Oklahoma Administrative Code › Title 365 - Insurance Department › Chapter 10 - Life, Accident and Health › Subchapter 5 - Minimum Standards; Contract Guidelines › Part 5 - LONG-TERM CARE INSURANCE › Section 365:10-5-43.1 - Unintentional lapse

Current through Vol. 41, No. 20, July 1,
				  2024
Each insurer offering long-term care insurance shall, as a
					 protection against unintentional lapse, comply with the following:
(1)
Notice requirements.
(A)
Notice before lapse or
				  termination.
No individual long-term care policy or certificate shall 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 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 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 (2) years.
(B)
Payroll or pension deduction plan
				  notice requirements.
When the policyholder or certificateholder pays
				  premium for a long-term care insurance policy or certificate through a payroll
				  or pension deduction plan, the requirements contained in (A) of this paragraph
				  need not be met until sixty (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)
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 (30) days before the effective date of the lapse or termination, has
				  given notice to the insured and to those persons designated pursuant to this
				  Section, 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 (30)
				  days after a premium is due and unpaid. Notice shall be deemed to have been
				  given as of five (5) days after the date of mailing.