State RegulationsOH specificDifficulty 3/5
A Columbus resident's individual sickness and accident policy was reinstated earlier this month. Within days she is injured in an accident, and 7 days after reinstatement she is diagnosed with an unrelated illness. Under the Ohio reinstatement provision, what does the reinstated policy cover?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
ORC 3923.04(D) limits what a reinstated policy covers: only accidents occurring after reinstatement and sickness beginning more than 10 days after reinstatement. The accident here occurred after reinstatement and is covered; the illness began only 7 days after reinstatement, inside the 10-day window, so it is not covered. Reinstatement premiums also apply to no period more than 60 days prior.
Why the other options are wrong
- A) Wrong because the accident occurred after reinstatement and is covered under ORC 3923.04(D); only the early-arriving sickness is excluded.
- B) Wrong because ORC 3923.04(D) expressly excludes sickness beginning within 10 days after reinstatement, which this illness did.
- C) Wrong because it reverses the rule — the sickness is the excluded loss and the accident is the covered one.
Memory hook
Accidents count at once; sickness needs more than 10 days.