State RegulationsNY specificDifficulty 1/5
Under the required time limit on certain defenses provision of a New York individual accident and health policy, once the policy has been in force for two years the insurer may NOT contest the policy on the basis of
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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)(B), after two years from the date of issue the insurer may not contest the policy based on the insured's health before the policy was issued. This is the health-insurance counterpart of incontestability: the insurer must complete its underwriting investigation within the contestable window or accept the risk as issued. The only carved-out exception is for fraudulent misstatements in the application.
Why the other options are wrong
- B) Fraudulent misstatements are the statutory exception and remain contestable after two years.
- C) The time limit does not restrict the insurer's rights regarding premium default.
- D) The provision concerns pre-issue health, not the insured's current occupation.
Memory hook
After two years, pre-issue health is off the table, but fraud never is.