l>6.6.3104A : UNINTENTIONAL LAPSE - Administrative nlinux.org of the State of Montana
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Department: STATE AUDITOR
Chapter: INSURANCE DEPARTMENT
Subchapter: Long-Term Care
Latest version of the embraced rule presented in Administrative nlinux.org of Montana (ARM):
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6.6.3104AUNINTENTIONAL LAPSE

(1) Each issuer supplying long-term care insurance shall, as a protection versus unintentional lapse, comply through the following:

(a) No individual irreversible treatment policy or certificate shall be issued till the issuer has actually obtained from the applicant either a created desigcountry of at least one person, in addition to the applicant, who is to receive notice of lapse or termination of the plan or certificate for nonpayment of premium, or a composed waiver dated and signed by the applicant electing not to designate extra persons to receive notice. The applicant has the best to designate at least one perkid that is to get the notification of termicountry, in enhancement to the insured. Desigcountry shall not constitute acceptance of any type of liability on the third party for solutions gave to the insured. The create used for the created designation need to carry out area clearly designated for listing at leastern one perboy. The designation shall include each person"s full name and home resolve. In the situation of an applicant who elects not to designate a secondary person, the waiver shall state: "Protection versus unintended lapse. I understand also that I can designate at leastern one perchild various other than myself to receive alert of lapse or termination of this irreversible care insurance policy or certificate for nonpayment of premium. I understand also that notification will not be offered till 30 days after a premium is due and unphelp. I elect NOT to designate a person to get this notice." The issuer shall inform the insured of the right to readjust this created desigcountry, no much less often than as soon as eextremely two years.

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(b) When the policyholder or certificateholder pays the premium for a permanent treatment insurance plan or certificate via a payroll or pension deduction arrangement, the requirements had in (1)(a) need not be met until 60 days after the policyholder or certificateholder is no longer on such a payment arrangement. The application or enrollment form for such policies or certificates shall clearly suggest the payment setup selected by the applicant.

(c) No individual irreversible care policy or certificate shall lapse or be terminated for nonpayment of premium unless the issuer, at least 30 days before the efficient day of the lapse or termination, has offered notification to the insured and also to those persons designated pursuant to (1)(a) at the deal with provided by the insured for purposes of receiving notification of lapse or termicountry. Notice shall only be reliable if it is mailed via:

(i) certified mail, or the issuer obtains a certificate of mailing by the United States Postal Service;

(ii) a commercial shipment service, and also the issuer obtains at the time of mailing a composed receipt from the company reflecting the date of mailing, the variety of items mailed, and the name and resolve of the insured and those persons designated pursuant to (1)(a) to whom the alert was mailed; or

(iii) first-course United States mail, and also the issuer obtains at the time of mailing a written receipt from the USA Postal Service mirroring the day of mailing, the number of items mailed, and the name and address of the insured and those persons designated pursuant to (1)(a) to whom the notification was mailed.

(d) Tbelow is a presumption that notice is yielded five days after the date of mailing, as confirmed in the composed receipt obtained by the insurer pursuant to (1)(c). The insurer shall retain any type of and also all proof of mailing the notification, including the list of recipients, as applicable, and a copy of the alert, for at least three years following the day of alert. Notice may not be provided till 30 days after a premium is due and unpassist.

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(2) In addition to the requirement in (1), a irreversible treatment insurance policy or certificate shall incorporate a provision that gives for reinstatement of coverage, in the occasion of lapse if the issuer is offered proof that the policyholder or certificateholder was cognitively impaired or had actually a loss of practical capacity prior to the grace duration consisted of in the plan or certificate expired. This choice shall be available to the insured if requested within five months after termination and also shall allow for the collection of past due premium, wbelow correct. The typical of proof of cognitive impairment or loss of useful capacity shall not be more stringent than the advantage eligibility criteria on cognitive handicap or the loss of useful capacity included in the policy and also certificate.