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State RegulationsNY specificDifficulty 1/5

In a New York long-term care insurance solicitation, what is the Outline of Coverage required under Reg 62?

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Answer & full 3-part explanation (select an option above, or peek)

Why B is correct

Under Reg 62 (11 NYCRR Part 52), an Outline of Coverage must be given to long-term care applicants in New York. It is a plain-language summary of the policy's principal benefits, exclusions, reductions, and limitations, written so the applicant can compare the coverage with alternatives before buying. It is a consumer-disclosure document, not a part of the underwriting or claims process.

Why the other options are wrong

  • A) A physician's questionnaire is underwriting evidence used to evaluate insurability; the Outline of Coverage is a disclosure document for the applicant, not a medical record.
  • C) Claims manuals govern internal administration after a loss and are never the required solicitation disclosure handed to the applicant.
  • D) No New York rule lets an insurer promise that long-term care premiums will never rise; a guaranteed renewable policy can still be re-rated by class.

Memory hook

Outline of Coverage: the plain-English menu of benefits, exclusions, and limits - given to the applicant.

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