapers, magazines, radio scripts, television scripts, billboards, sales talks, presentations, and personal testimonials. Additional requirements:

■    Insurance companies are responsible for the accuracy of its personal testimonials.

■    Insurers may include statistical information as long as it is accurate and the source is named.

■    The agent must include the full name of the insurer when advertising a certain type of policy.

■    When an agent misleads the public in an advertisement, both the insurer and agent are held accountable.

■    When insurers advertise that a group endorses a certain health product, the public must be made aware of any control the insurer may have over the group.

■    When insurers advertise by comparison of like products, the comparisons must be complete to include rates, policies, benefits, and dividends.

■    The history of a very high or unique claim settlement cannot be used in advertising by the agent or insurance company.

Prohibited Forms of  Advertising

■    No advertisement of a hospital or facility confinement benefit shall advertise that the amount of the benefit is payable on a weekly or monthly basis when, in fact, the amount of the benefit is based on a daily pro rata basis related to the total amount of days of confinement.

■    An advertisement cannot use the words: “only,” “just,” “merely,” “minimum,” or similar words to imply a minimal imposition of restrictions and reductions.

■    An advertisement cannot imply that claim settlements are generous or liberal or use similar words to imply the same thing.

■    Any advertisement that uses a policy title to misrepresent or that might misrepresent coverage is unlawful.

Do Not Call Registry – The Federal Trade Commission amended the Telephone Consumer

Protection Act (TCPA) to give consumers a choice about receiving unwanted telemarketing calls. It is illegal for most telemarketers or sellers to call a number listed on the National Do Not Call Registry. Companies must update their list at least once every 31 days. The TCPA also limits the hours that telemarketers may call noncustomers at home to between the hours of 8 am – 9 pm.

Sales Presentation – Agents are required to provide prospective health insurance buyers with all sales materials used when soliciting policies of insurance.

Outline of Coverage – An outline of coverage (also called a policy summary) must be provided to a prospective buyer of health insurance at the time of application or policy delivery. The outline of coverage includes benefits, premiums, and other relevant information regarding the sale of the policy.

Healthcare, Health Insurance, Marketing, Telemarketers, Phone Solicitors, Health Insurance Agents, Do Not Call Registry

Follow Us on Facebook

Follow Us on Twitter

Author: The Williamson Group

Veteran Owned Small Consulting Business

Leave a Reply

%d bloggers like this: