<html> <head> <title>Rule 20:06:39:21 Definition of ordinarily prudent person in preexisting condition clauses.</title> <META NAME="Keywords" Content="Administrative Rules 20:06:39:21"> <META NAME="Description" Content="Administrative Rules 20:06:39:21 Definition of ordinarily prudent person in preexisting condition clauses."> <meta name=Generator content="Microsoft Office HTML Filter 2.0"> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Originator content="Microsoft Word 10"> <style> <!-- --> </style> </head> <body lang=EN-US> <div> <p><b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 20:06:39:21.&nbsp;&nbsp;Definition of ordinarily prudent person in preexisting condition clauses.</b> 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 <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-17-84">58-17-84</A> and <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-17-97">58-17-97</A> and does not apply to the contestability clause of a contract.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 25 SDR 90, effective January 3, 1999.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>General Authority:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-17-87">58-17-87(3)(4)(11)(15).</A></p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Law Implemented:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-17-84">58-17-84</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-17-97">58-17-97.</A></p> </div> </body> </html>