North Dakota Administrative Code › Title 45 - Insurance, Commissioner of › Article 45-06 - Accident and Health Insurance › Chapter 45-06-05 - Long-Term Care Insurance Model Regulation › Section 45-06-05-04.1 - Unintentional lapse

Current through Supplement No. 393, July, 2024
Each insurer offering long-term care insurance shall, as a
				  protection against unintentional lapse, comply with the following:
1.
a.
				Notice before lapse or termination. An individual long-term care
				policy or certificate may not be issued until the insurer 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 does
				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 must
				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 must 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 any person to receive such
				notice."
The insurer 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
				certificate holder pays premium for a long-term care insurance policy or
				certificate through a payroll or pension deduction plan, the requirements
				contained in subdivision a need not be met until sixty days after the
				policyholder or certificate holder is no longer on such a payment plan. The
				application or enrollment form for such policies or certificates must clearly
				indicate the payment plan selected by the applicant.
c. Lapse or termination for nonpayment of
				premium. An individual long-term care policy or certificate may not 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 pursuant to subdivision a of subsection
				1, at the address provided by the insured for purposes of receiving notice of
				lapse or termination. Notice must be given by first-class mail, postage
				prepaid, and notice may not be given until thirty days after a premium is due
				and unpaid. Notice is deemed to have been given as of five days after the date
				of mailing.