An insured under an individual accident and sickness policy has filed written proof of loss and, unhappy with the insurer's progress, wants to file a lawsuit immediately. Under Va. Code § 38.2-3503(A), what constraint applies to bringing legal action on the claim?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
The legal-actions provision required by Va. Code § 38.2-3503(A) imposes a double window on suing over an individual accident and sickness claim: no action may be started until 60 days after written proof of loss is filed, giving the insurer a fixed period to investigate and pay, and no action may be started at all after 3 years from the time proof of loss is required. Both boundaries are mandatory policy content in Virginia. An insured who sues too early loses on timing, and one who waits past the 3-year limit loses the claim entirely — a structure the Virginia Bureau of Insurance expects in every compliant policy.
Why the other options are wrong
- A) Lawsuits are expressly contemplated by the provision itself; the regulator route does not displace the courts.
- C) There is no filing-fee mechanism payable to the insurer; only the statutory 60-day wait and 3-year limit govern timing.
- D) A formal written denial is not a precondition; the 60-day period after proof of loss runs regardless of whether the insurer denies the claim.
Memory hook
Wait 60 days after proof, sue within 3 years — the courtroom has a timetable.