State RegulationsOH specificDifficulty 2/5
An Ohio long-term care policy issued to a Canton resident excludes losses from a preexisting condition. Under ORC 3923.44, how restrictive may the policy's definition of 'preexisting condition' be?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
ORC 3923.44(B)(4) and (B)(5) cap how Ohio long-term care policies may define preexisting conditions: no more restrictively than a condition for which medical advice was given or treatment recommended or received within 6 months preceding the effective date. The exclusion may reach only a loss or confinement beginning within 6 months following the effective date, and ORC 3923.44(D) bars waiving or riding out specifically named preexisting diseases or conditions beyond that period.
Why the other options are wrong
- A) The statutory lookback is 6 months, not 12 months; a 12-month definition would be more restrictive than the law allows.
- C) Nondisclosure is a separate underwriting matter; it does not expand the statutory definition of preexisting condition.
- D) A blanket exclusion for any prior diagnosis exceeds the 6-month lookback and confinement limits Ohio imposes.
Memory hook
LTC pre-x: 6 months back to define, 6 months forward to exclude.