"Long Term Care Insurance Policy" Defined

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Sec. 5. (a) As used in this chapter, "long term care insurance policy" means an insurance policy providing coverage for at least twelve (12) consecutive months for each covered person on an expense incurred, indemnity, prepaid, or other basis for one (1) or more necessary diagnostic, preventive, therapeutic, rehabilitative, maintenance, or personal care services provided in a setting other than an acute care wing of a hospital.

(b) The term includes the following:

(1) A policy advertised, marketed, or offered as long term care insurance.

(2) A group or individual annuity, a life insurance policy, or riders that provide directly or supplement long term care insurance.

(3) A policy or rider that provides for payment of benefits based upon cognitive impairment or the loss of functional capacity.

(c) The term does not include the following:

(1) An insurance policy that is offered primarily to provide basic hospital expense coverage, basic medical-surgical expense coverage, hospital confinement indemnity coverage, major medical expense coverage, disability income protection coverage, accident only coverage, specified disease or specified accident coverage, comprehensive coverage, catastrophic coverage, or limited benefit health coverage.

(2) A life insurance policy that accelerates the death benefit specifically for terminal illness, a medical condition requiring extraordinary medical intervention, or a permanent institutional confinement, and that provides the option of a lump sum payment for those benefits and in which neither the benefits nor the eligibility for the benefits is conditioned upon the receipt of long term care.

(3) An insurance policy that is offered primarily to provide basic Medicare supplemental coverage (as defined under IC 27-8-13).

As added by P.L.275-1987, SEC.1. Amended by P.L.114-1991, SEC.9.


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