State RegulationsIL specificDifficulty 1/5
An Illinois individual accident and health policy requires written proof of loss within 30 days of the loss, and the policyowner cannot reasonably furnish proof that quickly. Under the Illinois Insurance Code minimum standard enforced for individual A&H policies, what is the outer deadline for filing written proof of loss when it is not reasonably possible to do so within the standard period?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
215 ILCS 5/357.8 requires written proof of loss under an individual accident and health policy within 90 days of the loss, and allows proof to be furnished within 1 year when it is not reasonably possible to provide it within the standard period. A form that demands proof faster than the statute allows is more restrictive than the Illinois minimum that individual A&H policies must honor, consistent with the minimum-standards approach of 50 Ill. Adm. Code 2007. The policyowner's right to the extended window does not depend on the insurer's consent.
Why the other options are wrong
- A) 20 days is the statutory notice-of-claim period under 215 ILCS 5/357.6, not the proof-of-loss deadline, and there is no rule denying extensions.
- B) 45 days is neither the standard proof-of-loss period nor the extended deadline; 215 ILCS 5/357.8 controls, and the extension is statutory rather than a matter of insurer grace.
- D) 6 months is not the proof-of-loss outer limit, and the deadline is measured from the loss, not from any waiting period.
Memory hook
90 days is standard, 1 year when proof is truly impossible.