Section 58-17-97 - Provisions covering preexisting conditions. - South-dakota Statutes

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Statutes > South-dakota > Title-58 > Chapter-17 > Statute-58-17-97

58-17-97. Provisions covering preexisting conditions. Any accident and sickness policy or certificate subject to the provisions of this chapter, other than a health benefit plan as defined in § 58-17-66, shall comply with the following provisions:
(1) 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;
(2) No policy or certificate may define a preexisting condition more restrictively than:
(a) 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;
(b) 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
(c) A pregnancy existing on the effective date of coverage.

Source: SL 1997, ch 288, § 2; SL 2001, ch 275, § 4.

State Codes and Statutes

Statutes > South-dakota > Title-58 > Chapter-17 > Statute-58-17-97

58-17-97. Provisions covering preexisting conditions. Any accident and sickness policy or certificate subject to the provisions of this chapter, other than a health benefit plan as defined in § 58-17-66, shall comply with the following provisions:
(1) 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;
(2) No policy or certificate may define a preexisting condition more restrictively than:
(a) 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;
(b) 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
(c) A pregnancy existing on the effective date of coverage.

Source: SL 1997, ch 288, § 2; SL 2001, ch 275, § 4.

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State Codes and Statutes

Statutes > South-dakota > Title-58 > Chapter-17 > Statute-58-17-97

58-17-97. Provisions covering preexisting conditions. Any accident and sickness policy or certificate subject to the provisions of this chapter, other than a health benefit plan as defined in § 58-17-66, shall comply with the following provisions:
(1) 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;
(2) No policy or certificate may define a preexisting condition more restrictively than:
(a) 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;
(b) 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
(c) A pregnancy existing on the effective date of coverage.

Source: SL 1997, ch 288, § 2; SL 2001, ch 275, § 4.