§431:10H-222  Reporting requirements. (a)  Every insurer shall maintain records for each producer of the producer'samount of replacement sales as a per cent of the producer's total annual salesand the amount of lapses of long-term care insurance policies sold by theproducer as a per cent of the producer's total annual sales.

(b)  Every insurer shall report annually byJune 30 the ten per cent of its producers with the greatest percentages oflapses and replacements as measured in subsection (a).  The form shall be inthe format contained in Appendix G to the April, 2002, NAIC Long-Term CareInsurance Model Regulation.

(c)  Reported replacement and lapse rates donot alone constitute a violation of insurance laws or necessarily implywrongdoing.  The reports are for the purpose of reviewing more closely produceractivities regarding the sale of long-term care insurance.

(d)  Every insurer shall report annually byJune 30 the number of lapsed policies as a per cent of its total annual salesand as a per cent of its total number of policies in force as of the end of thepreceding calendar year.  The form shall be in the format contained in AppendixG to the April, 2002, NAIC Long-Term Care Insurance Model Regulation.

(e)  Every insurer shall report annually byJune 30 the number of replacement policies sold as a per cent of its totalannual sales and as a per cent of its total number of policies in force as ofthe end of the preceding calendar year.  The form shall be in the formatcontained in Appendix G to the April, 2002, NAIC Long-Term Care Insurance ModelRegulation.

(f)  For qualified long-term care insurancecontracts, every insurer shall report annually by June 30, the number of claimsdenied for each class of business, expressed as a percentage of claims denied. The form shall be in the format contained in Appendix E to the April, 2002,NAIC Long-Term Care Insurance Model Regulation.

(g)  Reports required under this section shallbe filed with the commissioner.

(h)  For purposes of this section:

"Claim" means a request for paymentof benefits under an in force policy regardless of whether the benefit claimedis covered under the policy or any terms or conditions of the policy have beenmet.  Claims shall be subject to the definition of "denied".

"Denied" means the insurer refuses topay a claim for any reason other than for claims not paid for failure to meetthe waiting period or because of an applicable preexisting condition.

"Policy" means only long-term careinsurance.

"Report" means on a statewide basis.[L 1999, c 93, pt of §2; am L 2001, c 216, §22; am L 2007, c 233, §17]