Kansas Administrative Regulations

Agency 40.  Insurance Department

Article 4.  Accident and Health Insurance

 

40-4-37b Long-term care insurance; marketing practices; prohibitions; limitations.

 

A policy shall not be advertised, described, solicited, delivered or issued for delivery in this state as long-term care insurance if the policy, contract or rider limits or excludes coverage by type of illness, treatment, medical condition or accident, except for the following:

(a)  Mental or nervous disorders without demonstrable organic disease. This provision shall not exclude coverage for loss which results from organic brain disease, including alzheimer's disease or senile dementia;

(b)  alcoholism and drug addiction;

(c)  illness, treatment, medical condition or accident arising from:

(1)  Participation in a felony, riot or insurrection;

(2)  suicide, attempted suicide, or intentionally self-inflicted injury, whether sane or insane;

(3)  aviation; or

(4)  war or act of war, whether declared or undeclared;

(d)  benefits provided under medicare or governmental programs other than medicaid, any state or federal workers' compensation or employer's liability or occupational disease law;

(e)  services performed by a member of the covered person's immediate family; and

(f)  services for which no charge is normally made in the absence of insurance.

 

(Authorized by K.S.A. 40-103, K.S.A. 1991 Supp. 40-2228; implementing K.S.A. 1991 Supp. 40-2228; effective Jan. 4, 1993.)