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• The Time Limit on Certain Defenses provision limits the time during which the insurance company may challenge the validity of an insurance claim based on a misstatement made on the insured's application.
• Under the time limit on certain defenses provision, the policy is incontestable after it has been in force a certain period of time, usually two years.
• This is similar to the incontestable clause in a life
insurance policy. Unlike life policies, a fraudulent statement on a health insurance application is grounds for contest at any time, unless the policy is guaranteed renewable
• An insurance company can usually contest the information contained in an accident and health application starting on the date the insurance company dates the policy
• There is a TIME LIMIT for which you must DEFEND yourself. This applies to the contestable period (application), preexisting conditions, and new claims
(conditions that must be met while a claim is pending.
• If you file a claim that you broke your leg yesterday, and the insurance company sees you moving a grand piano up 5 flights of stairs, you will probably have to DEFEND your claim. However, at some point, it is expected your leg will heal.
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