§431:10A-524 Policy standards. [Section repealed on July 1, 2000. L 1999, c 93, §§8,18.] (a) No long-term care insurance policy may:
(1) Be canceled, nonrenewed, or otherwise terminated on the grounds of the age or the deterioration of the mental or physical health of the insured individual or certificate holder;
(2) Contain a provision establishing a new waiting period in the event existing coverage is converted to or replaced by a new or other form within the same company, except with respect to an increase in benefits voluntarily selected by the insured individual or group policyholder; or
(3) Provide coverage for skilled nursing care only or provide significantly more coverage for skilled nursing care in a facility than coverage for lower levels of care.
(b) No long-term care insurance policy or certificate other than a policy or certificate thereunder issued to a group meeting the requirements of paragraph (1) of the definition of "group long-term care insurance" shall use a definition of preexisting condition which is more restrictive than the following: "preexisting condition" means a condition for which medical advice or treatment was recommended by or received from a provider of health care services within six months preceding the effective date of coverage of an insured person.
(c) No long-term care insurance policy or certificate other than a policy or certificate thereunder issued to a group meeting the requirements of paragraph (1) of the definition of "group long-term care insurance" may exclude coverage for a loss or confinement which is the result of a preexisting condition unless the loss or confinement begins within six months following the effective date of coverage of an insured person.
(d) The commissioner may extend the limitation periods in subsections (b) and (c) as to specific age group categories in specific policy forms upon findings that the extension is in the best interest of the public.
(e) The definition of "preexisting condition" does not prohibit an insurer from using an application form designed to elicit the complete health history of an applicant, and, on the basis of the answers on that application, from underwriting in accordance with that insurer's established underwriting standards. Unless otherwise provided in the policy or certificate, a preexisting condition, regardless of whether it is disclosed on the application or not, need not be covered until the waiting period described in subsection (c) expires. No long-term care insurance policy or certificate may exclude or use waivers or riders of any kind to exclude, limit, or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions beyond the waiting period described in subsection (c). [L 1989, c 335, pt of §2; am L 1991, c 48, §7]