State RegulationsNY specificDifficulty 1/5
For purposes of New York long-term care insurance under Reg 62, when is a condition considered 'preexisting'?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
Under Reg 62 (11 NYCRR Part 52 (Reg 62)), a preexisting condition is one for which the insured received, or was advised to receive, medical advice, diagnosis, care, or treatment during the look-back period before the policy's effective date. The definition ties any exclusion to recent, documented care rather than to the insured's entire lifetime medical history.
Why the other options are wrong
- A) The definition is not lifetime-wide; only conditions connected to recent care within the limited look-back period qualify.
- B) Conditions first arising after issue are post-issue conditions, not preexisting ones, and they are covered like any other condition.
- D) Failure to disclose a condition to the agent raises a misrepresentation issue; it is not the definition of a preexisting condition.
Memory hook
Preexisting = advised or treated within the look-back, not lifetime history.