500.3911 Preexisting condition; limitation period; definition.
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500.3911 Preexisting condition; limitation period; definition.
Sec. 3911.
(1)A preexisting condition limitation period in a long-term care insurance policy, other than a group long-term care certificate described in section 3901(c)(i), shall not exceed 1 of the following:
(a)Six months after the effective date of coverage.
(b)A period of time set by the commissioner if the commissioner has found that a longer limitation period than provided for in subdivision
(a)is justified because the group is specially limited by age, group categories, or other specific policy provisions and that the longer limitation period will be in the best interest of the public.
(2)A long-term care insurance policy, other than a group long-term care certificate described in section 3901(c)(i) , shall not use a definition of preexisting condition that is more restrictive than the definition in section 3901.
(3)The definition of preexisting condition does not prohibit an insurer from using an application form designed to elicit the complete health history of an applicant and, on the basis of the answers on that application, underwrite in accordance with that insurer's established underwriting standards.
(4)Unless otherwise provided in the policy, a preexisting condition, regardless of whether it is disclosed on the application, need not be covered until after the limitation period. A long-term care insurance policy shall not exclude or use waivers or riders of any kind to exclude, limit, or reduce coverage or benefits for specifically named or described preexisting conditions beyond the limitation period.
History: Add. 1992, Act 84, Imd. Eff. June 2, 1992
Popular Name: Act 218