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S.D. Codified Laws § 58-17-97

Provisions covering preexisting conditions

Applied in 1 court decision — leading case Brake v. Hutchinson Technology Incorporated Group Disability Income Insurance Plan (2013)

Most recently applied in Brake v. Hutchinson Technology Incorporated Group Disability Income Insurance Plan (October 2013)

Source: SL 1997, ch 288, § 2; SL 2001, ch 275, § 4; SL 2013, ch 248, § 1.

Any accident and sickness policy or certificate subject to the provisions of this chapter, other than credit health insurance as defined in subdivision 58-19-2(1) and a health benefit plan as defined in § 58-17-66, shall comply with the following provisions:

(1) No policy or certificate may deny, exclude, or limit benefits for a covered individual for claims incurred more than twelve months following the effective date of the person's coverage due to a preexisting condition;

(2) No policy or certificate may define a preexisting condition more restrictively than:

(a) A condition that would have caused an ordinarily prudent person to seek medical advice, diagnosis, care, or treatment during the twelve months immediately preceding the effective date of coverage;

(b) A condition for which medical advice, diagnosis, care, or treatment was recommended or received during the twelve months immediately preceding the effective date of coverage; or

(c) A pregnancy existing on the effective date of coverage.

Official source: South Dakota Legislature. Reproduced from public-domain South Dakota statutes; confirm against the official source for the current text. Not legal advice.