HEARING - U.S. Senate Special Committee on Aging

161
(2) No long-term care insurance policy may exclude coverage for a
loss or confinement which is the result of a pre-existing
condition unless such loss or confinement begins with the
periods specified in (a) or (b) below:
(a) 6 months following the effective date of coverage of an
insured person who is 65 years of age or older on the
effective date of coverage; or
(b) 24 months following the effective date of coverage of on
insured person who is under 65 on the effective date of
coverage.
(3) The commissioner may extend the limitation periods set forth
in subsections 5[C] el and (2) above as to specific age group
categories in specific policy forms upon findings that the
extension is in the best interest of the public.
[4] The definition of "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.
Comments The definition of pre-existing condition is consistent with the
requirement of Section 5 of the NAIC Model Regulation to implement the
Individual Accident and Sickness Insurance Minimum Standards Act.
Companies now selling long-term care insurance generally use much shorter
pro-existing condition periods then those authorized, in part for business
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