State RegulationsOH specificDifficulty 3/5
After a Toledo insured submits a claim, the insurer's adjuster learns of statements the insured made to her agent that were never included in the application. Under Ohio law, how may the insurer use those statements?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
ORC 3923.04(A) provides that statements made to the insurer or its agent that are not in the application cannot be used to avoid the policy or to deny a claim. Because the entire contract consists of the policy and the endorsed application, out-of-application statements are simply outside the record the insurer may rely on.
Why the other options are wrong
- B) Wrong because materiality is irrelevant under ORC 3923.04(A); statements not in the application cannot be used at all to avoid the policy or defeat a claim.
- C) Wrong because the 2-year limit in ORC 3923.04(B) governs defenses based on statements in the application, not the absolute bar on out-of-application statements.
- D) Wrong because no superintendent approval is involved; the statutory entire-contract rule itself excludes such statements.
Memory hook
Not in the application? Not usable against the insured.