[Code of Federal Regulations]
[Title 5, Volume 2]
[Revised as of January 1, 2004]
From the U.S. Government Printing Office via GPO Access
[CITE: 5CFR875.408]

[Page 425-426]
 
                    TITLE 5--ADMINISTRATIVE PERSONNEL
 
          CHAPTER I--OFFICE OF PERSONNEL MANAGEMENT (CONTINUED)
 
PART 875_FEDERAL LONG TERM CARE INSURANCE PROGRAM--Table of Contents
 
                           Subpart D_Coverage
 
Sec. 875.408  What is the significance of incontestability?

    (a) Incontestability means coverage issued based on an erroneous 
application may remain in effect. Such coverage will not remain in 
effect, and your claim may be denied, under any of the following 
conditions:
    (1) If your coverage has been in force for less than 6 months, the 
Carrier may void your coverage or deny a claim upon a showing that 
information on your signed application that was material to your 
approval for coverage is different than what is shown in your medical 
records.
    (2) If your coverage has been in force for at least 6 months but 
less than 2 years, the Carrier may void your coverage or deny a claim 
upon a showing that information on your signed application that was 
material to your approval for coverage is different than what is shown 
in your medical records, and pertains to the condition for which 
benefits are sought.
    (3) After your coverage has been in effect for 2 years, the Carrier 
may void your coverage only upon a showing that you knowingly and 
intentionally made a false or misleading statement or omitted 
information in your signed

[[Page 426]]

application for coverage regarding your health status.
    (b) Your coverage can be contested at any time when the Carrier 
finds that you were not an eligible individual at the time you applied 
and were approved for coverage.
    (c) If the Carrier voids coverage after it has paid benefits, it 
cannot recover the benefits already paid.
    (d) Incontestability does not apply when you have not paid your 
premiums on a timely basis.