Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.31 - Long-Term Care › Rule 6.6.3104A - UNINTENTIONAL LAPSE

Current through Register Vol. 13, July 5, 2024
(1) Each issuer
				offering long-term care insurance shall, as a protection against unintentional
				lapse, comply with the following:
(a) No
				individual long-term care policy or certificate shall be issued until the
				issuer has received from the applicant either 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 must provide space clearly designated for listing at least
				one person. The designation shall include each person's full name and home
				address. 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 or certificate for nonpayment of premium. I understand that
				notice will not be given until 30 days after a premium is due and unpaid. I
				elect NOT to designate a person to receive this notice." The issuer shall
				notify the insured of the right to change this written designation, no less
				often than once every two years.
(b) When the policyholder or
				certificateholder pays the premium for a long-term care insurance policy or
				certificate through a payroll or pension deduction plan, the requirements
				contained in (1)(a) need not be met until 60 days after the policyholder or
				certificateholder is no longer on such a payment plan. The application or
				enrollment form for such policies or certificates shall clearly indicate the
				payment plan selected by the applicant.
(c) No individual long-term care policy or
				certificate shall lapse or be terminated for nonpayment of premium unless the
				issuer, at least 30 days before the effective date of the lapse or termination,
				has given notice to the insured and to those persons designated pursuant to
				(1)(a) at the address provided by the insured for purposes of receiving notice
				of lapse or termination. Notice shall only be effective 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 delivery service, and the
				issuer obtains at the time of mailing a written receipt from the service
				showing the date 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 notice was mailed; or
(iii)
				first-class United States mail, and the issuer obtains at the time of mailing a
				written receipt from the United States Postal Service showing the date 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 notice was
				mailed.
(d) There is a
				presumption that notice is delivered five days after the date of mailing, as
				evidenced in the written receipt obtained by the insurer pursuant to (1)(c).
				The insurer shall retain any and all evidence of mailing the notice, including
				the list of recipients, as applicable, and a copy of the notice, for at least
				three years following the date of notice. Notice may not be given until 30 days
				after a premium is due and unpaid.