This text of North Dakota § 26.1-45-07.1 (Defined term requirements - Claim payments) is published on Counsel Stack Legal Research, covering North Dakota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.
1. A long-term care insurance policy delivered or issued for delivery in this state may not
include the following terms, unless the terms are defined in the policy and consistent
with the following requirements:
a. "Activities of daily living" means bathing, continence, dressing, eating, toileting,
and transferring.
b. "Bathing" includes washing oneself by sponge bath, or in a tub or shower, and the
process of getting into and out of the tub or shower.
c. "Cognitive impairment" includes a deficiency in an individual's:
(1)Short-term or long-term memory;
(2)Orientation as to an individual, place, or time;
(3)Deductive or abstract reasoning; or
(4)Judgment as it relates to safety awareness.
d. "Continence" includes the ability to maintain control of bowel and bladder
function, or when un
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1. A long-term care insurance policy delivered or issued for delivery in this state may not
include the following terms, unless the terms are defined in the policy and consistent
with the following requirements:
a. "Activities of daily living" means bathing, continence, dressing, eating, toileting,
and transferring.
b. "Bathing" includes washing oneself by sponge bath, or in a tub or shower, and the
process of getting into and out of the tub or shower.
c. "Cognitive impairment" includes a deficiency in an individual's:
(1) Short-term or long-term memory;
(2) Orientation as to an individual, place, or time;
(3) Deductive or abstract reasoning; or
(4) Judgment as it relates to safety awareness.
d. "Continence" includes the ability to maintain control of bowel and bladder
function, or when unable to maintain control of bowel or bladder function, the
ability to perform associated personal hygiene, including caring for a catheter or
colostomy bag.
e. "Dressing" includes putting on and taking off any item of clothing and any
necessary brace, fastener, or artificial limb.
f. "Eating" includes feeding oneself from a receptacle, including a plate, cup, or
table, or being fed through a feeding tube or intravenously.
g. "Toileting" includes getting to and from the toilet and on and off the toilet, and
performing associated personal hygiene.
h. "Transferring" includes moving into or out of a bed, chair, or wheelchair.
2. A policy defined under this chapter may not prohibit or delay payment of policy benefits
to a basic care facility as defined under section 23-09.3-01 if the insured:
a. Meets the criteria for eligibility for benefits under the policy for care or services
that are medically necessary;
b. Is unable to perform two or more activities of daily living without supervision or
direct assistance; or
c. Has cognitive impairment requiring continual supervision.
3. An insurer shall provide a copy of the long-term care insurance policy to the insured or
a representative of the insured within thirty days of a request for a copy of the policy.