State RegulationsNY specificDifficulty 2/5
A New York insured holds two individual accident and health policies issued by the same insurer, both covering the same type of loss. Under the other benefits provision, the insurer's liability for that loss is
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
Under N.Y. Ins. Law §3216(d)(2)(E), when the same insurer has issued more than one policy covering the same loss, its total liability is limited to the largest amount payable under a single policy. The insured cannot collect twice for one loss from one company; the companion requirement is that premium paid for the duplicating coverage be returned, so the insured is not charged for coverage that cannot pay.
Why the other options are wrong
- A) Double recovery from the same insurer is exactly what the provision prevents.
- C) Pro-rating the loss between the two policies is not the same-insurer rule.
- D) Neither policy is given priority by date of issue; liability is capped at the largest single benefit.
Memory hook
Same insurer, same loss: the largest single benefit only.