Sec. 3911.
(1) A preexisting condition limitation period in a long-term care insurance policy, other than a group long-term care certificate described in section 3901(c)(i), shall not exceed 1 of the following:
(a) Six months after the effective date of coverage.
(b) A period of time set by the commissioner if the commissioner has found that a longer limitation period than provided for in subdivision (a) is justified because the group is specially limited by age, group categories, or other specific policy provisions and that the longer limitation period will be in the best interest of the public.
(2) A long-term care insurance policy, other than a group long-term care certificate described in section 3901(c)(i) , shall not use a definition of preexisting condition that is more restrictive than the definition in section 3901.
(3) The definition of preexisting condition does not prohibit an insurer from using an application form designed to elicit the complete health history of an applicant and, on the basis of the answers on that application, underwrite in accordance with that insurer's established underwriting standards.
(4) Unless otherwise provided in the policy, a preexisting condition, regardless of whether it is disclosed on the application, need not be covered until after the limitation period. A long-term care insurance policy shall not exclude or use waivers or riders of any kind to exclude, limit, or reduce coverage or benefits for specifically named or described preexisting conditions beyond the limitation period.
History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218
Structure Michigan Compiled Laws
Chapter 500 - Insurance Code of 1956
Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)
218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)
Section 500.3901 - Long-Term Care Insurance; Definitions.
Section 500.3902 - Offer of Long-Term Care Coverage by Subsidiary of Health Care Corporation.
Section 500.3908 - Long-Term Care Partnership Program Policy; Conversion or Replacement.
Section 500.3911 - Preexisting Condition; Limitation Period; Definition.
Section 500.3913 - Home Health Care Benefits.
Section 500.3915 - Certain Conditions Prohibited.
Section 500.3919 - Institutionalization; Extension of Benefits; Limitations.
Section 500.3929 - Increasing Premiums Prohibited; Conditions.
Section 500.3933 - Summary of Coverage.
Section 500.3935 - Statement Relating to Request for Additional Information.
Section 500.3937 - Shopper's Guide; Format; Providing to Applicants; Exception.
Section 500.3941 - Advertising; Filing Copy With Commissioner.
Section 500.3942a - Reporting Requirements; Agent Activities; Preparation of Report.
Section 500.3943 - Right to Return Policy; Notice; “Direct Response Solicitation” Defined.
Section 500.3945 - Violation; Penalty.
Section 500.3949 - Life and Long-Term Care Benefits; Marketing; Compliance.
Section 500.3953 - Disclosure Statement.
Section 500.3955 - Compliance With Chapter and Applicable Laws.