Insurance

Contestability Period

The contestability period is typically the first two years of a life insurance policy during which the insurer can investigate and deny claims based on material misrepresentation or fraud in the application.

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Exam Tip

Contestability = first 2 years, insurer can investigate. After 2 years = incontestable (except fraud). Suicide clause is separate!

What is the Contestability Period?

The contestability period is a timeframe (typically 2 years from policy issue) during which an insurance company can investigate claims and potentially deny or reduce benefits if the policyholder made material misrepresentations on the application.

Key Features

FeatureDescription
DurationUsually 2 years from policy issue
PurposeProtect insurer from fraud
TriggerDeath claim filed during period
InvestigationCompany can review application accuracy

What Insurers Can Contest

IssueExample
Medical HistoryUndisclosed heart condition
LifestyleLied about smoking status
OccupationConcealed dangerous job
Family HistoryOmitted hereditary diseases
Other InsuranceUndisclosed existing policies

Contestability Timeline

TimeframeInsurer's Rights
Year 1-2Can contest for any material misrepresentation
After Year 2Generally cannot contest (with exceptions)
ExceptionFraud may be contested indefinitely

Material Misrepresentation

To void a policy, the misrepresentation must be:

RequirementMeaning
MaterialWould have affected underwriting decision
Made by ApplicantPolicyholder or authorized representative
Related to RiskConnected to insurance risk
Relied UponInsurer relied on the information

Outcomes if Contested

FindingOutcome
Fraud ProvenPolicy voided, premiums returned
MisrepresentationBenefit may be adjusted or denied
No Issues FoundClaim paid normally
Minor InaccuracyUsually paid, possibly adjusted

Reinstatement and Contestability

If a policy lapses and is reinstated:

  • New 2-year contestability period may begin
  • Applies to statements on reinstatement application
  • Original contestability may still apply to original application

Suicide Clause vs. Contestability

ClauseTimeframeCoverage
Contestability2 yearsMisrepresentation issues
SuicideUsually 2 yearsDeath by suicide

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