431:10-101

Scope; effective dates

ARTICLE 10H

LONG-TERM CARE INSURANCE

Note

See table at end of this Article for derivation of HRS sections from the National Association of Insurance Commissioners 1998 Model Act or Regulations.

Cross References

Long-term care financing, see chapter 346C.

PART I. LONG-TERM CARE INSURANCE MODEL ACT

[§431:10H-101] Purpose. The purpose of this article is to promote the public interest, to promote the availability of long-term care insurance policies, to protect applicants for long-term care insurance, as defined, from unfair or deceptive sales or enrollment practices, to establish standards for long-term care insurance, to facilitate public understanding and comparison of long-term care insurance policies, and to facilitate flexibility and innovation in the development of long-term care insurance coverage. [L 1999, c 93, pt of §2]g out of the operation, maintenance, or use of a motor scooter, but not involving a motor vehicle.

“Owner” means a person who holds the legal title to a motorcycle or motor scooter; except that when a motorcycle or motor scooter is the subject of a security agreement or lease with a term of not less than one year, with the debtor or lessee having the right of possession, the term owner shall mean the debtor or lessee. Whenever transfer of title to a motorcycle or motor scooter occurs, the seller shall be considered the owner until delivery of the executed title to the buyer. Upon delivery of the executed title, the buyer holding the equitable title shall be considered the owner.

“Person” means, when appropriate to the context, not only individuals, but corporations, firms, associations, and societies. [L 1989, c 208, pt of §1]Case Notes

As chapter 432D does not cover the field of managed care regulation and because §§432D-2, 432E-1, and this article can be read together and there is no explicit language or policy reason not to give each statute effect, chapter 432D does not repeal chapter 432E by implication. 126 H. 326, 271 P.3d 621 (2012).

Properly licensed HMOs, like plaintiff, were authorized pursuant to §432D-1 to “provide or arrange”, at their option, for the closed panel health care services required under the managed care plan program; accident and health insurers were authorized under §431:10A-205(b) to arrange for medical services for members using a defined network of providers, i.e., particular “hospitals or persons”; thus, this article and chapter 432D authorized both accident and health insurers and HMOs, as risk-bearing entities, to provide the closed panel product required by the managed care plan contracts. 126 H. 326, 271 P.3d 621 (2012).

PART I. INDIVIDUAL ACCIDENT AND HEALTH

OR SICKNESS POLICIES

Note

Part heading amended by L 2002, c 155, §48.

Attorney General Opinions

Section 431:10A-601 applied to all parts of article 10A if the category of policy under consideration included family coverage, as defined in §431:10A-103. Att. Gen. Op. 97-10.

Case Notes

Under this article and §431:10A-105(2)(A)(ii), standard “incontestability clause” of contract precluded insurer from denying insured “total disability benefit” contracted for, notwithstanding that HIV infection that caused the disability arguably “manifested” itself prior to policy’s effective date of coverage. 86 H. 262, 948 P.2d 1103.

§431:10A-101 Applications and exceptions. This part shall apply to all policies of accident and health or sickness insurance delivered or issued for delivery in this State, except that nothing in this part shall apply to or affect:

(1) Any policy of workers’ compensation insurance or any policy of vehicle or liability insurance with or without supplementary coverage therein;

(2) Any policy or contract of reinsurance;

(3) Any blanket or group policy of insurance; or

(4) Life insurance, endowment, or annuity contracts, or contracts supplemental thereto which contain only such provisions relating to accident and health or sickness insurance as:

(A) Provide additional benefits in case of death, dismemberment, or loss of sight by accident; or

(B) Operate to safeguard such contracts against lapse, or to give a special surrender value, special benefit, or an annuity in the event that the insured or annuitant shall become totally and permanently disabled, as defined by the contract or supplemental contract. [L 1987, c 347, pt of §2; am L 2002, c 155, §49]