Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 425 - LONG-TERM CARE INSURANCE › Appendix 031-425-A

Current through 2024-29, July 17, 2024
Cautions about Replacing Existing
				  Insurance:
NOTICE TO APPLICANT REGARDING REPLACEMENT OF INDIVIDUAL
				  ACCIDENT AND SICKNESS OR LONG-TERM CARE INSURANCE
[Insurance company's name and address]
SAVE THIS NOTICE! IT MAY BE IMPORTANT TO YOU IN THE
				  FUTURE.
According to [your application] [information you have
				  furnished], you intend to lapse or otherwise terminate existing accident and
				  sickness or long-term care insurance and replace it with an individual
				  long-term care insurance policy to be issued by [company name] Insurance
				  Company. Your new policy provides 30 days within which you may decide, without
				  cost, whether you desire to keep the policy. For your own information and
				  protection, you should be aware of and seriously consider certain factors which
				  may affect the insurance protection available to you under the new
				  policy.
You should review this new coverage carefully, comparing it
				  with all accident and sickness or long-term care insurance coverage you now
				  have, and terminate your present policy only if, after due consideration, you
				  find that purchase of this long-term care coverage is a wise decision.
STATEMENT TO APPLICANT BY PRODUCER OR OTHER
				  REPRESENTATIVE:
(Use additional sheets, as necessary.)
I have reviewed your current medical or health insurance
				  coverage. I believe the replacement of insurance involved in this transaction
				  materially improves your position. My conclusion has taken into account the
				  following considerations, which I call to your attention:
1. Health conditions that you may presently have (preexisting
				  conditions), may not be immediately or fully covered under the new policy. This
				  could result in denial or delay in payment of benefits under the new policy,
				  whereas a similar claim might have been payable under your present
				  policy.
2. State law provides that your replacement policy or
				  certificate may not contain new waiting periods for coverage if the replacement
				  policy or certificate is issued by the same insurer and you have not increased
				  your level of benefits. If that is the case, your insurer will waive any period
				  applicable to waiting periods in the new policy or certificate to the extent
				  that such time was depleted under the original policy or certificate.
3. If you are replacing existing long-term care insurance
				  coverage, you may wish to secure the advice of your present insurer or its
				  agent regarding the proposed replacement of your present policy. This is not
				  only your right, but it is also in your best interest to make sure you
				  understand all the relevant factors involved in replacing your present
				  coverage.
4. If, after due consideration, you still wish to terminate
				  your present policy and replace it with new coverage, be certain to truthfully
				  and completely answer all questions on the application concerning your medical
				  health history. Failure to include all material medical information on an
				  application may provide a basis for the company to deny any future claims and
				  to refund your premium as though your policy had never been in force. After the
				  application has been completed and before your sign it, reread it carefully to
				  be certain that all information has been properly recorded.
______________________________________________________
(Signature of Producer or Other Representative)
[Typed Name and Address of Producer of Other
				  Representative]
The above "Notice to Applicant" was delivered to me
				  on:
______________________________
				  ________________________
(Applicant's Signature) (Date)