State RegulationsOH specificDifficulty 1/5
What is the primary purpose of the optional 'insurance with other insurers' provision in an individual accident and sickness policy?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
Under ORC 3923.05, the insurance-with-other-insurers provision caps recovery at the actual loss by requiring pro rata contributions from every policy covering it, with excess premiums for duplicate coverage refunded. Its purpose is to stop an insured from profiting from multiple A&H policies on the same loss. The Ohio Department of Insurance treats this anti-overinsurance function as the defining feature of the clause, which is permissive rather than required in Ohio individual sickness and accident policies.
Why the other options are wrong
- A) The provision discourages duplicate buying rather than encouraging it, because excess premiums become refundable and payments are capped under ORC 3923.05.
- B) Disclosure timing is not the clause's purpose; its substance is the pro rata payment limitation itself.
- C) Settlement priority among insurers is not addressed by this provision, which fixes each insurer's share of the loss instead.
Memory hook
Other-insurers clause = anti-double-dip clause.