State RegulationsNY specificDifficulty 1/5
Many New York individual accident and health policies carry an intoxicants and narcotics provision. How does that provision apply to a claim under the policy?
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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)(K), a New York individual accident and health policy may provide that the insurer is not liable for loss sustained while the insured is under the influence of intoxicants or narcotics. The provision reaches both alcohol and drugs, applies whenever the loss occurs, and functions as an exclusion for the individual claim rather than a voidance of the contract.
Why the other options are wrong
- B) The exclusion is not limited by the clock; it applies whenever the insured is under the influence at the time of loss.
- C) It covers narcotics as well as intoxicants; the provision names both.
- D) It excludes the claim, not the contract; the policy is not voided by the provision.
Memory hook
Under the influence means no benefits - alcohol or drugs, any hour.