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State RegulationsOH specificDifficulty 2/5

A Dayton resident bought an individual A&H policy and, without meaning to, gave an age on the application several years younger than her true age, so her premiums came out lower than they should have been. The policy includes the optional misstatement-of-age provision. When she submits a covered claim, what is the likely outcome?

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Answer & full 3-part explanation (select an option above, or peek)

Why C is correct

ORC 3923.05 makes misstatement of age one of the optional provisions Ohio insurers may attach to individual accident and sickness policies. When it is included and the insured's age was understated, the insurer pays the claim in the amount the premiums would have purchased at the correct older age, so the benefit shrinks to reflect the true price of coverage. The policy is not voided, and the Ohio Department of Insurance treats this adjustment mechanism as the standard cure for age errors in A&H coverage.

Why the other options are wrong

  • A) An innocent age error is not grounds for outright denial under ORC 3923.05; the statute's remedy is proportional adjustment of the benefit.
  • B) Rescission with a premium refund is not the prescribed remedy; the provision expressly contemplates continued coverage with adjusted benefits.
  • D) Age errors absolutely can be corrected after issue through this provision; paying in full would give the insured coverage she never paid for.

Memory hook

Understated age means the benefit shrinks to what the premiums truly bought.

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