Sec. 38a-501a-7 - Prohibition against post claims underwriting

ยง 38a-501a-7. Prohibition against post claims underwriting

(a) All applications for short term care policies except those that are guaranteed issue shall contain clear and unambiguous questions designed to ascertain the health condition of the applicant.

(b) If an application for short term care insurance contains a question that asks whether the applicant has had medication prescribed, it shall also ask the applicant to list the medication that has been prescribed. If the medications listed in such application were known by the insurer or should have been known at the time of application to be directly related to a medical condition for which coverage would otherwise be denied, then the policy shall not be rescinded for that condition.

(c) Except for policies that are guaranteed issue:

(1) The following language shall be set out conspicuously and in close conjunction with the applicant's signature block on an application for a short term care policy:

Caution: If your answers on this application are incorrect or untrue, (company) has the right to deny benefits or rescind your policy.

(2) The following language or language substantially similar to the following, shall be set out conspicuously on the short term care policy at the time of delivery:

Caution: The issuance of this short term care insurance policy is based upon your responses to the questions on your application. A copy of your application (is enclosed) (was retained by you when you applied). If your answers are incorrect or untrue, the company has the right to deny benefits or rescind your policy. The best time to clear up any questions is now, before a claim arises! If, for any reason any of your answers are incorrect, contact the company at this address: (insert address).

(d) A copy of the completed application shall be delivered to the insured no later than at the time of delivery of the policy unless it was retained by the applicant at the time of application.

(e) Every insurer selling or issuing short term care insurance coverage shall maintain a record of all policy rescissions, both statewide and nationally, except those that the insured voluntarily effectuated.

(Effective May 26, 2017)

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