58-17-97. Provisions covering preexisting conditions.
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/sd/title-58/chapter-58-17/58-17-97·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Any accident and sickness policy or certificate subject to the provisions of this chapter, other than credit health insurance as defined in subdivision 58-19-2(1) and a health benefit plan as defined in § 58-17-66 , shall comply with the following provisions:
(1)No policy or certificate may deny, exclude, or limit benefits for a covered individual for claims incurred more than twelve months following the effective date of the person's coverage due to a preexisting condition;
(2)No policy or certificate may define a preexisting condition more restrictively than:
(a)A condition that would have caused an ordinarily prudent person to seek medical advice, diagnosis, care, or treatment during the twelve months immediately preceding the effective date of coverage;
(b)A condition for which medical advice, diagnosis, care, or treatment was recommended or received during the twelve months immediately preceding the effective date of coverage; or
(c)A pregnancy existing on the effective date of coverage.