(1) All applications for long-term care
insurance policies or certificates except those which are guaranteed issue
shall contain clear and unambiguous questions designed to ascertain the health
condition of the applicant.
(2) If
an application for
long-term care insurance contains a question which asks
whether the applicant has had medication prescribed by a physician, it must
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denied, then the policy or certificate shall not be rescinded for that
condition.
(3) Except for
policies or certificates which are guaranteed issue:
a. The following language shall be set out
conspicuously and in close conjunction with the applicant's signature block on
an application for a
long-term care insurance policy or
certificate:
Caution: If your answers on this application are incorrect or
untrue, [company] has the right to deny benefits or rescind your policy.
b. The following language, or
language substantially similar to the following, shall be set out conspicuously
on the
long-term care insurance policy or
certificate at the time of delivery:
Caution: The issuance of this long-term care insurance
[policy] [certificate] is based upon your responses to the questions on your
application. A copy of your [application] [enrollment form] [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]
(4) A
copy of the completed application or enrollment form (whichever is applicable)
shall be delivered to the insured no later than at the time of delivery of the
policy or certificate.
(5) Every
insurer or other entity selling or issuing long-term care insurance benefits
shall maintain a record of all policy or certificate rescissions, both state
and countrywide, except those which the insured voluntarily effectuated and
shall annually furnish this information to the insurance commissioner in the
format prescribed by the National Association of Insurance Commissioners,
substantially similar to Appendix A.
Notes
Iowa Admin. Code r. 191-39.8
Amended by
IAB
May 5, 2021/Volume XLIII, Number 23, effective
6/9/2021
