State RegulationsNY specificDifficulty 1/5
Which of the following is NOT a ground on which a New York insurer may refuse renewal of an individual accident and health 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(g)(1), an insurer may refuse renewal of an individual accident and health policy only for specified grounds: nonpayment of premiums; fraud or intentional material misrepresentation; discontinuance of all coverage of that type or complete withdrawal from the individual market with required notice; the insured's move out of a network plan's service area; and other reasons permitted by HIPAA. Deterioration of the insured's health, claims experience, or health status is never a permitted ground.
Why the other options are wrong
- B) Nonpayment of premiums is expressly listed among the permitted grounds for refusal.
- C) Fraud or intentional material misrepresentation is expressly listed among the permitted grounds.
- D) Moving out of a network plan's service area is expressly listed for network products.
Memory hook
Sick does not mean kicked: health status can never end renewal.