State RegulationsNY specificDifficulty 2/5
While delivering an individual health policy in Albany, an agent tells the insured that the insurer will 'look the other way' on a policy requirement if a claim ever arises. Under New York's entire contract provision, which statement is correct?
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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)(1)(A), changes to an individual health policy are valid only when approved by an executive officer of the insurer and endorsed on the policy; agents have no authority to waive any provision or alter the contract in any form. An insured who relies on an agent's assurance of leniency has no enforceable right if the insurer later applies the provision as written.
Why the other options are wrong
- A) Putting a waiver in writing does not create authority the agent does not have.
- B) Verbal consent from the insurer cannot substitute for an executive officer's endorsement.
- D) Timing does not matter; an agent's waiver is ineffective at all times.
Memory hook
Agents sell; only executives amend.