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 Washington Administrative Code (Last Updated: November 23, 2016)
 Title 284. Insurance Commissioner, Office of
 Chapter 284-83. Long-term care insurance rules.

  Section 284-83-185. Sample claims denial reporting form.  

Latest version.
  • The following form for reporting claims denials must be used in this state.
    Claims Denial Reporting Form
    Long-Term Care Insurance
    For the State of                         
    For the Reporting Year of                
    Company Name:                            
    Due: June 30, annually
    Company Address:                           
                                               
    Company NAIC Number:                       
    Contact Person:                            
    Phone Number:                              
    Instructions
    The purpose of this form is to report all long-term care claim denials under in-force long-term care insurance policies. "Denied" means a claim that is not paid for any reason other than for claims not paid for failure to meet the waiting period or because of an applicable preexisting condition.
    [Statutory Authority: RCW 48.02.060, 48.83.070, 48.83.110, 48.83.120, 48.83.130(1), and 48.83.140 (4)(a). WSR 08-24-019 (Matter No. R 2008-09), § 284-83-185, filed 11/24/08, effective 12/25/08.]
RCW 48.02.060, 48.83.070, 48.83.110, 48.83.120, 48.83.130(1), and 48.83.140 (4)(a). WSR 08-24-019 (Matter No. R 2008-09), § 284-83-185, filed 11/24/08, effective 12/25/08.