Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 2/5
A group health policy terminates while an insured is totally disabled from an injury that began while the policy was in force. The policy contains an extension of benefits provision. What is the effect?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
An extension of benefits (also called continued benefits) clause protects an insured who is totally disabled when a policy terminates. The insurer continues to pay benefits for the disabling condition for a limited period after the policy ends, even though the policy is no longer in force. This prevents a gap in coverage for a loss that began while the insured was protected. The extension applies only to the condition already causing total disability, not to new conditions.
Why the other options are wrong
- A) Immediate termination would defeat the purpose of the clause, which is specifically to bridge care for an ongoing disabling condition.
- B) The extension is temporary and limited, not lifetime, and no additional premium is the norm only for that limited window.
- C) Conversion rights, not extension of benefits, would convert the coverage to an individual policy; the two provisions are distinct.
Memory hook
Extension of benefits keeps paying the disabling claim for a limited time after the policy ends. Bridge, not lifetime.