State RegulationsTN specificDifficulty 2/5
A Tennessee insured is hospitalized for an extended period and submits written proof of loss long after the standard deadline, explaining that earlier submission was not reasonably possible. The insurer rejects the proof as untimely. What is the correct outcome under Tennessee law?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
T.C.A. § 56-26-108(7) requires written proof of loss within 90 days after the commencement of the period for which the insurer is liable, but it relaxes the deadline when the insured cannot reasonably comply: proof given later is timely if it was not reasonably possible to give it within 90 days, and in no event (except in the absence of legal capacity) may proof be given later than 1 year after the time it is otherwise required. A hospitalized insured who explains the delay within the 1-year backstop stays covered.
Why the other options are wrong
- A) The 90-day period under T.C.A. § 56-26-108(7) is the standard deadline, but the same subsection expressly excuses delay when proof was not reasonably possible and provides the 1-year backstop.
- B) 6 months appears in the continuation-notice rule for long-duration loss-of-time benefits under T.C.A. § 56-26-108(5); it is not a cutoff for proof of loss.
- D) 45 days is the automatic-reinstatement backstop under T.C.A. § 56-26-108(4); it has nothing to do with proof-of-loss timing.
Memory hook
90 days to prove — hardship stretches it, 1 year is the wall.