Older Americans Long-Term Care Insurance Act of 1991

Older Americans Long-Term Care Insurance Act of 1991 - Amends the Internal Revenue Code to require that, for the purpose of determining the income tax liability of issuers of qualified long-term insurance, the contracts be treated as accident or health insurance. Applies this provision to policies covering at least 12 consecutive months of necessary diagnostic, preventive, therapeutic, rehabilitative, or personal care services that are provided in a setting other than an acute care unit of a hospital.

Directs the Secretary of Health and Human Services to: (1) submit to the Congress before 1993 a study on long-term insurance policies; and (2) report annually to the Congress regarding the certification of qualified long-term care insurance.

Treats qualified long-term care insurance as accident or health insurance and its benefits as benefits for personal injuries or sickness for purposes of determining appropriate tax exclusions for employer contributions or employee benefits.

Permits qualified long-term care insurance to be offered in cafeteria plans.

Excludes from gross income: (1) distributions or payments from individual retirement plans that are used during the year to pay the premiums for qualified long-term care coverage of individuals aged 59 1/2 or older; and (2) amounts received upon surrender, cancellation, or exchange of a life insurance contract and used during the year to pay the premiums for qualified long-term care insurance.

Provides that payments under a life insurance contract to an individual who is terminally ill or permanently confined to a nursing home shall be treated as death benefits, making such payments eligible for exclusion from gross income.

Requires any reference to a life insurance contract to be treated as including a reference to a qualified accelerated death benefit rider on such contract. Describes such a rider as one which provides for payments to a terminally ill individual or one who is permanently confined to a nursing home.