State RegulationsIL specificDifficulty 2/5
An Illinois individual accident and health policy contains a provision requiring the policyowner to give the insurer notice of claim within 45 days of a covered loss. Under the Illinois Insurance Code minimum standard enforced for individual A&H policies, what notice period must the policy actually provide?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
215 ILCS 5/357.6 requires written notice of claim under an individual accident and health policy within 20 days after the occurrence or start of the loss, or as soon as reasonably possible. The statute also requires written notice at least every 6 months for continuing losses. A 45-day notice requirement is more restrictive than the Illinois minimum and is inconsistent with the minimum-standards approach that 50 Ill. Adm. Code 2007 enforces for individual A&H policies, so the policy's provision must be conformed to the statutory period.
Why the other options are wrong
- A) 10 days is not the statutory notice period; 215 ILCS 5/357.6 sets it at 20 days or as soon as reasonably possible.
- B) 30 days understates the claimant's statutory right; the minimum is 20 days after the occurrence or start of loss, or as soon as reasonably possible.
- C) 6 months is the interval for continuing-loss notices under 215 ILCS 5/357.6, not the initial notice-of-claim deadline.
Memory hook
Notice in 20 days, or as soon as you possibly can.