Form LTC-D "Long-Term Care Insurance Suitability Letter" - Missouri

What Is Form LTC-D?

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-D 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-D "Long-Term Care Insurance Suitability Letter" - Missouri

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Long-Term Care Insurance Suitability Letter
Dear [Applicant]:
Your recent application for long-term care insurance included a “personal worksheet,”
which asked questions about your finances and your reasons for buying long-term care
insurance. For your protection, state law requires us to consider this information when we
review your application, to avoid selling a policy to those who may not need coverage.
[Your answers indicate that long-term care insurance may not meet your financial needs.
We suggest that you review the information provided along with your application,
including the booklet “Shopper’s Guide to Long-Term Care Insurance” and the page
titled “Things You Should Know Before Buying Long-Term Care Insurance.” Your state
insurance department also has information about long-term care insurance and may be
able to refer you to a counselor free of charge who can help you decide whether to buy
this policy.]
[You chose not to provide any financial information for us to review.]
(note to insurers: Choose the paragraph that applies.)
We have suspended our final review of your application. If, after careful consideration,
you still believe this policy is what you want, check the appropriate box below and return
this letter to us within the next sixty (60) days. We will then continue reviewing your
application and issue a policy if you meet our medical standards.
If we do not hear from you within the next sixty (60) days, we will close your file and not
issue you a policy. You should understand that you will not have any coverage until we
hear back from you, approve your application and issue you a policy.
Please check one box and return in the enclosed envelope.
Yes, [although my worksheet indicates that long-term care insurance may not be
a suitable purchase,] I wish to purchase this ________
coverage. Please resume review of my application.
Note: Delete the phrase in brackets if the applicant did not answer the questions about
income.
No. I have decided not to buy a policy at this time.
__________________________________________
______________________________
APPLICANT’S SIGNATURE
DATE
Please return to [issuer] at [address] by [date].
LTC-D
(Rev 11/15/2007)
Long-Term Care Insurance Suitability Letter
Dear [Applicant]:
Your recent application for long-term care insurance included a “personal worksheet,”
which asked questions about your finances and your reasons for buying long-term care
insurance. For your protection, state law requires us to consider this information when we
review your application, to avoid selling a policy to those who may not need coverage.
[Your answers indicate that long-term care insurance may not meet your financial needs.
We suggest that you review the information provided along with your application,
including the booklet “Shopper’s Guide to Long-Term Care Insurance” and the page
titled “Things You Should Know Before Buying Long-Term Care Insurance.” Your state
insurance department also has information about long-term care insurance and may be
able to refer you to a counselor free of charge who can help you decide whether to buy
this policy.]
[You chose not to provide any financial information for us to review.]
(note to insurers: Choose the paragraph that applies.)
We have suspended our final review of your application. If, after careful consideration,
you still believe this policy is what you want, check the appropriate box below and return
this letter to us within the next sixty (60) days. We will then continue reviewing your
application and issue a policy if you meet our medical standards.
If we do not hear from you within the next sixty (60) days, we will close your file and not
issue you a policy. You should understand that you will not have any coverage until we
hear back from you, approve your application and issue you a policy.
Please check one box and return in the enclosed envelope.
Yes, [although my worksheet indicates that long-term care insurance may not be
a suitable purchase,] I wish to purchase this ________
coverage. Please resume review of my application.
Note: Delete the phrase in brackets if the applicant did not answer the questions about
income.
No. I have decided not to buy a policy at this time.
__________________________________________
______________________________
APPLICANT’S SIGNATURE
DATE
Please return to [issuer] at [address] by [date].
LTC-D
(Rev 11/15/2007)