§ 26.1-36-48 — Short-term care insurance - Rules - Penalty

1. "Short-term care" means any insurance policy, group certificate of insurance, or rider
advertised, marketed, offered, or designed to provide coverage for less than twelve
consecutive months for each covered period on an expense-incurred, indemnity,
prepaid, or other basis for one or more necessary or medically necessary diagnostic,
preventative, therapeutic, rehabilitative, maintenance, adult day care, or personal care
services provided in an insured's own home or a licensed facility setting other than an
acute care unit of a hospital.
2. Any policy or rider advertised, marketed, or offered as short-term care insurance must
comply with this section and all other applicable insurance laws to the extent the other
laws do not conflict with this section.
3. The insurance commissioner:
a. May adopt rules that include standards for full and fair disclosure setting forth the
manner, content, and required disclosures for the sale of short-term care
insurance policies, terms of renewability, initial and subsequent conditions of
eligibility, nonduplication of coverage provisions, coverage of dependents,
pre-existing conditions, termination of insurance, continuation or conversion,
probationary periods, limitations, exceptions, reductions, elimination periods,
requirements for replacement, recurrent conditions, incontestability, rescission,
return of policy provisions, and definitions of terms.
b. May adopt rules establishing loss ratio standards for short-term care insurance
policies; provided, that a specific reference to short-term care insurance policies
is contained in the rules.
c. May adopt rules to promote premium adequacy; protect the policyholder in the
event of substantial rate increases; and to establish minimum standards for
correcting abusive marketing practices, replacement forms, insurance producer
testing, penalties, and reporting practices for short-term care insurance.
4. In addition to any other penalties provided by the laws of this state, any insurer and
any insurance producer found to have violated any requirement of this title relating to
the regulation of short-term care insurance or the marketing of such insurance is
subject to a fine of up to three times the amount of any commission paid for each
policy involved in the violation or up to ten thousand dollars, whichever is greater.