(1)  For a policy or certificate that has been in force for less than six months, an insurer may rescind a long-term care insurance policy or certificate upon a showing of misrepresentation that is material to the acceptance for coverage.

Terms Used In Utah Code 31A-22-1411

  • Certificate: means evidence of insurance given to:
(a) an insured under a group insurance policy; or
(b) a third party. See Utah Code 31A-1-301
  • Insurance: includes :
    (i) a risk distributing arrangement providing for compensation or replacement for damages or loss through the provision of a service or a benefit in kind;
    (ii) a contract of guaranty or suretyship entered into by the guarantor or surety as a business and not as merely incidental to a business transaction; and
    (iii) a plan in which the risk does not rest upon the person who makes an arrangement, but with a class of persons who have agreed to share the risk. See Utah Code 31A-1-301
  • Long-term care insurance: includes :
    (i) any of the following that provide directly or supplement long-term care insurance:
    (A) a group or individual annuity or rider; or
    (B) a life insurance policy or rider;
    (ii) a policy or rider that provides for payment of benefits on the basis of:
    (A) cognitive impairment; or
    (B) functional capacity; or
    (iii) a qualified long-term care insurance contract. See Utah Code 31A-1-301
  • Policy: includes a service contract issued by:
    (i) a motor club under Chapter 11, Motor Clubs;
    (ii) a service contract provided under Chapter 6a, Service Contracts; and
    (iii) a corporation licensed under:
    (A) Chapter 7, Nonprofit Health Service Insurance Corporations; or
    (B) Chapter 8, Health Maintenance Organizations and Limited Health Plans. See Utah Code 31A-1-301
    (2)  For a policy or certificate that has been in force for at least six months but less than two years, an insurer may rescind a long-term care insurance policy or certificate upon a showing of misrepresentation that:

    (a)  is material to the acceptance for coverage; and

    (b)  pertains to the condition for which benefits are sought.

    Enacted by Chapter 344, 1995 General Session