02-031 C.M.R. ch. 585, § 6 - Limitations on Loss of Coverage and Right to Reinstatement for Persons with Cognitive Impairment or Functional Incapacity

Current through 2022-14, April 6, 2022

A. All policies subject to this Rule shall include notice of the right to seek reinstatement after cancellation, termination, or lapse, if loss of coverage is attributable to the policyholder's affliction with cognitive impairment or functional incapacity.
B. Within 90 days after cancellation, termination, or lapse of coverage, the policyholder, any person authorized to act on behalf of the policyholder, or any dependent of the policyholder covered under the policy may request reinstatement of the policy on the basis that loss of coverage was a result of the policyholder's cognitive impairment or functional incapacity at the time of cancellation, termination, or lapse.
C. If a policyholder, any person authorized to act on behalf of the policyholder, or any dependent of the policyholder covered under the policy requests reinstatement of coverage pursuant to this Section, an insurer may request a medical demonstration that the policyholder suffered from cognitive impairment or functional incapacity at the time of cancellation, termination, or lapse. If the insurer waives its right to request a medical demonstration or a medical demonstration substantiates that loss of coverage was the result of the existence of cognitive impairment or functional incapacity at the relevant time, the policy shall be reinstated. The medical demonstration may be at the expense of the policyholder.
D. A policy reinstated pursuant to this Section must cover any loss or claim occurring from the date of the termination, cancellation, or lapse, and shall be issued without any evidence of insurability.
E. Premium for policy reinstatement pursuant to this Section shall be paid from the date of the last premium payment at the rate which would have been in effect had the policy remained in force. Payment shall be made within 15 days after request by the insurer.

Notes

02-031 C.M.R. ch. 585, § 6

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