20-1691.10. Contestable periods

A. If a policy or certificate has been in force for less than six months, an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim only on a showing of misrepresentation that is material to the acceptance for coverage.

B. If a policy or certificate has been in force for at least six months but less than two years, an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim only on a showing of misrepresentation that is both material to the acceptance for coverage and that pertains to the condition for which benefits are sought.

C. After a policy or certificate has been in force for two years it is not contestable solely for misrepresentation, but the insurer may contest the policy or certificate on a showing that the insured knowingly and intentionally misrepresented relevant facts relating to the insured's health.

D. An insurance producer or third party administrator shall not issue a long-term insurance policy or certificate pursuant to the underwriting authority granted to the insurance producer or third party administrator by an insurer that is based on medical or health status.

E. If an insurer paid benefits under the long-term care insurance policy or certificate, the insurer shall not recover the benefit payments if the insurer rescinds the policy or certificate.

F. If an insured dies, this section does not apply to the remaining death benefit of a life insurance policy that accelerates benefits for long-term care. Section 20-1204 applies to the remaining death benefits.