NAC687B.067. Applications: Questions; required statements; required information for applicants 80 years of age or older.

     1. An application for a long-term care insurance contract or certificate that is not guaranteed issue must contain clear and unambiguous questions designed to ascertain the condition of the applicant’s health.

     2. If an application for a long-term care insurance contract or certificate contains a question which asks whether the applicant has had medication prescribed by a physician, the applicant must be required to list any medication that has been prescribed. If an insurer knows, or should know, at the time of application that a medication listed by the applicant on the application is directly related to a medical condition for which coverage would otherwise be denied, the insurer shall not later rescind the long-term care insurance contract or certificate for that condition.

     3. Except for a long-term care insurance contract or certificate that is guaranteed issue:

     (a) A statement in the following form must be set out conspicuously and in close proximity to the block for the applicant’s signature on an application for a long-term care insurance contract or certificate:

Caution: If your answers on this application are incorrect or untrue, [Company Name] has the right to deny benefits or rescind your policy.

     (b) A statement in substantially the following form must be set out conspicuously on the long-term care insurance contract or certificate at the time of delivery:

Caution: The issuance of this [policy] [certificate] of long-term care insurance is based upon your responses to the questions on your application. A copy of your [application] [enrollment form] [is enclosed] [was retained by you when you applied]. If your answers are incorrect or untrue, the company has the right to deny benefits or rescind your [policy] [certificate]. The best time to clear up any questions is now, before a claim arises! If, for any reason, any of your answers is incorrect, contact the company at this address: [insert address].

     (c) Prior to issuing a long-term care insurance contract or certificate to an applicant who is at least 80 years old, an insurer shall obtain one of the following:

          (1) A report of a physical examination;

          (2) An assessment of functional capacity;

          (3) An attending physician’s statement; or

          (4) Copies of medical records.

     (Added to NAC by Comm’r of Insurance, eff. 12-15-94; A by R028-10, 12-16-2010, eff. 10-1-2011)