State RegulationsOH specificDifficulty 2/5
An Ohio individual sickness and accident policy contains the optional misstatement-of-age provision, and the insurer discovers the insured stated the wrong age in the application. What is the consequence under this provision?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
ORC 3923.05 makes misstatement of age an optional provision for individual A&H policies. When it is included, a misstated age does not void the policy; instead the benefits are adjusted to the amount the premiums paid would have purchased at the correct age, keeping the coverage alive with an equitable correction.
Why the other options are wrong
- A) Wrong because the whole point of the misstatement-of-age provision is to avoid forfeiture; the policy is not voided.
- C) Wrong because a premium refund and termination is not the remedy; the policy continues with recalculated benefits.
- D) Wrong because the benefit amount is not left unchanged — it is reduced or adjusted to match the correct-age premium value.
Memory hook
Wrong age? Recalculate the benefit, don't rescind the policy.