State RegulationsNY specificDifficulty 1/5
Which statement about the illegal occupation provision in a New York individual accident and health policy is correct?
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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)(2)(J), New York individual accident and health policies may include an illegal occupation provision stating that the insurer is not liable for loss sustained in consequence of the insured's being engaged in an illegal occupation. The exclusion requires a connection between the unlawful activity and the loss; it does not void the contract and does not turn on the insured's record.
Why the other options are wrong
- B) That describes ordinary occupational risk, the wrong subject; this provision concerns unlawful activity, not lawful work.
- C) It affects the individual claim, not the existence of the contract.
- D) A criminal record alone is not enough; the loss must be connected to engagement in an illegal occupation.
Memory hook
Illegal occupation excludes the loss, not the whole policy.