State RegulationsVA specificDifficulty 2/5
A Virginia policyholder's newborn daughter is diagnosed with a congenital heart defect shortly after birth. Under Va. Code § 38.2-3411, how is the baby's coverage handled?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
Va. Code § 38.2-3411 requires newborn coverage from the moment of birth, expressly including medically diagnosed congenital defects and birth abnormalities. The newborn receives 31 days of automatic coverage under the parents' plan; to continue beyond that automatic period, the insurer must be notified and the required premium paid. This means a congenital condition diagnosed at birth can never be treated as a basis for denial or surcharge during the mandated newborn protection that Virginia law provides.
Why the other options are wrong
- A) Excluding a congenital defect as preexisting contradicts Va. Code § 38.2-3411, which mandates coverage of congenital defects from the moment of birth.
- B) The automatic period is 31 days under Va. Code § 38.2-3411, and congenital defects are covered rather than excluded during it.
- C) There is no surcharge mechanism for a newborn's congenital condition; the statute mandates coverage from birth for 31 days, then notice and premium to continue.
Memory hook
Born covered: day one, defect included, 31 days to formalize.