reglab/statecodes huggingface dataset:
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10E-102 Over-insurance prohibited; exceptions.

§431:10E-102 Over-insurance prohibited; exceptions.
(a) Over-insurance shall be deemed to exist if property or an insurable interest in the property is insured by one or more insurance contracts against the same hazard in any amount in excess of the actual cash value of the property or of such interest, as determined as of the effective date of the insurance or of any renewal thereof.
(b) For the purposes of this section only, the term actual cash value means the cost of replacement less such depreciation as is properly applicable to the subject insured.
(c) No person shall knowingly sell, solicit, negotiate, or make any contract for insurance which would result in over-insurance of the property or interest therein proposed to be insured, except as is provided in section 431:10E-103.
(d) Each violation of this section shall subject the violator to the penalties provided by this code. [L 1987, c 347, pt of §2; am L 2002, c 155, §74]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10E-103 Exceptions.

§431:10E-103 Exceptions.
Section 431:10E-102 does not apply to:
(1) Insurance on buildings and building service equipment pertaining thereto and part thereof, and machinery, tools, and other equipment appurtenant to or used in connection with any trade, business, manufacturing process, governmental operations, or public and private institutions, and household furniture and furnishings in dwelling houses, with respect to the difference between the actual value of the insured property at the time any loss or damage occurs and the cost of repairing, rebuilding, or replacing with new materials of like size, kind and quality, such property as has been damaged or destroyed by fire or other peril insured against.
(2) Insurance against the cost of demolition or reconstruction, or both, of any portion of the insured premises which has not suffered damage, and the additional cost of repair or reconstruction, or both, of portions of the insured premises which have suffered damage, necessary to comply with applicable laws or ordinances. [L 1987, c 347, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10E-123 Definitions.

§431:10E-123 Definitions.
As used in this part, "inquiry" means a telephone call or other communication made to an insurer regarding the terms, conditions, or coverage afforded under an insurance policy that does not result in a claim, including questions concerning whether a policy will cover a loss or the process for filing a claim. The term shall not constitute a claim for purposes of section 431:13-103(a)(11). [L 2012, c 80, pt of §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10E-124 Use of inquiries and other information.

§431:10E-124 Use of inquiries and other information.
An insurer shall not refuse to issue, refuse to renew, or cancel a homeowners insurance policy, or establish rates for coverage based in whole or in part on inquiries made by any consumer to an insurer, unless the inquiry provides information not previously disclosed by the insured. [L 2012, c 80, pt of §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10E-141 Lava zone defined.

Revision Note
Part heading added by revisor pursuant to §23G-15.
§431:10E-141 Lava zone defined.
As used in this article, "lava zone" means a volcanic hazard zone identified by the United States Geological Survey on the island of Hawaii. [L 2015, c 32, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10E-142 Provisions for properties in lava zones in the county of Hawaii.

§431:10E-142 Provisions for properties in lava zones in the county of Hawaii.
(a) Where the mayor of the county of Hawaii has issued a proclamation declaring the existence of a state of emergency due to the threat of imminent disaster from a lava flow in a lava zone, the total number (rounded to the nearest whole number) of property insurance policies that an insurer may non-renew in a lava zone shall be limited for each calendar year to five per cent of the total number of covered policies of the insurer in force in that lava zone.
(b) Notwithstanding subsection (a), an insurer may cancel or non-renew a property insurance policy where:
(1) Premium payments for the policy are not made after reasonable demand therefor; or
(2) The commissioner determines the financial soundness of the insurer would be impaired. [L 2015, c 32, pt of §2]
Cross References
Hawaii property insurance association, issuance of new policies on properties in lava zones, see §431:21-119.
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10E-152 Extended coverage.

§431:10E-152 Extended coverage.
Insurers seeking to provide multi-peril coverage for residential property after July 1, 2016, shall submit to the commissioner a written request for permission to write the coverage. The commissioner may disapprove the request. If the request is disapproved, the insurer shall not write the coverage. [L 2016, c 141, pt of §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10F-101 Requirements deemed met by surety insurer.

Cross References
Bail agents; sureties, see article 9N.
§431:10F-101 Requirements deemed met by surety insurer.
Whenever by law or by rule of any court, public official, or public body, a surety bond is required or is permitted to be given, provided the bond is otherwise proper and its conditions are guaranteed by an authorized surety insurer or by an unauthorized surety insurer pursuant to article 8, part II, the bond shall be approved and accepted and shall be deemed to fulfill all requirements as to number of sureties, residence or status of sureties, and other similar requirements, and no justification by the surety shall be necessary. For the purpose of this section, surety bond shall also include a recognizance, obligation, stipulation or undertaking. [L 1987, c 347, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10F-102 Fiduciary bonds, expense.

§431:10F-102 Fiduciary bonds, expense.
Any fiduciary required by law to give bonds, may include, as part of the fiduciary's lawful expense to be allowed by the court or official by whom the fiduciary was appointed, the reasonable amount paid as premium for the bonds to the surety insurer who issued or guaranteed the bonds. [L 1987, c 347, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10F-103 Court bonds, costs.

§431:10F-103 Court bonds, costs.
In any proceeding, the party entitled to recover costs may include in the costs such reasonable sum as was paid to the surety insurer as premium for any bond or undertaking required therein, and as may be allowed by the court having jurisdiction of the proceeding. [L 1987, c 347, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10F-105 Directed suretyship; coercion of contractors.

§431:10F-105 Directed suretyship; coercion of contractors.
(a) No person may require as a condition precedent to the granting, awarding, or issuing a contract for the construction or renovation of improvements to real property, that the person whose obligation under such contract is to provide, construct, or renovate improvements to real property is to acquire or negotiate a surety bond or other contract guaranteeing completion of such improvements through a particular surety insurer or group of surety insurers, or a particular producer or group of producers.
(b) The commissioner may examine and investigate the insurance related activities of any person whom the commissioner believes may be in violation of this section. Any person may submit to the commissioner a complaint or any material pertinent to the enforcement of this section.
(c) Nothing in this section shall prevent a person who grants, awards, or issues contracts for the construction or renovation of improvements to real property from requiring a person to acquire or negotiate a surety bond or other contract guaranteeing completion of the improvements through authorized surety insurers or producers licensed to do business in the State or both. [L 2007, c 251, §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10G-101 Definitions.

Case Notes
The plain language of this chapter as well as its legislative history disqualified plaintiff, who was injured by someone operating a motorcycle, from no-fault benefits. 91 H. 299 (App.), 983 P.2d 200 (1999).
PART I. GENERAL PROVISIONS
§431:10G-101 Definitions.
As used in this article:
"Accidental harm" means bodily injury, death, sickness, or disease caused by a motorcycle or motor scooter accident to a person.
"Injury" means accidental harm not resulting in death.
"Motorcycle" has the meaning prescribed by section 286-2.
"Motorcycle accident" means an accident arising out of the operation, maintenance, or use of a motorcycle, but not involving a motor vehicle.
"Motor scooter" has the meaning prescribed by section 286-2.
"Motor scooter accident" means an accident arising out of the operation, maintenance, or use of a motor scooter, but not involving a motor vehicle.
"Owner" means a person who holds the legal title to a motorcycle or motor scooter; except that when a motorcycle or motor scooter is the subject of a security agreement or lease with a term of not less than one year, with the debtor or lessee having the right of possession, the term owner shall mean the debtor or lessee. Whenever transfer of title to a motorcycle or motor scooter occurs, the seller shall be considered the owner until delivery of the executed title to the buyer. Upon delivery of the executed title, the buyer holding the equitable title shall be considered the owner.
"Person" means, when appropriate to the context, not only individuals, but corporations, firms, associations, and societies. [L 1989, c 208, pt of §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10G-102 Conditions of operation and registration of motorcycles and motor scooters.

§431:10G-102 Conditions of operation and registration of motorcycles and motor scooters.
No person shall drive a motorcycle or motor scooter upon any public street, road, or highway of this State at any time unless such motorcycle or motor scooter is insured at all times under a liability policy as provided in section 431:10G-301; provided that this article shall not apply to any antique motorcycle or motor scooter as defined in section 249-1. [L 1989, c 208, pt of §1; am L 1996, c 56, §3]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10G-103 Motorcycle or motor scooter self-insurance.

§431:10G-103 Motorcycle or motor scooter self-insurance.
The motorcycle or motor scooter insurance required by section 431:10G-102 may be satisfied by any owner of a motorcycle or motor scooter if:
(1) Such owner provides proof of qualifications as a self-insurer, and a surety bond or other securities affording security substantially equivalent to that afforded under a policy meeting the requirements of section 431:10G-301 and providing coverage at all times for the entire motorcycle or motor scooter registration period, as determined and approved by the commissioner under rules; and
(2) The commissioner is satisfied that in case of injury, death, or property damage, any claimant would have the same rights against such owner as the claimant would have had if a policy meeting the requirements of section 431:10G-301 had been applicable to such motorcycle or motor scooter. [L 1989, c 208, pt of §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10G-104 Prerequisites for obtaining coverage.

§431:10G-104 Prerequisites for obtaining coverage.
(a) Any person seeking to obtain the liability coverage required by this part after June 7, 1989, shall first:
(1) Have obtained a valid motorcycle or motor scooter license; or
(2) Have obtained a valid motorcycle or motor scooter learner's permit and have taken and passed a motorcycle education course approved by the department of transportation.
(b) A temporary insurance binder covering a period of not more than ninety days may be issued to a person who has a valid motorcycle or motor scooter learner's permit. To obtain a temporary binder, a person shall submit proof to the insurer of the person's enrollment in an approved motorcycle education course. The temporary insurance binder shall be subject to cancellation should the person fail to take, complete, and pass the course for which proof was submitted to the insurer. [L 1989, c 208, pt of §1; am L 1990, c 241, §1; am L 1991, c 174, §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10G-105 Tort liability.

§431:10G-105 Tort liability.
(a) With respect to accidental harm incurred in or arising out of a motorcycle accident or motor scooter accident, tort liability is not abolished.
(b) Any owner or operator of a motorcycle or motor scooter involved in a motor vehicle accident as defined in section 431:10C-103 and who incurs accidental harm as defined in section 431:10C-103, including such person's representative or legal guardian, shall have a cause of action in tort as provided in section 431:10C-306. [L 1989, c 208, pt of §1; am L 1997, c 251, §54]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10G-106 Verification of insurance.

§431:10G-106 Verification of insurance.
Every insurer shall issue to each of its insureds a paper or electronic proof of insurance card for each motorcycle or motor scooter for which a liability policy under this article is written. The electronic proof of insurance card may be accessed directly through the licensed insurer's website, application, or database. The proof of insurance card shall show the following:
(1) Name, make, year, and factory or serial number of the motorcycle or motor scooter; provided that insurers of five or more motorcycles or motor scooters that are under common registered ownership and used in the regular course of business shall not be required to indicate the name, make, year, and the factory or serial number of each motorcycle or motor scooter;
(2) Policy number;
(3) Names of the insured and the insurer; and
(4) Effective dates of coverage including the expiration date.
The proof of insurance card shall be carried on, or accessible on a mobile electronic device, as defined in section 291C-137, by the person operating the insured motorcycle or motor scooter at all times and shall be exhibited to a law enforcement officer upon demand. [L 1989, c 208, pt of §1; am L 2004, c 122, §59; am L 2016, c 82, §4]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10G-107 Drivers education fund underwriters fee; motorcycle and motor scooter operators education fund.

§431:10G-107 Drivers education fund underwriters fee; motorcycle and motor scooter operators education fund.
(a) The commissioner shall assess and levy upon each insurer, and self-insurer, a drivers education fund underwriters fee of $2 a year on each motorcycle or motor scooter insured by each insurer or self-insurer. This fee shall be due and payable on an annual basis by means and at a time to be determined by the commissioner.
(b) There is created in the treasury of the State a special fund to be known as the motorcycle and motor scooter operators education fund. The commissioner shall deposit the fees collected under this section into the motorcycle and motor scooter operators education fund.
(c) The fees deposited for each fiscal year into the motorcycle and motor scooter operators education fund, when appropriated, shall be available to the department of transportation for the administration of a drivers education program for operators of motorcycles or motor scooters. The department of transportation may spend the amount collected from these fees for the purposes of this section. [L 1989, c 208, pt of §1; am L 1997, c 184, §1; am L 2002, c 121, §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10G-108 Penalties.

§431:10G-108 Penalties.
Any person who violates this article shall be subject to a citation by the police and shall be subject to a nonsuspendable fine of not less than $100 nor more than $1,000, thirty days imprisonment, a one year driver's license suspension, or any combination thereof, for each violation.
Any person cited under this section shall have an opportunity to present a good faith defense, including but not limited to lack of knowledge or proof of insurance. The general penalty provision of this section shall not apply to:
(1) Any operator of a motorcycle or motor scooter owned by another person if the operator's own insurance covers such driving;
(2) Any operator of a motorcycle or motor scooter owned by that person's employer during the normal scope of that person's employment; or
(3) Any operator of a borrowed motorcycle or motor scooter if the operator holds a reasonable belief that the subject vehicle is insured. [L 1989, c 208, pt of §1; am L 2000, c 64, §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-101 Purpose.

Note
See table at end of this Article for derivation of HRS sections from the National Association of Insurance Commissioners 1998 Model Act or Regulations.
Cross References
Long-term care financing, see chapter 346C.
PART I. LONG-TERM CARE INSURANCE MODEL ACT
§431:10H-101 Purpose.
The purpose of this article is to promote the public interest, to promote the availability of long-term care insurance policies, to protect applicants for long-term care insurance, as defined, from unfair or deceptive sales or enrollment practices, to establish standards for long-term care insurance, to facilitate public understanding and comparison of long-term care insurance policies, and to facilitate flexibility and innovation in the development of long-term care insurance coverage. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-102 Scope.

§431:10H-102 Scope.
The requirements of this article shall apply to policies delivered or issued for delivery in this State on or after July 1, 2000. This article is not intended to supersede the obligations of entities subject to this article to comply with the substance of other applicable insurance laws insofar as they do not conflict with this article, except that laws and regulations designed and intended to apply to medicare supplement insurance policies shall not be applied to long-term care insurance. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-105 Extraterritorial jurisdiction; group policies.

§431:10H-105 Extraterritorial jurisdiction; group policies.
No group long-term insurance coverage may be offered to a resident of this State under a group policy issued in another state to a group described in paragraph (4) under the definition of "group long-term care insurance" in section 431:10H-104, unless this State or another state having statutory and regulatory long-term care insurance requirements substantially similar to those adopted in this State has made a determination that these requirements have been met. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-106 Rules.

§431:10H-106 Rules.
The commissioner may adopt rules that include standards for full and fair disclosure setting forth the manner, content, and required disclosures for the sale of long-term care insurance policies, terms of renewability, initial and subsequent conditions of eligibility, non-duplication of coverage provisions, coverage of dependents, preexisting conditions, termination of insurance, continuation or conversion, probationary periods, limitations, exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions, and definition of terms. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-107 Basic standards.

§431:10H-107 Basic standards.
No long-term care insurance policy may:
(1) Be canceled, nonrenewed, or otherwise terminated on the grounds of the age or the deterioration of the mental or physical health of the insured individual or certificate holder;
(2) Contain a provision establishing a new waiting period if existing coverage is converted to or replaced by a new or other form within the same company, except with respect to an increase in benefits voluntarily selected by the insured individual or group policyholder; or
(3) Provide coverage for skilled nursing care only or provide significantly more coverage for skilled care in a facility than coverage for lower levels of care. [L 1999, c 93, pt of §2]
Revision Note
Subsection designation deleted pursuant to §23G-15.
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-108 Preexisting conditions--group and individual policies.

§431:10H-108 Preexisting conditions--group and individual policies.
(a) No long-term care insurance policy or certificate other than a policy or certificate thereunder issued to a group as defined in paragraph (1) of the definition of "group long-term care insurance" in section 431:10H-104 shall use a definition of "preexisting condition" which is more restrictive than the following: "Preexisting condition" means a condition for which medical advice or treatment was recommended by, or received from a provider of health care services within six months preceding the effective date of coverage of an insured person.
(b) No long-term care insurance policy or certificate other than a policy or certificate thereunder issued to a group as defined in paragraph (1) of the definition of "group long-term care insurance" in section 431:10H-104 may exclude coverage for a loss or confinement which is the result of a preexisting condition unless the loss or confinement begins within six months following the effective date of coverage of an insured person.
(c) The commissioner may extend the limitation periods in subsections (a) and (b) as to specific age group categories in specific policy forms upon findings that the extension is in the best interest of the public.
(d) The definition of "preexisting 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. Unless otherwise provided in the policy or certificate, a preexisting condition, regardless of whether it is disclosed on the application, need not be covered until the waiting period described in subsection (b) expires. No long-term care insurance policy or certificate may exclude or use waivers or riders of any kind to exclude, limit, or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions beyond the waiting period described in subsection (b). [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-109 Prior hospitalization; prior institutionalization.

§431:10H-109 Prior hospitalization; prior institutionalization.
(a) 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.
(b) A long-term care insurance policy containing 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.
(c) A long-term care insurance policy that conditions eligibility of non-institutional benefits on the prior receipt of institutional care shall not require a prior institutional stay of more than thirty days. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-110 Loss ratio standards; factors; commissioner approval.

§431:10H-110 Loss ratio standards; factors; commissioner approval.
The commissioner may adopt rules establishing loss ratio standards for long-term care insurance policies; provided that a specific reference to long-term care insurance policies is contained in the rule. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-111 Right to return; free look provision.

§431:10H-111 Right to return; free look provision.
Long-term care insurance applicants shall have the right to return the policy or certificate within thirty days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason. Long-term care insurance policies and certificates shall have a notice prominently printed on the first page or attached thereto stating in substance that the applicant shall have the right to return the policy or certificate within thirty days of its delivery and to have the premium refunded if, after examination of the policy or certificate, other than a certificate issued pursuant to a policy issued to a group defined in paragraph (1) of the definition of "group long-term care insurance" in section 431:10H-104, the applicant is not satisfied for any reason. This section shall also apply to a denial of an application for a long-term care contract. Any refund shall be made within thirty days of the return or denial. [L 1999, c 93, pt of §2; am L 2007, c 233, §7]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-112 Outline of coverage required.

§431:10H-112 Outline of coverage required.
(a) An outline of coverage shall be delivered to a prospective applicant for long-term care insurance at the time of initial solicitation through means that prominently direct the attention of the recipient to the document and its purpose. The commissioner shall prescribe a standard format, including style, arrangement, and overall appearance, and the content of an outline of coverage. In the case of producer solicitations, a producer shall deliver the outline of coverage prior to the presentation of an application or enrollment form. In the case of direct response solicitation, the outline of coverage shall be presented in conjunction with any application or enrollment form. In the case of a policy issued to a group defined in paragraph (1) of the definition of "group long-term care insurance" in section 431:10H-104, an outline of coverage shall not be required to be delivered; provided that the information described in subsection (b) is contained in other materials relating to enrollment. Upon request, these other materials shall be made available to the commissioner.
(b) The outline of coverage shall include:
(1) A description of the principal benefits and coverage provided in the policy;
(2) A statement of the principal exclusions, reductions, and limitations contained in the policy;
(3) A statement of the terms under which the policy or certificate, or both, may be continued in force or discontinued, including any reservation in the policy of a right to change premium. Continuation or conversion provisions of group coverage shall be specifically described;
(4) A statement that the outline of coverage is a summary only, not a contract of insurance, and that the policy or group master policy contains governing contractual provisions;
(5) A description of the terms under which the policy or certificate may be returned and premium refunded;
(6) A brief description of the relationship of costs of care and benefits; and
(7) A statement that discloses to the policyholder or certificate holder whether the policy is intended to be a federally tax-qualified long-term care insurance contract under section 7702B(b) of the Internal Revenue Code of 1986, as amended. [L 1999, c 93, pt of §2; am L 2003, c 212, §93; am L 2007, c 233, §8]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-113 Group policy certificate requirements.

§431:10H-113 Group policy certificate requirements.
A certificate issued pursuant to a group long-term care insurance policy which is delivered or issued for delivery in this State shall include:
(1) A description of the principal benefits and coverage provided in the policy;
(2) A statement of the principal exclusions, reductions, and limitations contained in the policy; and
(3) A statement that the group master policy determines governing contractual provisions. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-114 Life insurance policies offering long-term care benefits.

§431:10H-114 Life insurance policies offering long-term care benefits.
(a) At the time of policy delivery, a policy summary shall be delivered for an individual life insurance policy that provides long-term care benefits within the policy or by rider. In the case of direct response solicitations, the insurer shall deliver the policy summary upon the applicant's request, but regardless of the request shall make delivery no later than at the time of policy delivery. In addition to complying with all applicable requirements, the policy summary shall also include:
(1) An explanation of how the long-term care benefit interacts with other components of the policy, including deductions from death benefits;
(2) An illustration of the amount of benefits, the length of benefit, and the guaranteed lifetime benefits if any, for each covered person;
(3) Any exclusions, reductions, and limitations on benefits of long-term care;
(4) A statement that any long-term care inflation protection option required by section 431:10H-220 is not available under this policy;
(5) If applicable to the policy type, the summary shall also include a disclosure of the effects of exercising other rights under the policy, a disclosure of guarantees related to long-term care costs of insurance charges, and current and projected maximum lifetime benefits; and
(6) The provisions of the policy summary listed above may be incorporated into a basic illustration required to be delivered or into the life insurance policy summary that is required to be delivered.
(b) Any time a long-term care benefit funded through a life insurance vehicle by the acceleration of the death benefit is in benefit payment status, a monthly report shall be provided to the policyholder. The report shall include:
(1) Any long-term care benefits paid out during the month;
(2) An explanation of any changes in the policy, for example death benefits or cash values, due to long-term care benefits being paid out; and
(3) The amount of long-term care benefits existing or remaining.
(c) Any policy advertised, marketed, or offered as long-term care or nursing home insurance shall comply with this article. [L 1999, c 93, pt of §2; am L 2007, c 233, §9]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-115 Incontestability period--group and individual policies.

§431:10H-115 Incontestability period--group and individual policies.
(a) For a policy or certificate that has been in force for less than six months an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim upon a showing of misrepresentation that is material to the acceptance of coverage.
(b) For a policy or certificate that has been in force at least six months but less than two years, an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim upon a showing of misrepresentation that is both material to the acceptance of coverage and which pertains to the condition for which benefits are sought.
(c) After a policy or certificate has been in force for two years it is not contestable solely upon the grounds of misrepresentation alone. The policy or certificate may be contested only upon a showing that the insured knowingly and intentionally misrepresented relevant facts relating to the insured's health.
(d) No long-term care insurance policy or certificate may be field issued based on medical or health status. For purposes of this subsection, "field issued" means a policy or certificate issued by a producer or a third-party administrator pursuant to the underwriting authority granted to the producer or third party administrator by an insurer.
(e) If an insurer has paid benefits under the long-term care insurance policy or certificate, the benefit payments may not be recovered by the insurer if the policy or certificate is rescinded.
(f) In the event of the death of the insured, this section shall not apply to the remaining death benefit of a life insurance policy that accelerates benefits for long-term care. In this situation, the remaining death benefits under these policies shall be governed by article 10D of this chapter. In all other situations, this section shall apply to life insurance policies that accelerate benefits for long-term care. [L 1999, c 93, pt of §2; am L 2003, c 212, §94]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-116 Nonforfeiture benefits.

§431:10H-116 Nonforfeiture benefits.
(a) Except as provided in subsection (b), a long-term care insurance policy shall not be delivered or issued for delivery in this State unless the policyholder or certificate holder has been offered an option to purchase a policy or certificate that includes a nonforfeiture benefit. The offer of a nonforfeiture benefit may be in the form of a rider that is attached to the policy. If the policyholder or certificate holder declines the nonforfeiture benefit, the insurer shall provide a contingent benefit upon lapse that shall be available for a specified period of time following a substantial increase in premium rates.
(b) For a group long-term care insurance policy, the offer of a nonforfeiture benefit under subsection (a) shall be made to the group policyholder. However, if the policy is issued as a group long-term care insurance, other than to a continuing care retirement community or other similar entity, the offering shall be made to each proposed certificate holder.
(c) The commissioner shall adopt rules to specify the type of nonforfeiture benefits to be offered as part of long-term care insurance policies or certificates, the standards for nonforfeiture benefits, and the rules for contingent benefit upon lapse, including a determination of the specified period of time during which a contingent benefit upon lapse shall be available and the substantial premium rate increase that triggers a contingent benefit upon lapse as provided in subsection (a). [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-116.5 Delivery of the contract or certificate of insurance.

§431:10H-116.5 Delivery of the contract or certificate of insurance.
If an application for a long-term care insurance contract or certificate is approved, the issuer shall deliver the contract or certificate of insurance to the applicant no later than thirty days after the date of approval. [L 2007, c 233, pt of §3]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-116.6 Denial of claims; compliance requirements.

§431:10H-116.6 Denial of claims; compliance requirements.
(a) If a claim under a long-term care insurance contract is denied, the issuer, within sixty days of the date of a written request by the policyholder or certificate holder, or a representative thereof shall:
(1) Provide a written explanation of the reasons for the denial; and
(2) Make available all information directly related to the denial.
(b) Any policy or rider advertised, marketed, or offered as long-term care or nursing home insurance shall comply with this article. [L 2007, c 233, pt of §3]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-117 Authority to adopt rules.

§431:10H-117 Authority to adopt rules.
The commissioner may adopt reasonable rules to promote premium adequacy and to protect the policyholder in the event of substantial rate increases, and to establish minimum standards for marketing practices, producer compensation, producer testing, penalties, and reporting practices for long-term care insurance. [L 1999, c 93, pt of §2; am L 2003, c 212, §95]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-202 Renewability.

§431:10H-202 Renewability.
(a) The terms "guaranteed renewable" and "noncancellable" shall not be used in any individual long-term care insurance policy without further explanatory language in accordance with the disclosure requirements of section 431:10H-211. A policy issued to an individual shall not contain renewal provisions other than guaranteed renewable or noncancellable.
(b) The term "guaranteed renewable" may be used only when the insured has the right to continue the long-term care insurance in force by the timely payment of premiums and when the insurer has no unilateral right to make any change in any provision of the policy or rider while the insurance is in force, and cannot decline to renew, except that rates may be revised by the insurer on a class basis.
(c) The term "noncancellable" means the insured has the right to continue the long-term care insurance in force by the timely payment of premiums during which period the insurer has no right to unilaterally make any change in any provision of the insurance or in the premium rate.
(d) The term "level premium" may only be used when the insurer does not have the right to change the premium.
(e) In addition to the other requirements of this section, a qualified long-term care insurance contract shall be guaranteed renewable, within the meaning of section 7702B(b)(1)(C) of the Internal Revenue Code of 1986, as amended. [L 1999, c 93, pt of §2; am L 2007, c 233, §11]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-203 Limitations and exclusions.

§431:10H-203
Limitations and exclusions.
(a) A policy may not be delivered or issued for delivery in this State as long-term care insurance if the policy limits or excludes coverage by type of illness, treatment, medical condition, or accident, except as follows:
(1) Preexisting conditions or diseases;
(2) Mental or nervous disorders; however, this shall not permit exclusion or limitation of benefits on the basis of Alzheimer's disease;
(3) Alcoholism and drug addiction;
(4) Illness, treatment, or medical condition arising out of:
(A) War or act of war, whether declared or undeclared;
(B) Participation in a felony, riot, or insurrection;
(C) Service in the armed forces or units auxiliary thereto;
(D) Suicide (sane or insane), attempted suicide, or intentionally self-inflicted injury; or
(E) Aviation (this exclusion applies only to non-fare-paying passengers);
(5) Treatment provided in a government facility (unless required by law), services for which benefits are available under medicare or other governmental program (except medicaid), any state or federal workers' compensation, employer's liability, or occupational disease law, or any motor vehicle insurance law, services provided by a member of the covered person's immediate family, and services for which no charge is normally made in the absence of insurance;
(6) Expenses for services or items available or paid under another long-term care insurance or health insurance policy; or
(7) In the case of a qualified long-term care insurance contract, expenses for services or items to the extent that the expenses are reimbursable under title XVIII of the Social Security Act or would be so reimbursable but for the application of a deductible or coinsurance amount.
(b) This section is not intended to prohibit exclusions and limitations by type of provider. However, no long-term care issuer may deny a claim because services are provided in a state other than the state of policy issue under the following conditions:
(1) When the state other than the state of policy issue does not have the provider licensing, certification, or registration required in the policy, but where the provider satisfies the policy requirements outlined for providers in lieu of licensure, certification, registration; or
(2) When the state other than the state of policy issue licenses, certifies, or registers the provider under another name.
For purposes of this subsection, "state of policy issue" means the state in which the individual policy or certificate was originally issued.
(c) This section is not intended to prohibit territorial limitations. [L 1999, c 93, pt of §2; am L 2007, c 233, §12]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-204 Extension of benefits.

§431:10H-204 Extension of benefits.
Termination of long-term care insurance shall be without prejudice to any benefits payable for institutionalization if the institutionalization began while the long-term care insurance was in force and continues without interruption after termination. The extension of benefits beyond the period the long-term care insurance was in force may be limited to the duration of the benefit period, if any, or to payment of the maximum benefits and may be subject to any policy waiting period, and all other applicable provisions of the policy. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-204.5 Electronic enrollment for group policies.

§431:10H-204.5 Electronic enrollment for group policies.
(a) In the case of a group defined in paragraph (1) of the definition of "group long-term care insurance" in section 431:10H-104, any requirement that a signature of an insured be obtained by an agent or insurer shall be deemed satisfied if:
(1) The consent is obtained by telephonic or electronic enrollment by the group policyholder or insurer. A verification of enrollment information shall be provided to the enrollee;
(2) The telephonic or electronic enrollment provides necessary and reasonable safeguards to assure the accuracy, retention, and prompt retrieval of records; and
(3) The telephonic or electronic enrollment provides necessary and reasonable safeguards to assure that the confidentiality of individually identifiable information and privileged information is maintained.
(b) The insurer shall make available, upon request of the commissioner, records that will demonstrate the insurer's ability to confirm enrollment and coverage amounts. [L 2007, c 233, pt of §4]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-206 Discontinuance and replacement.

§431:10H-206 Discontinuance and replacement.
If a group long-term care insurance policy is replaced by another group long-term care insurance policy issued to the same policyholder, the succeeding insurer shall offer coverage to all persons covered under the previous group policy on its date of termination. Coverage provided or offered to individuals by the insurer and premiums charged to person under the new group policy shall not:
(1) Result in an exclusion for preexisting conditions that would have been covered under the group policy being replaced; and
(2) Vary or otherwise depend on the individual's health or disability status, claim experience, or use of long-term care services. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-207 Premiums charged--group and individual policies.

§431:10H-207 Premiums charged--group and individual policies.
(a) The premium charged to an insured shall not increase due to either:
(1) Increasing age of the insured at ages beyond sixty-five; or
(2) The duration the insured has been covered under the policy.
(b) The purchase of additional coverage shall not be considered a premium rate increase, but for purposes of the calculation required under section 431:10H-233, the portion of the premium attributable to the additional coverage shall be added to and considered part of the initial annual premium.
(c) A reduction of benefits shall not be considered a premium change, but for purpose of calculation required under section 431:10H-233, the initial annual premium shall be based on reduced benefits. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-208 Unintentional lapse.

§431:10H-208 Unintentional lapse.
(a) Each insurer offering long-term care insurance, as a protection against unintentional lapse, shall comply with this section.
(b) No individual long-term care policy or certificate shall be issued until the insurer has received from the applicant a written designation of at least one person, in addition to the applicant, who is to receive notice of lapse or termination of the policy or certificate for nonpayment of premium, or a written waiver dated and signed by the applicant electing not to designate additional persons to receive notice. The applicant has the right to designate at least one person who is to receive the notice of termination, in addition to the insured. Designation shall not constitute acceptance of any liability on the third party for services provided to the insured. The form used for the written designation shall provide space clearly designated for listing at least one person. The designation shall include each person's full name and home address.
(c) In the case of an applicant who elects not to designate an additional person, the waiver shall state:
"Protection Against Unintended Lapse. I understand that I have the right to designate at least one person other than myself to receive notice of lapse or termination of this long-term care insurance policy for nonpayment of premium. I understand that notice will not be given until thirty (30) days after a premium is due and unpaid. I elect NOT to designate a person to receive this notice."
(d) The insurer shall notify the insured of the right to change this written designation, no less often than every two years.
(e) When the policyholder or certificate holder pays premium for a long-term care insurance policy or certificate through a payroll or pension deduction plan, the notice requirement contained in subsection (c) need not be met until sixty days after the policyholder or certificate holder is no longer on a payment plan. The application or enrollment form for these policies or certificates shall clearly indicate the payment plan selected by the applicant. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-209 Lapse or termination for nonpayment of premium.

§431:10H-209 Lapse or termination for nonpayment of premium.
No individual long-term care policy or certificate shall lapse or be terminated for nonpayment of premium unless the insurer, at least thirty days before the effective date of the lapse or termination, has given notice to the insured and to those persons designated in section 431:10H-208 at the address provided by the insured for purposes of receiving notice of lapse or termination. Notice shall be given by first class United States mail, postage prepaid and notice may not be given until thirty days after a premium is unpaid. Notice shall be deemed to have been given as of five days after the date of mailing. [L 1999, c 93, pt of §2]