§ 26.1-45-06 — Pre-existing conditions

North Dakota § 26.1-45-06

• Jurisdiction: North Dakota
• Title 26.1: Insurance
• Ch. 26.1-45: Long-Term Care Insurance

Text

1. No long-term care insurance policy or certificate other than a policy or certificate
issued to a group as defined in subdivision a of subsection 3 of section 26.1-45-01
may define "pre-existing condition" as more restrictive than meaning a condition for
which medical advice or treatment was recommended by, or received from a provider
of health care services, within six months preceding the effective date of coverage of
an insured person.
2. No long-term care insurance policy or certificate issued on a group long-term care
insurance policy other than a policy or certificate issued to a group as defined in
subdivision a of subsection 3 of section 26.1-45-01 may exclude coverage for a loss or
confinement that is the result of a pre-existing condition unless the loss or confinement
begins within six months following the effective date of coverage of an insured person.
3. The commissioner may extend the limitation periods set forth in this section as to the
specific age group categories or specific policy forms upon findings that the extension
is in the best interest of the public.

4. The limitation on defining a pre-existing 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, from underwriting in accordance
with that insurer's established underwriting standards. Unless otherwise provided in
the policy or certificate, a pre-existing condition, regardless of whether it is disclosed
on the application, need not be covered until the waiting period described in
subsection 2 expires. No long-term care insurance policy or certificate may exclude or
use waivers or riders of any kind to exclude, limit, or reduce coverage or benefits for
specifically named or described pre-existing diseases or physical conditions beyond
the waiting period described in subsection 2.