State RegulationsVA specificDifficulty 1/5
An individual accident and sickness policy contains a pre-existing condition exclusion. In Virginia health insurance, what does such an exclusion accomplish?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
Under Va. Code § 38.2-3514.1, a pre-existing condition exclusion reaches conditions for which the insured sought or received medical advice, diagnosis, care, or treatment before the policy's effective date, and it bars coverage for those conditions only for the period the policy states. The exclusion targets health problems that predate the contract, not the insured's future health. Defining the exclusion by prior treatment keeps new conditions covered while giving the insurer protection against applicants who buy insurance only after a problem is already known.
Why the other options are wrong
- A) A blanket first-year exclusion regardless of history is not the pre-existing concept; the exclusion is keyed to conditions treated before the effective date.
- B) Future, newly developed conditions are exactly what the exclusion does not touch; rescission for later illness is not its function.
- C) Conditions arising after the effective date are covered; the exclusion operates backward, on pre-effective-date conditions.
Memory hook
Pre-existing = treated before the effective date; the exclusion looks backward, not forward.