State RegulationsMI specificDifficulty 3/5
A claim for care related to a condition the insured was treated for before the LTC policy's effective date arrives after the policy's printed preexisting-condition limitation period has run. The condition was not excluded by name in the application. Under Michigan's LTC framework, what is the strongest position for the insured?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
Michigan's preexisting-condition limitation for LTC policies (M.C.L. 500.3911) is a temporary deferral, and the concept operates like the corresponding rule in Michigan's disability framework: a limitation period postpones coverage for prior conditions, while a named exclusion removes a condition from the contract outright. Once the limitation period has expired, a preexisting condition that was never excluded by name in the application cannot be used to deny the claim, and DIFS oversees compliance with these policy provisions.
Why the other options are wrong
- A) Permanent disqualification of all prior conditions confuses a time-limited limitation with a lifetime exclusion.
- B) LTC preexisting conditions do become covered once the limitation period runs, provided they were not excluded by name.
- D) No court action is needed; the statutory framework itself ends the limitation when its period expires.
Memory hook
The clock kills the limitation; only a named exclusion survives it.