Nevada Administrative Code
Chapter 687B - Contracts of Insurance
CONTRACTS FOR LONG-TERM CARE
Section 687B.0689 - Rescission or denial of claim upon showing of misrepresentation material to acceptance for coverage; field issuance of contract or certificate

Universal Citation: NV Admin Code 687B.0689

Current through February 27, 2024

1. For a long-term care insurance contract or certificate that has been in force for less than 6 months, an insurer may rescind the long-term care insurance contract or certificate or deny an otherwise valid long-term care insurance claim upon a showing of misrepresentation that is material to the acceptance for coverage.

2. For a long-term care insurance contract or certificate that has been in force for not less than 6 months but less than 2 years, an insurer may rescind the long-term care insurance contract or certificate or deny an otherwise valid long-term care insurance claim upon a showing of misrepresentation which is both material to the acceptance for coverage and which pertains to the condition for which benefits are sought.

3. After a long-term care insurance contract or certificate has been in force for 2 years, it is not contestable upon the grounds of misrepresentation alone and may be contested only upon a showing that the insured knowingly and intentionally misrepresented relevant facts relating to the insured's health.

4. A long-term care insurance contract or certificate may be field-issued if the compensation to the field issuer is not based on the number of long-term care insurance contracts or certificates issued.

5. If an insurer has paid benefits under a long-term care insurance contract or certificate, the benefit payments must not be recovered by the insurer if the long-term care insurance contract or certificate is rescinded.

6. The provisions of this section apply to policies of life insurance which accelerate benefits for long-term care except that, in the event of the death of the insured, this section does not apply to the remaining death benefit of a policy of life insurance that accelerates benefits for long-term care, and the remaining death benefits under such a policy must be governed by NRS NRS 688A.080.

7. As used in this section, "field-issued" means issued by a producer or a third-party administrator pursuant to the underwriting authority granted to the producer or third-party administrator by an insurer, using the insurer's underwriting guidelines.

Added to NAC by Comm'r of Insurance by R028-10, 12-16-2010, eff. 10-1-2011

NRS 679B.130

Disclaimer: These regulations may not be the most recent version. Nevada 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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