431:10-212

Contract limitations for handicapped children

[§431:10H-212] Disclosure; riders and endorsements. (a) Except for riders or endorsements by which the insurer effectuates a request made in writing by the insured under an individual long-term care insurance policy, all riders or endorsements added to an individual long-term care insurance policy after the date of issue or at reinstatement or renewal that reduce or eliminate benefits or coverage in the policy shall require signed acceptance by the individual insured.

(b) After the date of policy issuance, any rider or endorsement that increases benefits or coverage with a concomitant increase in premium during the policy term shall be agreed to in writing by the insured, except if the increased benefits or coverages are required by law.

© Where a separate additional premium is charged for benefits provided in connection with riders or endorsements, the premium charge shall be set forth in the policy, rider, or endorsement. [L 1999, c 93, pt of §2]

(b) For purposes of this section:

“Dependent” means a child of the insured individual:

(1) Under eighteen years of age;

(2) Under twenty-three years of age who is attending an educational institution and relying upon the insured individual for financial support; or

(3) Regardless of age who is incapable of self-sustaining employment by reason of intellectual disability or physical handicap and is chiefly dependent upon the insured individual for support and maintenance.

“Individual” includes a person or a member of any group provided in section 431:10D-202 and sections 431:10D-204 through 431:10D-210. [L 1987, c 347, pt of §2; am L 2004, c 122, §53; am L 2008, c 155, §3; am L 2011, c 220, §12]thus, provider had standing to contest insurer’s denial of no-fault insurance benefits. 90 H. 1, 975 P.2d 211.