§ 26.1-45-07 — Prior institutionalization requirement prohibited

1. No long-term care insurance policy or certificate may be delivered or issued for
delivery in this state if such policy:
a. Conditions eligibility for any benefits on a prior hospitalization requirement.
b. Conditions eligibility for benefits provided in an institutional care setting on the
receipt of a higher level of such institutional care.
c. Conditions eligibility for any benefits other than waiver of premium,
postconfinement, postacute care, or recuperative benefits on a prior
institutionalization requirement.
2. a. A long-term care insurance policy containing postconfinement, postacute care, or
recuperative benefits must clearly label in a separate paragraph of the policy or
certificate entitled "limitations or conditions on eligibility for benefits" such
limitations or conditions, including any required number of days of confinement.
b. A long-term care insurance policy or rider which conditions eligibility of
noninstitutional benefits on the prior receipt of institutional care may not require a
prior institutional stay of more than thirty days.
3. No long-term care insurance policy or rider which provides benefits only following
institutionalization may condition such benefits upon admission to a facility for the
same or related conditions within a period of less than thirty days after discharge from
the institution.