State RegulationsNC specificDifficulty 2/5
A North Carolina insurer is drafting the claim provisions for its individual health policy forms. What is the shortest claim filing deadline the insurer may require after the date of service?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
G.S. 58-3-225(f) lets insurers require claims to be submitted within 180 days after the date of service — 180 days after discharge for facility claims — but forbids them from requiring fewer than 180 days. Filing after the deadline is still allowed when it was not reasonably possible to file on time, and in no event later than 1 year.
Why the other options are wrong
- A) 90 days is a floor North Carolina expressly rejects; insurers must give at least 180 days.
- C) 60 days is far shorter than the statutory minimum and would be an unlawful filing requirement.
- D) 1 year is the outside limit for late filings excused by impossibility, not the standard window an insurer may impose.
Memory hook
Insurers can demand 180 days for filing — never a day less.