Indiana Code
Chapter 12. Long Term Care Insurance
27-8-12-10.5. Loss or Confinement Resulting From a Preexisting Condition; Exclusion of Coverage; Limitation Period; Rules

Sec. 10.5. (a) As used in this section, "preexisting condition" means a condition for which medical advice or treatment was recommended by or received from a provider of health care services within six (6) months preceding the effective date of coverage of an insured individual.
(b) A long term care insurance policy may not use a definition of preexisting condition that is more restrictive than the definition contained in subsection (a).
(c) Except for a group long term care policy under IC 27-8-5-16(1) or IC 27-1-12-37, a long term care insurance policy may not exclude coverage for a loss or confinement that is the result of a preexisting condition unless the loss or confinement begins within six (6) months following the effective date of coverage of an insured individual.
(d) The commissioner may extend the limitation period under subsections (a) and (c) concerning a specific age group category in a specific policy form upon a finding by the commissioner that the extension is in the best interest of the public.
(e) This section does not prohibit an insurer from doing any of the following:
(1) Using an application form designed to elicit the complete health history of an applicant.
(2) Based on an application, underwriting in accordance with the insurer's established underwriting standards.
(f) Unless otherwise provided in the policy or certificate, a preexisting condition, regardless of whether the condition is disclosed on the application, need not be covered until after the waiting period described in subsection (c).
(g) A long term care insurance policy may not exclude or use a waiver or rider to exclude, limit, or reduce coverage or benefits for a specifically named or described preexisting disease or physical condition beyond the waiting period described in subsection (c).
As added by P.L.114-1991, SEC.12.

Structure Indiana Code

Indiana Code

Title 27. Insurance

Article 8. Life, Accident, and Health

Chapter 12. Long Term Care Insurance

27-8-12-1. "Applicant" Defined

27-8-12-2. "Certificate" Defined

27-8-12-3. "Certificate Holder" Defined

27-8-12-4. "Insurance Policy" Defined

27-8-12-4.5. "Long Term Care Facility" Defined

27-8-12-5. "Long Term Care Insurance Policy" Defined

27-8-12-6. Compliance With Statutory Requirements

27-8-12-7. Policy Disclosure Standards; Marketing Practices; Continuing Education; Penalties; Reporting Practices; Rules

27-8-12-7.1. Qualification of Long Term Care Policies; Rules

27-8-12-8. Loss Ratio Standards Rule

27-8-12-9. Termination of Policy on Grounds of Age or Deteriorated Health

27-8-12-10. "Preexisting Condition" Defined; Exclusion of Coverage; Limitations

27-8-12-10.5. Loss or Confinement Resulting From a Preexisting Condition; Exclusion of Coverage; Limitation Period; Rules

27-8-12-10.6. Conditions on Eligibility for Benefits; Restrictions

27-8-12-11. Establishment of New Waiting Period

27-8-12-12. No Obligation Return Period; Notice

27-8-12-13. Direct Response Solicitation Issued Policies; No Obligation Return Period; Notice

27-8-12-14. Outline of Coverage; Contents

27-8-12-14.5. Policy Summary; Requirements

27-8-12-14.6. Benefits Funded Through Life Insurance by Acceleration of Death Benefits; Benefit Payment Status Report; Contents

27-8-12-15. Group Policy Certificate; Contents

27-8-12-16. Application of General Insurance Law

27-8-12-17. Group Policies Issued in Another State; Requirements

27-8-12-18. Insurance Producer Commissions

27-8-12-19. Violations; Civil Penalty; Amount