State RegulationsNY specificDifficulty 3/5
Which statement correctly contrasts the illegal occupation exclusion with the intoxicants and narcotics exclusion in New York individual accident and health policies?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
Under N.Y. Ins. Law §3216(d)(2)(J), the illegal occupation exclusion addresses loss sustained in consequence of the insured's engagement in an illegal occupation, so it looks to the insured's activity. Under N.Y. Ins. Law §3216(d)(2)(K), the intoxicants and narcotics exclusion addresses loss sustained while the insured is under the influence, so it looks to the insured's condition when the loss occurs. Both are provisions in individual accident and health policies and can coexist.
Why the other options are wrong
- A) Neither provision requires a conviction; each is applied by the insurer when its own conditions are met.
- B) Both provisions appear in individual accident and health policies; neither is limited to life insurance.
- D) Nothing prevents both provisions from appearing in the same policy; they cover different grounds for exclusion.
Memory hook
Activity versus condition: illegal occupation is what you do, intoxication is how you are.