Section 21.53.040. Prior hospital or institutional care conditions prohibited.

   (a) A long-term care insurance policy may not be delivered or issued for delivery in this state if the policy conditions eligibility
        (1) on a prior hospitalization requirement;
        (2) on the receipt of a higher level of institutional care, when care is provided in an institutional setting;
        (3) for noninstitutional benefits on a prior institutional stay of more than 30 days for which benefits are paid;
        (4) on admission to an institutional care facility for the same or a related condition within a period of less than 30 days after discharge from the institution, if the policy provides benefits only following institutionalization; or
        (5) for a benefit, other than a waiver of premium, postconfinement, postacute care, or recuperative benefit, on a prior institutionalization.
   (b) A long-term care insurance policy containing a postconfinement, postacute care, or recuperative benefit must clearly label the limitations or conditions, including any required number of days of confinement, "Limitations or Conditions on Eligibility for Benefits" in a separate paragraph of the policy.

Notes

History

(Sec. 2 ch 106 SLA 1990; am Sec. 67 ch 23 SLA 2011)