211 CMR, § 65.10

Current through Register 1533, October 25, 2024
Section 65.10 - Protection Against Unintentional Lapse

No individual or group long-term care insurance policy may be issued unless it complies with the following:

(1)Notice of Nonpayment of Premiums Before Lapse or Termination. No individual or group longterm care insurance policy may be issued until the carrier has received from the applicant either a written designation of at least one person, in addition to the applicant, who is to receive notice of lapse or termination of the policy or certificate for nonpayment of premium, or a written waiver dated and signed by the applicant electing not to designate additional persons to receive notice. In the case of an applicantwho elects not to designate an additional person, the waiver shall state: "Protection against unintended lapse. I understand that I have the right to designate at least one person other than myself to receive notice of lapse or termination of this long-term care insurance policy for nonpayment of premium. I understand that notice shall not be given until 30 days after a premium is due and unpaid. I elect NOT to designate a person to receive this notice." The carrier shall notify theinsured of the right to change this written designation, no less often than once every two years.
(2)Lapse or termination for nonpayment of premium. No individual or group long-term care insurance policy shall lapse or be terminated for nonpayment of premium unless the carrier, at least 30 days before the effective date of the lapse or termination, has given notice to the insured and to those persons designated pursuant to 211 CMR 65.10(1), at the address provided by the insured for purposes ofreceivingnotice of lapse or termination. Notice shall be given by first class United States mail, postage prepaid; and notice may not be given until 30 days after a premium is due and unpaid. Notice shall be deemed to have been given as of ten days after the date of mailing.
(3)Reinstatement. All individual or group long-term care insurance policies shallinclude a provision for reinstatement of coverage, in the event of lapse, if the carrier is provided proof that the policyholder or certificateholder was cognitively impaired or had a loss of functional capacity before expiration of the policy's grace period. Reinstatement shallbeavailableto the insured if requested within five months after termination, and shall allow for the collection of past due premium, where appropriate.

211 CMR, § 65.10