State RegulationsNC specificDifficulty 1/5
In North Carolina, what is the shortest claim-filing window a health insurer is permitted to require in its policy?
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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 health claims to be filed within 180 days after the date of service — or 180 days after discharge for facility claims — but prohibits requiring fewer than 180 days. Filing after the window is still allowed when it was not reasonably possible to file sooner, and in no event later than 1 year after the deadline.
Why the other options are wrong
- A) Ninety days is the NAIC-model proof-of-loss figure that North Carolina does not adopt; G.S. 58-3-225(f) sets the floor at 180 days.
- C) One year is the outside limit for late filing under G.S. 58-3-225(f), not the minimum window a policy may impose.
- D) Sixty days is the provider claim-status reporting trigger in G.S. 58-3-225(g); the claim-filing floor is 180 days.
Memory hook
Policies can demand 180 days but never a day less.