Form LTC-2 "Notice to Applicant Regarding Replacement of Accident and Sickness or Long-Term Care Insurance" - Missouri

What Is Form LTC-2?

This is a legal form that was released by the Missouri Department of Commerce and Insurance - a government authority operating within Missouri. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 15, 2007;
  • The latest edition provided by the Missouri Department of Commerce and Insurance;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form LTC-2 by clicking the link below or browse more documents and templates provided by the Missouri Department of Commerce and Insurance.

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Download Form LTC-2 "Notice to Applicant Regarding Replacement of Accident and Sickness or Long-Term Care Insurance" - Missouri

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NOTICE TO APPLICANT REGARDING REPLACEMENT OF ACCIDENT AND SICKNESS
OR LONG-TERM CARE INSURANCE
[Insurance company’s name and address]
SAVE THIS NOTICE! IT MAY BE IMPORTANT TO YOU IN THE FUTURE.
According to [your application] [information you have furnished], you intend to lapse or otherwise terminate
existing accident and sickness or long-term care insurance and replace it with the long-term care insurance
policy delivered herewith issued by [company name] Insurance Company. Your new policy provides thirty
(30) days within which you may decide, without cost, whether you desire to keep the policy. For your own
information and protection, you should be aware of and seriously consider certain factors which may affect
the insurance protection available to you under the new policy.
You should review this new coverage carefully, comparing it with all accident and sickness or long-term care
insurance coverage you now have, and terminate your present policy only if, after due consideration, you
find that purchase of this long-term care coverage is a wise decision.
1. Health conditions which you may presently have (preexisting conditions), may not be immediately or fully
covered under the new policy. This could result in denial or delay in payment of benefits under the new
policy, whereas a similar claim might have been payable under your present policy.
2. State law provides that your replacement policy or certificate may not contain new preexisting conditions
or probationary periods. Your insurer will waive any time periods applicable to preexisting conditions or
probationary periods in the new policy (or coverage) for similar benefits to the extent such time was spent
(depleted) under the original policy.
3. If you are replacing existing long-term care insurance coverage, you may wish to secure the advice of
your present insurer or its producer regarding the proposed replacement of your present policy. This is not
only your right, but it is also in your best interest to make sure you understand all the relevant factors
involved in replacing your present coverage.
4. [To be included only if the application is attached to the policy.] If, after due consideration, you still wish to
terminate your present policy and replace it with new coverage, read the copy of the application attached to
your new policy and be sure that all questions are answered fully and correctly. Omissions or misstatements
in the application could cause an otherwise valid claim to be denied. Carefully check the application and
write to [company name and address] within thirty (30) days if any information is not correct and complete,
or if any past medical history has been left out of the application.
[Company Name]
Form LTC-2
(Rev 11/15/2007)
NOTICE TO APPLICANT REGARDING REPLACEMENT OF ACCIDENT AND SICKNESS
OR LONG-TERM CARE INSURANCE
[Insurance company’s name and address]
SAVE THIS NOTICE! IT MAY BE IMPORTANT TO YOU IN THE FUTURE.
According to [your application] [information you have furnished], you intend to lapse or otherwise terminate
existing accident and sickness or long-term care insurance and replace it with the long-term care insurance
policy delivered herewith issued by [company name] Insurance Company. Your new policy provides thirty
(30) days within which you may decide, without cost, whether you desire to keep the policy. For your own
information and protection, you should be aware of and seriously consider certain factors which may affect
the insurance protection available to you under the new policy.
You should review this new coverage carefully, comparing it with all accident and sickness or long-term care
insurance coverage you now have, and terminate your present policy only if, after due consideration, you
find that purchase of this long-term care coverage is a wise decision.
1. Health conditions which you may presently have (preexisting conditions), may not be immediately or fully
covered under the new policy. This could result in denial or delay in payment of benefits under the new
policy, whereas a similar claim might have been payable under your present policy.
2. State law provides that your replacement policy or certificate may not contain new preexisting conditions
or probationary periods. Your insurer will waive any time periods applicable to preexisting conditions or
probationary periods in the new policy (or coverage) for similar benefits to the extent such time was spent
(depleted) under the original policy.
3. If you are replacing existing long-term care insurance coverage, you may wish to secure the advice of
your present insurer or its producer regarding the proposed replacement of your present policy. This is not
only your right, but it is also in your best interest to make sure you understand all the relevant factors
involved in replacing your present coverage.
4. [To be included only if the application is attached to the policy.] If, after due consideration, you still wish to
terminate your present policy and replace it with new coverage, read the copy of the application attached to
your new policy and be sure that all questions are answered fully and correctly. Omissions or misstatements
in the application could cause an otherwise valid claim to be denied. Carefully check the application and
write to [company name and address] within thirty (30) days if any information is not correct and complete,
or if any past medical history has been left out of the application.
[Company Name]
Form LTC-2
(Rev 11/15/2007)