State RegulationsNY specificDifficulty 2/5
Two years after a New York Medicare supplement policy is issued, the insured is diagnosed with cancer and begins filing claims. The insurer wants to end the coverage. Under Reg 193, the insurer:
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
Under Reg 193 (11 NYCRR Part 58), New York Medicare supplement policies must be guaranteed renewable: once issued, the coverage continues while premiums are paid, and the insurer may not refuse renewal because the insured's health deteriorates or claims mount. A cancer diagnosis after issue is precisely what the guarantee protects against. As with other guaranteed renewable coverage, the insurer's financial remedy is a class-level premium adjustment, not dropping the individual who became ill.
Why the other options are wrong
- A) Advance notice cannot convert a health-based nonrenewal into a lawful one; the guarantee bars that ground entirely.
- B) Mid-term cancellation because the insured filed claims is exactly what the guaranteed renewable standard forbids.
- D) Refunding premiums does not purchase a right to nonrenew that the regulation withholds.
Memory hook
Cancer after issue: renew anyway - that is the Medigap guarantee.