State RegulationsNY specificDifficulty 1/5
Under New York's other benefits provision for individual health policies, what must the insurer do with premiums collected for coverage that duplicates another policy it issued on the same insured?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
Under N.Y. Ins. Law §3216(d)(2)(E), when the insurer's liability is capped at the largest amount payable under a single policy, the premium attributable to the excess, duplicating coverage must be refunded to the insured. The insured keeps the benefit one policy promised and gets back the money paid for coverage that could not pay a second time.
Why the other options are wrong
- A) Crediting the money against renewals is not the required remedy.
- B) The insurer does not forfeit the premium; it returns it.
- C) Excess premiums are not converted into commission.
Memory hook
Duplicate coverage? The extra premium comes back.