State RegulationsNY specificDifficulty 1/5
An individual accident and health policy is delivered to a resident of Albany. Under the time limit on certain defenses provision required by N.Y. Ins. Law §3216(d)(1)(B), for how long after the date of issue may the insurer use nonfraudulent misstatements in the application to void the policy or deny claims?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Under N.Y. Ins. Law §3216(d)(1)(B), after 2 years from the date of issue no misstatement made by the applicant in the application may be used to void the policy or to deny a claim for loss incurred or disability commencing after the 2-year period, except fraudulent misstatements. Nonfraudulent misstatements therefore lose their defensive force once the initial 2-year period runs, and coverage for later losses is secure.
Why the other options are wrong
- B) The defense cut-off runs for 2 years, not 6 months; shorter look-back periods belong to preexisting-condition rules in other lines of coverage.
- C) Misstatements cannot be raised indefinitely; the insurer loses ordinary misstatement defenses after the initial 2-year period.
- D) Misstatements can be used during the initial 2-year period; what disappears after that is the insurer's ability to rely on nonfraudulent ones.
Memory hook
The 2-year shield covers mistakes, not lies.