LD 1865
pg. 2
Page 1 of 2 RESOLVE Chapter 131 LD 1865 Title Page
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LR 2789
Item 1

 
Bureau of Insurance that has been submitted to the Legislature for
review pursuant to the Maine Revised Statutes, Title 5, chapter
375, subchapter 2-A is authorized only if the following changes are
made.

 
1. In Section 4(K) with regard to the definition of
preexisting condition, the look-back period for a preexisting
condition is changed from 12 months to 24 months.

 
2. In Section 5(A) with regard to prohibited policy
provisions, language is added to clarify that that section is not
intended to restrict the use of elimination periods for
disability income benefits.

 
3. In Section 6(A) with regard to minimum standards for
health insurance benefits generally, language is added to permit
an insurer to void or contest a policy or deny claims for a
sickness first manifested before the effective date of the policy
that was fraudulently not disclosed or fraudulently
misrepresented in an application for coverage.

 
4. In Section 6(A)(8) with regard to minimum standards for
health insurance benefits generally, the maximum time period
between the date of an accident and the date of loss is shortened
from 180 days to 90 days for accidental death and dismemberment
benefits and from 90 days to 30 days for disability coverage.

 
5. In Section 6(H) with regard to minimum standards for
individual disability income protection coverage, the maximum
elimination period is changed from 365 days to 730 days in cases
of coverage having a benefit period of more than 2 years, and the
shortest permissible maximum benefit period is changed from 6
months to 3 months.

 
6. In Section 6(J)(2)(c) with regard to specified disease
coverage, language is added to provide an exception for lump-sum
benefits based on diagnosis of a specified disease.

 
7. In Section 6(J)(4) and Section 6(J)(5) with regard to
specified disease coverage, language is added to permit the
Superintendent of Insurance to approve different minimum benefits
for cancer coverage on an expense-incurred basis or a per diem
indemnity basis if the superintendent determines that the minimum
benefits are in the interest of the consumer.

 
Emergency clause. In view of the emergency cited in the preamble,
this resolve takes effect when approved.

 
Effective April 14, 2004.


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