Section 27-19-103 – Definitions.
Section 27-19-103 Definitions. Unless the context requires otherwise, the definitions in this section apply throughout this article. (1) APPLICANT. In the case of: a. An individual long-term care insurance policy, the person who seeks to contract for benefits. b. A group long-term care insurance policy, the proposed certificate holder. (2) CERTIFICATE. Any certificate issued under […]
Section 27-19-25 – Optional Policy Provisions – Illegal Occupation.
Section 27-19-25 Optional policy provisions – Illegal occupation. There may be a provision as follows: “Illegal Occupation: The insurer shall not be liable for any loss to which a contributing cause was the insured’s commission of, or attempt to commit, a felony or to which a contributing cause was the insured’s being engaged in an […]
Section 27-19-51 – Purpose of Article.
Section 27-19-51 Purpose of article. The purpose of this article is to establish certain definitions, policy provisions, anticipated loss ratio standards, and disclosure requirements applicable to group and individual Medicare supplement disability policies and to authorize the implementation of these requirements through regulations promulgated by the Commissioner of Insurance consistent with the uniform standards developed […]
Section 27-19-104 – Coverage Under Policy Issued in Other State.
Section 27-19-104 Coverage under policy issued in other state. No group long-term care insurance coverage may be offered to a resident of this state under a group policy issued in another state to a group described in Section 27-19-103(4)d, unless this state or another state having statutory and regulatory long-term care insurance requirements substantially similar […]
Section 27-19-26 – Optional Policy Provisions – Intoxicants and Narcotics.
Section 27-19-26 Optional policy provisions – Intoxicants and narcotics. There may be a provision as follows: “Intoxicants and Narcotics: The insurer shall not be liable for any loss sustained or contracted in consequence of the insured’s being intoxicated or under the influence of any narcotic unless administered on the advice of a physician.” (Acts 1953, […]
Section 27-19-52 – Definitions.
Section 27-19-52 Definitions. For purposes of this article, the following terms shall have the meaning indicated herein: (1) APPLICANT. Includes either of the following: a. In the case of an individual Medicare supplement policy or subscriber contract, the person who seeks to contract for insurance benefits. b. In the case of a group Medicare supplement […]
Section 27-19-105 – Regulations for Long-Term Care Policies; Outline of Coverage, Policy Summary, and Monthly Report.
Section 27-19-105 Regulations for long-term care policies; outline of coverage, policy summary, and monthly report. (a) The commissioner may adopt regulations that include standards for full and fair disclosure setting forth the manner, content, and required disclosures for the sale of long-term care insurance policies, terms of renewability, initial and subsequent conditions of eligibility, nonduplication […]
Section 27-19-27 – Order of Provisions in Policy.
Section 27-19-27 Order of provisions in policy. The provisions which are the subject of Sections 27-19-4 through 27-19-26, or any corresponding provisions which are used in lieu thereof in accordance with such sections, shall be printed in the consecutive order of the provisions in such sections or, at the option of the insurer, any such […]
Section 27-19-52.1 – Applicability of Article.
Section 27-19-52.1 Applicability of article. (a) Except as otherwise specifically provided, this article shall apply to both of the following: (1) All Medicare supplement policies delivered or issued for delivery in this state on or after August 1, 2000. (2) All certificates issued under group Medicare supplement policies, which certificates have been delivered or issued […]
Section 27-19-106 – Effect of Misrepresentation; Field Issuance.
Section 27-19-106 Effect of misrepresentation; field issuance. (a) For a policy or certificate that 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 upon a showing of misrepresentation that is material to the acceptance for […]