376.1124. Rescinding of a long-term care policy, permitted when--grounds for contesting--no field issuance, when.
Rescinding of a long-term care policy, permitted when--groundsfor contesting--no field issuance, when.
376.1124. 1. For a policy or certificate that has been in force lessthan six months, an insurer may rescind a long-term care insurance policy orcertificate, or deny an otherwise valid long-term care insurance claim upon ashowing of misrepresentation that is material to the acceptance for coverage.
2. For a policy or certificate that has been in force for at least sixmonths but less than two years, an insurer may rescind a long-term careinsurance policy or certificate, or deny an otherwise valid long-term careinsurance claim upon a showing of misrepresentation that is both material tothe acceptance of coverage and which pertains to the conditions for whichbenefits are sought.
3. After a policy or certificate has been in force for two years, suchpolicy or certificate is not contestable upon the grounds of misrepresentationalone. Such policy or certificate may be contested only upon a showing thatthe insured knowingly and intentionally misrepresented relevant facts relatingto the insured's health.
4. No long-term care insurance policy or certificate shall be fieldissued based on medical or health status. For purposes of this subsection,"field issued" means a policy or certificate issued by an agent or third-partyadministrator pursuant to the underwriting authority granted to the agent orthird-party administrator by an insurer.
5. If an insurer has paid benefits under the long-term care insurancepolicy or certificate, the benefit payments shall not be recovered by theinsurer if such policy or certificate is rescinded.
6. In the event of the death of the insured, this section shall notapply to the remaining death benefit of a life insurance policy thataccelerates benefits for long-term care. In this situation, the remainingdeath benefits under these such policies shall be governed by thecontestability provisions otherwise applicable in the policy to life insurancebenefits. In all other situations, this section shall apply to life insurancepolicies that accelerate benefits for long-term care.
(L. 2002 H.B. 1568 merged with S.B. 1009)