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 […]
Section 27-19-28 – Exclusion of Hospitalization Benefits for Mental Patients in Tax-Supported Institutions.
Section 27-19-28 Exclusion of hospitalization benefits for mental patients in tax-supported institutions. (a) No policy of health, sickness, or accident insurance delivered, or issued for delivery, in this state, including both individual and group policies, which provide coverage for psychiatric treatment or mental illness shall exclude hospitalization benefits for mental patients in tax-supported institutions of […]
Section 27-19-53 – Standards for Policy Provisions; Limitations of Benefits.
Section 27-19-53 Standards for policy provisions; limitations of benefits. (a) The commissioner shall issue reasonable regulations to establish specific standards for policy provisions of Medicare supplement policies and certificates. The standards shall be in addition to and in accordance with applicable laws of this state, including Article 1 and Chapter 20. No requirement of this […]
Section 27-19-107 – Nonforfeiture Benefits.
Section 27-19-107 Nonforfeiture benefits. (a) Except as provided in subsection (b), a long-term care insurance policy may not be delivered or issued for delivery in this state unless the policyholder or certificateholder has been offered the option of purchasing a policy or certificate including a nonforfeiture benefit. The offer of a nonforfeiture benefit may be […]