EstatePass
L&HCaliforniahard

Three years after issue, the insurer discovers that a California insured misstated her age on the application by 5 years (claimed 45, actually 50). She has just died. What is the insurer's CORRECT response under California law?

Pay the death benefit adjusted to what the paid premiums would have purchased at the insured's true age, per § 10369.3
BDeny the claim outright, treating the age misstatement as a material misrepresentation contestable under Ins. Code § 10113.5
CDeny the claim in full and refund all premiums paid into the policy by the insured during its term
DPay the full face amount and absorb the shortfall, because the policy has passed the two-year incontestability period

Why this is the answer

This problem turns on the interplay between TWO CA statutes. Under Ins. Code § 10113.5, after 2 years the insurer cannot contest the policy for misrepresentation (incontestability). But misstatement of age is treated as a special category: under Ins. Code § 10369.3 the insurer pays whatever amount of insurance the paid premiums would have purchased at the insured's correct age, regardless of how much time has passed. Because the insured was actually 5 years older, the premium paid for a 45-year-old buys less insurance for a 50-year-old, so the death benefit is reduced proportionally. (a) is wrong because the policy is incontestable. (b) is wrong because no rescission/refund is allowed. (d) is wrong because § 10369.3 specifically permits the adjustment.

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