State RegulationsFL specificDifficulty 2/5
Which provision, if included in a Florida health insurance policy, would violate the state's prohibited-provision rules?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
Under Chapter 627, Florida Statutes, a health policy may not restrict the insured's right to bring legal action to any period shorter than the limitation period provided by Florida law. Provisions on proof of loss, payment timing, and reinstatement terms are standard, permitted parts of a health policy. A shortened limitations clause would strip insureds of statutory rights and is therefore prohibited.
Why the other options are wrong
- A) Requiring proof of loss within the policy's stated time is a standard permitted provision.
- C) Providing for payment after due proof of loss is permitted and reflects the ordinary claims standard.
- D) Describing reinstatement terms after a lapse is a standard permitted provision in health policies.
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