20-1691. Definitions In this article, unless the context otherwise requires: 1. " Applicant" means: (a) In the case of an individual long-term care insurance policy, the person who seeks to contract for such benefits. (b) In the case of a group long-term care insurance policy, the proposed certificate holder. 2. " Certificate" means a certificate […]
20-1691.01. Applicability and scope A. Except as otherwise provided in this article, this article applies to all long-term care insurance policies delivered or issued for delivery in this state. This article does not supersede the obligations of any person subject to this article to comply with other applicable insurance laws in this title that do […]
20-1691.02. Adoption of rules The director may adopt reasonable rules to implement this article, including rules that: 1. Establish specific standards for policy provisions of long-term care insurance policies, including terms of renewability, initial and subsequent conditions of eligibility, nonduplication of coverage, coverage of dependents, preexisting conditions, termination of insurance, continuation, conversion, probationary periods, limitations, […]
20-1691.03. Limitations of long-term care insurance policies A. No insurer may cancel, fail to renew or otherwise terminate a long-term care insurance policy solely on the grounds of the age or the deterioration of the mental or physical health of the insured individual or certificate holder. B. No long-term care insurance policy may contain a […]
20-1691.04. Requirements for certain group coverage A. Before advertising, marketing or offering a policy within this state issued to a group defined in section 20-1691, paragraph 4, subdivision (c), the association or the insurer of the association shall file evidence with the director that the association meets all of the following requirements: 1. Consists of […]
20-1691.05. Prior institutionalization A. A long-term care insurance policy delivered or issued for delivery in this state on or after July 1, 1990 shall not condition availability of benefits on prior hospitalization. B. A long-term care insurance policy delivered or issued for delivery in this state on or after the effective date of this amendment […]
20-1691.06. Outline of coverage; certificate A. An outline of coverage shall be delivered to an applicant for a long-term care insurance policy at the time of initial solicitation through means that prominently direct the recipient s attention to the document and its purpose. In the case of direct response solicitations, the outline of coverage shall […]
20-1691.07. Right to return A. A person insured under a long-term care insurance policy or certificate shall have the right to return the policy or certificate within thirty days of its delivery and to have the premium refunded if, after examination, the insured person is not satisfied for any reason. Long-term care insurance policies or […]
20-1691.08. Rate and form review; disapproval A. A person shall not deliver or issue for delivery in this state any long-term care insurance policy or rate unless the person has first filed the form or rate with the director and the director has approved the form or rate. Unless the director issues an order affirmatively […]
20-1691.09. Penalties In addition to any other penalty provided by law, an insurer or insurance producer who is found to have violated any provision relating to the regulation of long-term care insurance or the marketing of long-term care insurance is subject to a civil penalty of up to three times the amount of any commissions […]
20-1691.10. Contestable periods A. If a policy or certificate has been in force for less than six months, an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim only on a showing of misrepresentation that is material to the acceptance for coverage. B. If a […]
20-1691.11. Nonforfeiture benefits A. Except as provided in subsection B of this section, a person shall not deliver or issue for delivery in this state a long-term care insurance policy unless the policyholder or certificate holder has been offered the option of purchasing a policy or certificate with a nonforfeiture benefit. The offer of the […]
20-1691.12. Insurance producer training course requirements A. An individual may not sell, solicit or negotiate long-term care insurance unless the individual: 1. Is licensed as an insurance producer for accident and health or sickness. 2. Has completed eight hours of initial long-term care training. 3. Has completed four hours of long-term care training in each […]
