58-17-97 Provisions covering preexisting conditions.
Provisions covering preexisting conditions.
Any accident and sickness policy or
certificate subject to the provisions of this chapter, other than credit health insurance as defined in
subdivision 58-19-2(1) and a health benefit plan as defined in § 58-17-66, shall comply with the
No policy or certificate may deny, exclude, or limit benefits for a covered individual for
claims incurred more than twelve months following the effective date of the person's
coverage due to a preexisting condition;
No policy or certificate may define a preexisting condition more restrictively than:
A condition that would have caused an ordinarily prudent person to seek medical
advice, diagnosis, care, or treatment during the twelve months immediately
preceding the effective date of coverage;
A condition for which medical advice, diagnosis, care, or treatment was
recommended or received during the twelve months immediately preceding the
effective date of coverage; or
A pregnancy existing on the effective date of coverage.
SL 1997, ch 288, § 2; SL 2001, ch 275, § 4; SL 2013, ch 248, § 1.