Sec. 21.53.060. Long-term care benefits under life insurance policies; denial of claims.

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(a)In addition to the requirements of AS 21.45 , at the time of policy delivery, a policy summary shall be included with an individual life insurance policy if the policy or policy rider provides long-term care benefits. In the case of direct response solicitations, the insurer shall deliver the policy summary upon the applicant's request but, regardless of request, shall deliver a policy summary not later than the time of policy delivery. The summary must include

(1)an explanation of how the long-term care benefits interact with other components of the policy, including deductions from death benefits;

(2)an illustration of the amount and length of benefits, and guaranteed lifetime benefits, if any, for each covered person;

(3)an explanation of each exclusion, reduction, and limitation on long-term care benefits;

(4)if applicable to the policy type,

(A)disclosure of the effects of exercising other rights under the policy;

(B)disclosure of guarantees related to the long-term care costs of insurance charges; and

(C)current and projected maximum lifetime benefits; and

(5)if the director adopts a regulation that permits but does not require inflation protection, and the policy does not provide for inflation protection, a statement that inflation protection is not available under the policy.

(b)If a long-term care benefit is paid under a life insurance policy by the acceleration of the policy death benefit, and is in benefit payment status, a monthly report shall be provided to the policyholder. The report must include

(1)long-term care benefits paid out during the month;

(2)an explanation of changes in the policy, including changes in death benefits or cash values, due to long-term care benefits being paid out; and

(3)the amount of long-term care benefits remaining.

(c)If a claim under a long-term care insurance policy is denied by an insurer, the insurer shall, within 60 days after the date of a written request by a policyholder or a representative of a policyholder,

(1)provide a written explanation of the reasons for the denial; and

(2)make available all information directly related to the denial.