State RegulationsGA specificDifficulty 3/5
An Atlanta insurer issued an individual accident and sickness policy three years ago. While reviewing a claim, the adjuster finds the insured understated his height and weight on the application, but there is no evidence of fraud and no written fraudulent misstatement. What may the insurer do?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Under O.C.G.A. § 33-29-3(b)(2)(A), after two years from issue, and absent fraud, no misstatement may be used to void the policy or deny a claim. Fraud requires a written, material misstatement, with a copy of the application furnished to the insured. An innocent misstatement discovered after the two-year limit cannot support any defense to the claim.
Why the other options are wrong
- B) After two years, and absent fraud, the policy cannot be voided for a misstatement.
- C) The statute bars using the misstatement to deny the claim at all — a partial denial is not authorized.
- D) Rescission is not available after the two-year limit in the absence of fraud, regardless of any premium refund.
Memory hook
Two years closes the door — unless fraud was in writing.