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State RegulationsNC specificDifficulty 2/5

An insured is injured in an accident and submits a claim under an individual accident and health policy. Under the standard provisions required by North Carolina law, written proof of loss must be furnished within how many days after the date of loss?

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Answer & full 3-part explanation (select an option above, or peek)

Why B is correct

Under G.S. 58-51-15(a)(7), written proof of loss on an accident and health claim must be furnished within 180 days after the date of loss (for periodic-payment claims, within 180 days after the end of the insurer's liability period). Late proof is accepted when it was not reasonably possible to file on time, and never later than 1 year. North Carolina deliberately departs from the model provision's 90-day figure, so 180 days is the only correct answer.

Why the other options are wrong

  • A: 90 days is the model-provision figure that North Carolina does not follow; the statutory period is 180 days under G.S. 58-51-15(a)(7).
  • C: 60 days is the waiting period before a legal action may be brought after written proof of loss under G.S. 58-51-15(a)(11), not the proof-of-loss deadline.
  • D: 20 days is the deadline for giving written notice of claim under G.S. 58-51-15(a)(5); proof of loss itself is due within 180 days.

Memory hook

NC proof of loss = 180 days — double the model 90.

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