State RegulationsFL specificDifficulty 2/5
A Florida insurer drafts a new individual health policy. Which of the following provisions is PROHIBITED from being included?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
Under Chapter 627, Florida Statutes, health policies may not contain provisions that let the insurer unilaterally alter the contract or cut benefits after issue. Required provisions such as grace, proof of loss, and physical examination provisions are permitted and generally mandatory, but any clause reserving a one-sided right to change the bargain is prohibited as inconsistent with Florida's minimum standards. The Office of Insurance Regulation reviews policy forms and would reject such a provision at filing.
Why the other options are wrong
- A) A grace period is a standard, permitted (and generally required) health policy provision.
- B) A proof-of-loss provision is a standard, permitted claims provision in health policies.
- D) A physical examination provision for claimants is a permitted standard provision in health policies.
Memory hook
The insurer can't rewrite the deal after signing.