West Virginia Code of State Rules › Agency 114 - Insurance Commission › Title 114 - LEGISLATIVE RULE INSURANCE COMMISSIONER › Series 114-32 - Long-Term Care Insurance › Section 114-32-5 - Unintentional Lapse

Current through Register Vol. XLI, No. 28, July 12, 2024
Each insurer offering long-term care insurance shall, as a
				  protection against unintentional lapse, comply with the following:
5.1.
5.1.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 a person to receive this notice." The insurer shall notify the
				insured of the right to change this written designation, no less often than once
				every two (2) years.
5.1.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 of this subsection need not be met until sixty (60) 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 shall clearly
				indicate the payment plan selected by the applicant.
5.1.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 subdivision a of this
				subsection, 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.