Fla. Admin. Code Ann. R. 69O-157.006 - Pre-existing Conditions
(1) No long-term
care insurance policy or certificate other than a policy or certificate
thereunder issued to a group as defined in Section
627.9405(1)(a),
F.S., shall use a definition of "preexisting condition" which is more
restrictive than the following: "Preexisting condition" means the existence of
symptoms which would cause an ordinarily prudent person to seek diagnosis,
care, or treatment, or a condition for which medical advice or treatment was
recommended by or received from a provider of health care services within 6
months preceding the effective date of coverage of an insured person.
(2) No long-term care insurance policy or
certificate other than a policy or certificate thereunder issued to a group as
defined in Section 627.9405(1)(a),
F.S., may exclude coverage for a loss or confinement which is the result of a
preexisting condition unless such loss or confinement begins within 6 months
following the effective date of coverage of an insured
person.
Notes
Rulemaking Authority 624.308(1), 627.9407(1) FS. Law Implemented 624.307(1), 627.9407(1), (4) FS.
New 5-17-89, Formerly 4-81.006, 4-157.006.
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