State RegulationsNY specificDifficulty 2/5
A lapsed New York individual health policy is submitted for reinstatement with payment of the overdue premiums, but the insurer takes no action on the request. If no premium remains unpaid, when is the policy automatically reinstated?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Under N.Y. Ins. Law §3216(d)(1)(D), when a reinstatement request is submitted with payment of overdue premiums and the insurer fails to act, the policy is automatically reinstated as of the 45th day, provided no premium is then unpaid. Insurer silence therefore restores coverage rather than prolonging the lapse, and the insured does not need an express approval to be protected.
Why the other options are wrong
- B) Ten days is the waiting period for sickness benefits after reinstatement.
- C) Sixty days is the window for applying overdue premiums retroactively.
- D) Automatic reinstatement upon insurer inaction is precisely what the statute provides.
Memory hook
No answer by day 45? The policy reinstates itself.