State RegulationsTN specificDifficulty 2/5
A Tennessee long-term care policy has been in force for one year. The insurer discovers an application misrepresentation that is unrelated to the condition for which the insured now claims benefits. May the insurer deny the claim on this basis?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
T.C.A. § 56-42-107(b) governs the middle tier of Tennessee's tiered long-term care contestability structure: once the policy has been in force more than 6 months but less than 2 years, the insurer may contest the policy only where the misrepresentation pertains to the condition for which benefits are claimed. A discovered misstatement unrelated to the claimed condition is not a basis to deny this claim, even though it might have supported rescission during the first 6 months.
Why the other options are wrong
- B) Broad contestability for any material misrepresentation applies only in the first 6 months under T.C.A. § 56-42-107(a), which has passed here.
- C) The 6-month mark narrows the insurer's grounds rather than expanding them; the misrepresentation must pertain to the claimed condition.
- D) The policy is not immune from challenge — a misrepresentation tied to the claimed condition remains actionable in this tier.
Memory hook
Middle tier: the lie must match the claim.