I. For a policy or certificate that has been in force for less than 6 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 coverage.
II. For a policy or certificate that has been in force for at least 6 months but less than 2-years, 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 both material to the acceptance for coverage and which pertains to the condition for which benefits are sought.
III. After a policy or certificate has been in force for 2 years, it is not contestable upon the grounds of misrepresentation alone; such policy or certificate may be contested only upon a showing that the insured knowingly and intentionally misrepresented relevant facts relating to the insured’s health.
IV. No long-term care insurance policy or certificate may be field issued based on medical or health status. For purposes of this section, "
field issued
" means a policy or certificate issued by an agent or a third party administrator pursuant to the underwriting authority granted to the agent or third party administrator by an insurer.
V. If an insurer has paid benefits under the long-term care insurance policy or certificate, the benefit payments may not be recovered by the insurer in the event that the policy or certificate is rescinded.
[Paragraph VI effective until January 1, 2023; see also paragraph VI set out below.]
VI. In the event of the death of the insured, this section shall not apply to the remaining death benefit of a life insurance policy that accelerates benefits for long-term care. In this situation, the remaining death benefits under these policies shall be governed by RSA 408:10. In all other situations, this section shall apply to life insurance policies that accelerate benefits for long-term care.
[Paragraph VI effective January 1, 2023; see also paragraph VI set out above.]
VI. In the event of the death of the insured, this section shall not apply to the remaining death benefit of a life insurance policy that accelerates benefits for long-term care. In this situation, the remaining death benefits under these policies shall be governed by RSA 408:13. In all other situations, this section shall apply to life insurance policies that accelerate benefits for long-term care.
Source. 2003, 180:1, eff. Aug. 23, 2003. 2022, 144:4, eff. Jan. 1, 2023.