State RegulationsNY specificDifficulty 2/5
An insurer issues a long-term care insurance policy in New York. Under Reg 62, how far back may the insurer look for preexisting conditions when the policy is issued?
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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 (Reg 62)), a long-term care insurer's preexisting condition provision may look back no more than 6 months before the effective date of coverage to identify conditions for which the insured received medical advice or treatment. This bounded look-back keeps the insurer from probing the applicant's entire history while still permitting reasonable protection against claiming immediately for known conditions.
Why the other options are wrong
- A) 2 years is the incontestability period for life and health policies, not the long-term care preexisting-condition look-back.
- C) 12 months is double the look-back Reg 62 permits for long-term care policies.
- D) An unlimited search of the insured's complete medical history is exactly what the limited look-back period forbids.
Memory hook
LTC look-back: 6 months back, and not a day further.