§ 27-8-12-10 — "Preexisting condition" defined; exclusion of coverage; limitations

(a) As used in this section, "preexisting
condition" means the existence of:
(1) either:
(A) symptoms that would cause an ordinarily prudent person to
seek diagnosis, care, or treatment; or
(B) a condition for which medical advice or treatment was
recommended by, or received from, a provider of health care
services; within
(2) a period not to exceed either:
(A) twelve (12) months preceding the effective date of coverage
of an insured person who is sixty-five (65) years of age or older
on the effective date of coverage; or
(B) twenty-four (24) months preceding the effective date of
coverage of an insured person who is less than sixty-five (65)
years of age on the effective date of coverage.
(b) A long term care insurance policy may exclude coverage for a
loss or confinement that is the result of a preexisting condition only if
that loss or confinement begins within:
(1) twelve (12) months following the effective date of coverage of
an insured person who is sixty-five (65) years of age or older on
the effective date of coverage; or
(2) twenty-four (24) months following the effective date of
coverage of an insured person who is under sixty-five (65) years
of age on the effective date of coverage.
(c) The insurance commissioner may extend the limitation periods
set forth in subsections (a)(2)(A), (a)(2)(B), and (b), concerning
specific age group categories in specific policies upon a finding that the
extension is in the best interest of the public.

Legislative History

As added by P.L.275-1987, SEC.1.