The Vermont Statutes Online
The Statutes below include the actions of the 2025 session of the General Assembly.
NOTE: The Vermont Statutes Online is an unofficial copy of the Vermont Statutes Annotated that is provided as a convenience.
(Cite as: 8 V.S.A. § 8093)
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§ 8093. Denial of claims; written explanation
(a) If a claim under a long-term care insurance contract is denied, the issuer shall,
within 60 days of the date of a written request by the policyholder or certificate
holder, or a representative thereof:
(1) provide a written explanation of the reasons for the denial; and
(2) make available all information directly related to the denial.
(b) After completion of all internal appeals, the policyholder or certificate holder may
appeal the insurer’s benefit trigger determination to an independent review organization
designated by the Commissioner, upon payment of a filing fee of no more than $15.00.
The filing fee may be waived or reduced upon a finding by the Commissioner that the
financial circumstances of the insured warrant a waiver or reduction. All other costs
of the independent review shall be paid by the insurer. (Added 2003, No. 124 (Adj. Sess.), § 2, eff. Jan. 1, 2005; amended 2009, No. 137 (Adj. Sess.), § 28.)