State RegulationsOH specificDifficulty 2/5
A Columbus insured holds individual A&H policies with two different insurers, and each policy contains the optional 'insurance with other insurers' provision. She suffers one covered loss. How do the insurers respond under the provision?
Select an option to reveal the answer and the full 3-part explanation — free, no signup.
Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
The optional insurance-with-other-insurers provision under ORC 3923.05 requires each insurer to pay its pro rata share of the covered loss, so that the combined payments from all policies do not exceed the actual loss. Any premium the insured paid for duplicated coverage above her pro rata share is refunded proportionally. This provision exists because Ohio law allows, but does not require, this clause, and the Ohio Department of Insurance recognizes it as the anti-overinsurance mechanism in individual A&H policies.
Why the other options are wrong
- B) Paying full benefits twice is exactly the overinsurance result the provision was designed to prevent under ORC 3923.05.
- C) The provision does not prioritize by purchase date; both insurers share the loss proportionately.
- D) The insured has no election to stack coverage; the pro rata sharing rule applies automatically once the clause is in the policy.
Memory hook
Two insurers, one loss: split it pro rata.