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State RegulationsNY specificDifficulty 3/5

In New York, an insurer may refuse to renew an individual accident and health policy for any of the following reasons EXCEPT:

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

Why C is correct

Under N.Y. Ins. Law §3216(g), an individual accident and health policy may be nonrenewed only for specified grounds: nonpayment of premiums; fraud or intentional material misrepresentation; discontinuance of all coverage of that type (with ninety days' notice); complete withdrawal from the individual market (with 180 days' notice and a written plan); the insured's move out of a network plan's service area; and other reasons permitted under HIPAA. The insured's health status or claims experience is never a permissible ground, and the policy's cancellation provision under §3216(d)(2)(H) operates within these statutory limits.

Why the other options are wrong

  • A) Nonpayment of premiums is the first enumerated ground for nonrenewal.
  • B) Fraud or intentional material misrepresentation is an enumerated ground.
  • D) Moving out of a network plan's service area is an enumerated ground.

Memory hook

Getting sick is never a reason to lose renewal.

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