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Hawaii long-term care insurance: exam rules and practice questions

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Long-term care is part C of section II on the Hawaii Accident and Health exam, Hawaii laws and rules pertinent to accident and health insurance only. That section has 12 of the 35 Hawaii questions. [1] The outline cites four sections of HRS chapter 431, article 10H: basic standards, the outline of coverage, policy definitions and suitability. [1] Our Hawaii health content outline page covers the basic standards. This page covers the rest of the long-term care rules a producer works with, from the application to a lapse, with 10 practice questions.

Preexisting conditions (HRS 431:10H-108)

Except for one category of group policy, a long-term care policy cannot define a preexisting condition more strictly than a condition for which medical advice or treatment was recommended by, or received from, a health care provider within six months before coverage took effect. [2] It also cannot exclude a loss or confinement caused by a preexisting condition unless that loss or confinement begins within six months after the effective date. [2] The commissioner may extend these periods for specific age groups in specific policy forms. [2]

Free look (HRS 431:10H-111)

Applicants may return the policy or certificate within thirty days of delivery and get the premium back if they are not satisfied for any reason. The notice of this right must be printed prominently on the first page or attached. Any refund is due within thirty days of the return, and the same refund rule applies when an application is denied. [3]

Contestability (HRS 431:10H-115)

How easily the insurer can rescind depends on how long the policy has been in force: [4]

Time in forceInsurer may rescind or deny a claim if
Less than six monthsmisrepresentation was material to the acceptance of coverage
Six months to less than two yearsmisrepresentation was material to acceptance and pertains to the condition for which benefits are sought
Two years or moreonly a showing that the insured knowingly and intentionally misrepresented relevant facts about their health

Two more rules from the same section: a long-term care policy may not be field issued based on medical or health status, and benefits already paid cannot be recovered if the policy is later rescinded. [4]

Renewability (HRS 431:10H-202)

An individual long-term care policy may only be guaranteed renewable or noncancellable. [5]

Lapse and reinstatement (HRS 431:10H-209, 210)

An individual policy cannot lapse for nonpayment unless the insurer mails notice at least thirty days before the lapse date, to the insured and to the persons designated under HRS 431:10H-208. The notice cannot go out until thirty days after the premium is unpaid, and it is deemed given five days after mailing. [6] If the insured was cognitively impaired or had a loss of functional capacity before the grace period ran out, the policy must allow reinstatement when requested within five months after termination, with past due premium collected where appropriate. [7]

Applications and benefit triggers (HRS 431:10H-218, 234)

Applications, other than guaranteed issue, must ask clear and unambiguous health questions. An application that asks whether the applicant has had medication prescribed by a physician must also ask the applicant to list it. If the insurer knew, or should have known, that a listed medication was directly related to a condition it would otherwise deny, it cannot rescind for that condition. [8] Benefit triggers cannot be stricter than a deficiency in not more than three activities of daily living, or the presence of cognitive impairment. [9]

Inflation protection and producer reports (HRS 431:10H-220, 222)

Insurers must offer inflation protection at the time of purchase. One qualifying option raises benefits each year, compounded annually at no less than five per cent. [10] Insurers also track each producer's replacement and lapse sales and report each year by June 30 the ten per cent of producers with the highest percentages. The law says those rates alone are not a violation. [11]

Practice questions

1. Under Hawaii law, what is the longest look-back an individual long-term care policy may use to define a preexisting condition?

A. Three months
B. Six months
C. Twelve months
D. Twenty-four months

Answer: B. (HRS 431:10H-108(a)) [2]

2. How long does a long-term care applicant have to return the policy for a full premium refund?

Answer: Thirty days from delivery. (HRS 431:10H-111) [3]

3. A policy has been in force for eight months. What must the insurer show to rescind it?

Answer: A misrepresentation material to acceptance that also pertains to the condition for which benefits are sought. (HRS 431:10H-115(b)) [4]

4. A policy has been in force for three years. Can the insurer contest it for an innocent misstatement?

Answer: No. After two years it can contest only on a showing that the insured knowingly and intentionally misrepresented relevant health facts. (HRS 431:10H-115(c)) [4]

5. An insurer rescinds a policy after paying some benefits. Can it recover what it paid?

Answer: No. (HRS 431:10H-115(e)) [4]

6. Which renewal provisions may an individual long-term care policy contain?

Answer: Only guaranteed renewable or noncancellable. (HRS 431:10H-202(a)) [5]

7. Under a guaranteed renewable policy, how may the insurer change premiums?

Answer: Only by revising rates on a class basis. (HRS 431:10H-202(b)) [5]

8. When is a lapse notice mailed on March 1 deemed given?

Answer: Five days after mailing, on March 6. (HRS 431:10H-209) [6]

9. An insured with cognitive impairment let the policy lapse. How long does she have to request reinstatement?

Answer: Five months after termination. (HRS 431:10H-210) [7]

10. What is the most an LTC policy may require for benefits based on activities of daily living?

Answer: A deficiency in not more than three of them. Cognitive impairment is the other trigger. (HRS 431:10H-234(a)) [9]

Study tips

Practice more with the free Hawaii accident and health practice test.

Prep Retention is independent and is not affiliated with Pearson VUE or the state.

Sources

Laws and exam documents quoted as of October 2026.

  1. Pearson VUE, Hawaii content outlines 121201 (effective January 1, 2026): https://www.pearsonvue.com/content/dam/VUE/vue/en/documents/publications/121201.pdf
  2. HRS 431:10H-108: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010H-0108.htm
  3. HRS 431:10H-111: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010H-0111.htm
  4. HRS 431:10H-115: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010H-0115.htm
  5. HRS 431:10H-202: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010H-0202.htm
  6. HRS 431:10H-209: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010H-0209.htm
  7. HRS 431:10H-210: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010H-0210.htm
  8. HRS 431:10H-218: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010H-0218.htm
  9. HRS 431:10H-234: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010H-0234.htm
  10. HRS 431:10H-220: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010H-0220.htm
  11. HRS 431:10H-222: https://data.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0010H-0222.htm

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