31A-22-1407 - Restricted conditional terms. - Utah Statutes

31A-22-1407. Restricted conditional terms.
(1) A long-term care insurance policy may not contain a provision that conditionseligibility:
(a) for any benefits on a prior hospitalization requirement;
(b) for benefits provided in an institutional care setting on the receipt of a higher level ofinstitutional care; or
(c) for any benefits on a prior institutionalization requirement except for eligibility for:
(i) waiver of premium;
(ii) post confinement;
(iii) post-acute care; or
(iv) recuperative benefits.
(2) A long-term care insurance policy containing post confinement, post-acute care, orrecuperative benefits shall clearly label the limitations or conditions, including any requirednumber of days of confinement in a separate paragraph of the policy or certificate that is entitled"Limitations or Conditions on Eligibility for Benefits."
(3) A long-term care insurance policy or rider that conditions eligibility of noninstitutionalbenefits on the prior receipt of institutional care may not require a prior institutional stay of morethan 30 days.

Amended by Chapter 116, 2001 General Session