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MICHIGAN STATUTES AND CODES
Section 500.3921 - Application; questions relating to health condition; delivery; record of policy rescissions; annual report to commissioner.
Act 218 of 1956
500.3921 Application; questions relating to health condition; delivery; record of policy rescissions; annual report to commissioner.
Sec. 3921.
(1) All applications for long-term care insurance policies except those that are guaranteed issue shall contain clear and unambiguous questions designed to ascertain the applicant's health condition.
(2) If an application for long-term care insurance contains a question that asks whether the applicant has had medication prescribed by a physician, it shall also ask the applicant to list the medication that has been prescribed.
(3) If any medications listed in an 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be directly related to a medical condition for which coverage would otherwise be denied, then the policy shall not be rescinded for that condition.
(4) Except for policies that are guaranteed issue, all of the following apply:
(a) The following language shall be set out conspicuously and in close conjunction with the applicant's signature block on an application for a long-term care insurance policy:
“Caution: If your answers on this application are incorrect or untrue, [company] has the right to deny benefits or rescind your policy.”
(b) The following language, or language substantially similar to the following, shall be set out conspicuously on the long-term care insurance policy at the time of delivery:
“Caution: The issuance of this long-term care insurance policy 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. 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 company at this address: [insert address]”
(c) Prior to issuance of a long-term care policy to an applicant age 80 or older, the insurer shall obtain 1 of the following:
(i) A report of a physical examination.
(ii) An assessment of functional capacity.
(iii) An attending physician's statement.
(iv) Copies of medical records.
(5) A copy of the completed application or enrollment form, whichever is applicable, shall be delivered to the insured no later than at the time of delivery of the policy unless it was retained by the applicant at the time of application.
(6) Every insurer or other entity selling or issuing long-term care insurance benefits shall maintain a record of all policy rescissions, both state and countrywide, except those the insured voluntarily effectuated, and shall annually furnish this information to the commissioner.
History: Add. 1992, Act 84, Imd. Eff. June 2, 1992
Popular Name: Act 218