State RegulationsFL specificDifficulty 3/5
A Florida individual health policy was issued 2 years ago. The insurer recently discovered that the insured made a non-fraudulent material misstatement in the application. What may the insurer do?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
Under Fla. Stat. 627.607, the time limit on certain defenses in a health policy is 2 years from the date of issue; after that, the insurer may use only fraudulent misstatements to void the policy or deny a claim. Because the misstatement here was non-fraudulent and the 2-year period has run, the insurer cannot void the policy, deny a claim, or reduce benefits because of it. This post-contestability protection is a key consumer safeguard in Florida health policies.
Why the other options are wrong
- A) After the 2-year contestable period has run, a non-fraudulent misstatement cannot be used to void a health policy.
- B) Denying a claim after the contestable period requires a fraudulent misstatement, not merely a material one.
- C) The statute provides no authority to reduce benefits based on a non-fraudulent misstatement discovered after 2 years.
Memory hook
Two years cleans the slate — unless you lied.