Under which circumstance can an insurer deny a claim after the incontestable period has passed?

Prepare for the California Accident and Sickness Exam with multiple choice questions and detailed explanations. Study effectively and ace your exam!

The correct answer highlights a critical aspect of insurance policies regarding the insurer's ability to deny claims. The incontestable period, often set at two years from the policy issue date, generally protects the insured from being denied a claim based on misrepresentations or inaccuracies in the application once this period has lapsed. However, non-payment of premiums represents a significant exception to this protection.

When premiums are not paid, the insurer retains the right to cancel the policy or deny a claim because the contract is effectively non-existent. Insurance is based on a mutual agreement that requires the policyholder to pay the agreed-upon premiums, and failure to do so breaches this contract. Thus, even after the incontestable period, non-payment allows the insurer to avoid liability for claims.

The other options do not provide sufficient grounds for an insurer to deny a claim after the incontestable period. Material misrepresentations would typically fall outside of the insurer's claim denial rights after that period if not discovered earlier. Change of beneficiaries and policy amendments are administrative changes that do not affect the validity of the policy or the insurer's obligation to pay claims as outlined in the contract, regardless of the incontestable period.

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