Oregon Statutes - Chapter 743 - Health and Life Insurance - Section 743.662 - Rescission of policy and denial of claims.

(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 or deny an otherwise valid long term care insurance claim upon a showing of a misrepresentation that is material to the acceptance for coverage.

(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 or deny an otherwise valid long term care insurance claim upon a showing of a misrepresentation that is material to the acceptance for coverage and also pertains to the condition for which benefits are sought.

(3) After a policy or certificate has been in force for two years, the policy or certificate is not contestable upon the ground of misrepresentation alone. The policy or certificate may be contested only upon a showing that the insured knowingly and intentionally misrepresented relevant facts relating to the insuredís health.

(4) A long term care insurance policy or certificate may not be field issued based on medical or health status. A policy or certificate is field issued for the purposes of this subsection if the policy or certificate is issued by an insurance producer or a third party administrator pursuant to underwriting authority granted to the insurance producer or third party administrator by an insurer.

(5) If an insurer has paid benefits under the long term care insurance policy or certificate, the insurer may not recover the benefit payments in the event that the policy or certificate is rescinded.

(6) This section does not apply to the remaining death benefit of a life insurance policy in the event of the death of the insured if the policy accelerates benefits for long term care, but this section otherwise applies to a life insurance policy that accelerates benefits for long term care. In the event of the death of an insured, the remaining death benefits under the life insurance policy are governed by ORS 743.168.

(7) This section is exempt from ORS 743A.001. [2007 c.486 §6]

Note: Section 18, chapter 486, Oregon Laws 2007, provides:

Sec. 18. Sections 6 [743.662] and 7 [743.664] of this 2007 Act and the amendments to ORS 743.650, 743.652, 743.653 and 743.655 by sections 1 to 4 of this 2007 Act apply to policies and certificates delivered or issued for delivery on or after January 1, 2008. [2007 c.486 §18]

Section:  Previous  743.652  743.653  743.654  743.655  743.656  743.657  743.660  743.662  743.663  743.664  743.666  743.669  743.672  743.675  743.678  Next

Last modified: August 7, 2008