Connecticut Administrative Code
Title 38a - Insurance Department
528a - Group Short-Term Care Insurance
Section 38a-528a-7 - Prohibition against post claims underwriting

Universal Citation: CT Reg of State Agencies 38a-528a-7

Current through March 14, 2024

(a) All applications for group short-term care certificates except those that are guaranteed issue shall contain clear and unambiguous questions designed to ascertain the health condition of the applicant.

(b) If an application for group short-term care insurance contains a question that asks whether the applicant has had medication prescribed, it shall also ask the applicant to list the medication that has been prescribed. If the medications listed in such 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directly related to a medical condition for which coverage would otherwise be denied, then the certificate shall not be rescinded for that condition.

(c) Except for certificates that are guaranteed issue:

(1) The following language shall be set out conspicuously and in close conjunction with the applicant's signature block on an application for group short-term care insurance:

Caution: If your answers on this application are incorrect or untrue, (insurer) has the right to deny benefits or rescind your coverage.

(2) The following language or language substantially similar to the following, shall be set out conspicuously on the group short-term care certificate at the time of delivery:

Caution: The issuance of this group short-term care insurance certificate is based upon your responses to the questions on your application. A copy of your application (is enclosed) (was retained by you when you applied). If your answers are incorrect or untrue, the insurer has the right to deny benefits or rescind your coverage. 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).

(d) A copy of the completed application shall be delivered to the insured no later than at the time of delivery of the certificate unless it was retained by the applicant at the time of application.

(e) Every insurer selling or issuing group short-term care insurance coverage shall maintain a record of all certificate or subscriber agreement rescissions, both statewide and nationally, except those that the insured voluntarily effectuated.

Disclaimer: These regulations may not be the most recent version. Connecticut may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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