State RegulationsGA specificDifficulty 2/5
Three years after an individual accident and sickness policy is issued in Georgia, the insurer tries to deny a claim by alleging the insured misstated her health history in the application. No fraud is alleged. What is the result?
Select an option to reveal the answer and the full 3-part explanation — free, no signup.
Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
Under O.C.G.A. § 33-29-3(b)(2)(A), after two years from the issue date of an individual A&S policy, no misstatement by the applicant, except fraud, may prevent the policy from taking effect or be used to deny a claim. Fraud requires a written, material misstatement relied on by the insurer, with a copy of the application furnished to the insured. At three years with no fraud, the defense is barred.
Why the other options are wrong
- A) The two-year time limit on defenses bars this challenge; misstatements cannot void the policy after that point absent fraud.
- C) Returning premiums is not the mechanism for this rule; the issue is whether the insurer may raise the misstatement at all, and it may not.
- D) The copy of the application relates to proving fraud, an exception the insurer is not invoking; it is not a defense available to the insurer here.
Memory hook
Two years locks the door — only fraud has a key.