An individual accident and health policy in Tennessee has been in force for more than 2 years. The insured submits a claim for a condition the insurer believes was preexisting at issue but that was not excluded by name or specific description in the policy. What is the correct outcome?

Why A is correct

T.C.A. § 56-26-108(2), the time limit on certain defenses, bars the insurer after 2 years from issue from using misstatements (except fraudulent ones) to void the policy or deny claims, and provides that no claim for loss incurred after 2 years may be reduced or denied because of a preexisting disease or condition that was not excluded by name or specific description on the date of loss. Policies designed to remain in force to age 50, or for 5 or more years if issued after age 44, may instead use the statute's alternate INCONTESTABLE wording.

Why the other options are wrong

• B) 3 years is not Tennessee's defense window; T.C.A. § 56-26-108(2) fixes it at 2 years from issue.
• C) 5 years appears in other Tennessee provisions (the life-policy legal-actions floor), not in the A&H time limit on certain defenses under T.C.A. § 56-26-108(2).
• D) The statute keys the outcome to whether the condition was excluded by name or specific description in the policy, not to a physician-knowledge test; T.C.A. § 56-26-108(2) imposes no such burden on the insured.

Memory hook

Two years, then only a named or described exclusion can stop the claim.