§ 58-17B-7 — Requirements for long

No long - term care insurance policy may be delivered or issued for delivery in this state if the policy: (1) Conditions eligibility for any benefits on a prior hospitalization requirement; (2) Conditions eligibility for benefits provided in an institutional care setting on the receipt of a higher level of institutional care; or (3) Conditions eligibility for any benefits other than waiver of premium, post - confinement, post - acute care or recuperative benefits on a prior institutionalization requirement. Post - confinement, post - acute care, or recuperative benefits do not include home health care, adult day care, or any other benefit based on treatment or services received. A long - term care insurance policy, continuing post - confinement, post - acute care, or recuperative benefits, shall 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. A long - term care insurance policy or rider which conditions eligibility of non - institutional benefits on the prior receipt of institutional care may not require a prior institutional stay of more than thirty days, except waiver of premium which may not require a prior institutional stay of more than ninety days.

Legislative History

SL 1989, ch 440, § 7; SL 1991, ch 401.