Rule 20:06:39:21 Definition of ordinarily prudent person in preexisting condition clauses.
20:06:39:21. Definition of ordinarily prudent person in
preexisting condition clauses. For diseases that
include symptoms of denial or failure to recognize the disease or illness, a
carrier shall define an ordinarily prudent person within the definition of a
preexisting condition in terms of the claimant's health-related circumstances
and how a similarly situated person would be expected to act in seeking medical
treatment or advice for that disease or illness. Nothing in this section
prohibits a carrier from investigating the existence of denial symptoms or
failure to recognize such disease or illnesses on a case by case basis. This
section applies to the definition of an ordinarily prudent person within the
preexisting condition clauses in SDCL 58-17-84 and 58-17-97 and does not apply to the contestability clause of a contract.
25 SDR 90, effective January 3, 1999.
Authority: SDCL 58-17-87(3)(4)(11)(15).
Implemented: SDCL 58-17-84, 58-17-97.
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