<html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><title></title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.sb3f982ab-89a7-48b9-912b-fa28de67e369Normal { text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont-000000 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sb3f982ab-89a7-48b9-912b-fa28de67e369000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont-000002 { color: #0000FF; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="sb3f982ab-89a7-48b9-912b-fa28de67e369Normal"><span xml:space="preserve" class="sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont">    </span><span class="sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont-000000">20:06:21:72.  Disclosure to applicant for a claim denial.</span><span xml:space="preserve" class="sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont"> If a claim under a long-term care insurance contract is denied, the issuer shall, within 60 days of the date of a written request by the policyholder or certificateholder, or a representative thereof:</span></p><p dir="ltr" class="sb3f982ab-89a7-48b9-912b-fa28de67e369Normal"><span xml:space="preserve" class="sb3f982ab-89a7-48b9-912b-fa28de67e369000001"> </span></p><p dir="ltr" class="sb3f982ab-89a7-48b9-912b-fa28de67e369Normal"><span xml:space="preserve" class="sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont">    (1)  Provide a written explanation of the reasons for the denial; and</span></p><p dir="ltr" class="sb3f982ab-89a7-48b9-912b-fa28de67e369Normal"><span xml:space="preserve" class="sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont">    (2)  Make available all information directly related to the denial.</span></p><p dir="ltr" class="sb3f982ab-89a7-48b9-912b-fa28de67e369Normal"><span xml:space="preserve" class="sb3f982ab-89a7-48b9-912b-fa28de67e369000001"> </span></p><p dir="ltr" class="sb3f982ab-89a7-48b9-912b-fa28de67e369Normal"><span xml:space="preserve" class="sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont">    </span><span class="sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont-000000">Source:</span><span xml:space="preserve" class="sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont"> 28 SDR 157, effective </span><span class="sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont">May 19, 2002.</span></p><p dir="ltr" class="sb3f982ab-89a7-48b9-912b-fa28de67e369Normal"><span xml:space="preserve" class="sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont">    </span><span class="sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont-000000">General Authority:</span><span xml:space="preserve" class="sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=58-17B-4"><span class="sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont-000002">58-17B-4</span></a><span class="sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont">.</span></p><p dir="ltr" class="sb3f982ab-89a7-48b9-912b-fa28de67e369Normal"><span xml:space="preserve" class="sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont">    </span><span class="sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont-000000">Law Implemented:</span><span xml:space="preserve" class="sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=58-17B-4"><span class="sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont-000002">58-17B-4</span></a><span class="sb3f982ab-89a7-48b9-912b-fa28de67e369DefaultParagraphFont">.</span></p><p dir="ltr" class="sb3f982ab-89a7-48b9-912b-fa28de67e369Normal"><span xml:space="preserve" class="sb3f982ab-89a7-48b9-912b-fa28de67e369000001"> </span></p></div></body></html>