NDAC 45-06-15-07
Prohibition against post-claims underwriting
Cite as N.D. Admin. Code ยง 45-06-15-07
1.
a.
If an application for short-term care insurance contains a question which asks whether
the applicant has had medication prescribed by a physician, it shall also ask the applicant
to list all medication that has been prescribed.
b.
If the medications listed in the application were known by the insurer, or should have
been known at the time of application, to be directly related to a medical condition for
which coverage would otherwise be denied, then the policy or certificate shall not be
rescinded for that condition.
2.
The following language, or language substantially similar to the following, shall be set out
conspicuously on the short-term care insurance policy or certificate no later than when it is
delivered:
"Caution: The issuance of this short-term care insurance (policy or certificate) is based
upon your responses to the questions on your application. A copy of your (application or
enrollment form) (is enclosed or was retained by you when you applied). If your answers,
to the best of your knowledge and belief, are incorrect or untrue, the insurer may have
the right to deny benefits or rescind your policy. The best time to clear up any questions
is now, before a claim arises! If, for any reason, any of your answers are incorrect,
contact the insurer at this address: (insert address)."
3.
A copy of the completed application or enrollment form, whichever is applicable, shall be
delivered to the insured no later than when the policy or certificate is delivered unless it was
retained by the applicant at the time of application.