Code of Massachusetts Regulations
211 CMR - DIVISION OF INSURANCE
Title 211 CMR 146.00 - Specified Disease Insurance
Section 146.05 - General Standards for Individual Policies

(1) An individual policy covering a single specified disease or combination of specified diseases may not be sold or offered for sale other than as specified disease coverage pursuant to 211 CMR 146.00. An individual specified disease insurance policy shall cover all forms of the disease or diseases specified in t he p olicy.

(2) Any individual specified disease policy issued which conditions payment upon pathological diagnosis of a covered disease, shall also provide that if such a pathological diagnosis is medically inappropriate or life threatening, a clinical diagnosis will be accepted in lieu thereof. Any form of medically appropriate diagnosis shall be accepted.

(3) An individual specified disease policy shall be either guaranteed renewable or noncanceable.

(4) Except for any policy provision regarding other specified disease coverage with the same insurer, benefits for specified disease coverage shall be paid regardless of other coverage.

(5) An individual specified disease policy may only include pre-existing condition limitations which exclude coverage for no more than six months after the effective date of coverage under the policy. The pre-existing condition limitation may only apply to a condition for which medical advice was given or treatment was recommended by, or received from, a licensed health care provider within the six-month period immediately preceding the effective date of coverage. If an individual specified disease policy contains any limitation with respect to pre-existing conditions, such limitations shall appear as a separate paragraph in the policy and shall be labeled as "Pre-Existing Condition Limitations".

(6) No policy shall provide for a reduction of benefits upon attainment of any age or other condition, or upon the occurrence of any event(s).