State RegulationsOH specificDifficulty 2/5
An agent in Dayton tells a policyholder that a new benefit he described over the phone overrides the printed policy wording. Under Ohio's entire-contract rule for individual sickness and accident policies, is the agent's claim valid?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
ORC 3923.04(A) makes the policy together with the copy of the application endorsed on it the entire contract, and it expressly states that no agent has authority to change the policy or to waive any of its provisions. Verbal promises by an agent have no effect on the contract's terms.
Why the other options are wrong
- A) Wrong because the entire-contract rule in ORC 3923.04(A) leaves no room for side changes, written or oral, made outside the policy and application.
- B) Wrong because ORC 3923.04(A) strips agents of any authority to alter the policy or waive provisions regardless of their representation of the insurer.
- D) Wrong because the superintendent does not modify individual policy terms; the limits on change come from the statute's entire-contract clause itself.
Memory hook
If it is not in the policy or the endorsed application, the agent cannot promise it.