Under a typical individual medical expense policy, expenses for an injury sustained while the insured is committing a felony or engaging in an illegal act are generally:
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
Individual medical expense policies contain standard exclusions for injuries or losses arising from the insured's commission of a felony or participation in an illegal act. Public policy prevents an insured from profiting from wrongful conduct, and the insurer cannot fairly price coverage for intentionally unlawful risk-taking. The common exclusions and limitations section of the outline (AH-III.A.1e) expects producers to recognize that criminal activity is treated as uninsurable, in the same family as war, intentional self-injury, and occupational injury that is covered by workers' compensation. When an injury occurs during a felony, the claim is denied because coverage never attaches to the loss.
Why the other options are wrong
- A) Injuries from felonies or illegal acts are not paid like ordinary accidents; the exclusion removes coverage entirely, so there is no equal-treatment scenario.
- C) No hospitalization-duration condition restores coverage for a felonious injury; the exclusion applies regardless of the treatment required.
- D) The exclusion is absolute and is not converted into coverage merely because a higher deductible would be applied or the insured would share more of the cost.
Memory hook
Crime pays nothing: injuries suffered during illegal acts are excluded.