Section 48.83.140 - Determining whether coverage is appropriate-Suitability standards-Information protected-RulesIssuers and their agents, if any, must determine whether issuing long-term care insurance coverage to a particular person is appropriate, except in the case of a life insurance policy that accelerates benefits for long-term care.
(1) An issuer must: (a) Develop and use suitability standards to determine whether the purchase or replacement of long-term care coverage is appropriate for the needs of the applicant or insured;(b) Train its agents in the use of the issuer's suitability standards; and(c) Maintain a copy of its suitability standards and make the standards available for inspection, upon request.(2) The following must be considered when determining whether the applicant meets the issuer's suitability standards:(a) The ability of the applicant to pay for the proposed coverage and any other relevant financial information related to the purchase of or payment for coverage;(b) The applicant's goals and needs with respect to long-term care and the advantages and disadvantages of long-term care coverage to meet those goals or needs; and(c) The values, benefits, and costs of the applicant's existing health or long-term care coverage, if any, when compared to the values, benefits, and costs of the recommended purchase or replacement.(3) The sale or transfer of any suitability information provided to the issuer or agent by the applicant to any other person or business entity is prohibited.(4)(a) The commissioner shall adopt, by rule, forms of consumer-friendly personal worksheets that issuers and their agents must use for applications for long-term care coverage.(b) The commissioner may require each issuer to file its current forms of suitability standards and personal worksheets with the commissioner.