According to the time Limit of Certain Defenses provision in an Individual Health insurance policy

§ 15-208. Time limit on specified defenses.
 

(a)  Two-year limit on misrepresentation.- Except as provided in subsection (c) of this section, each policy of health insurance shall contain the following provision: 
 

"Time limit on certain defenses: (1) After two years from the date of issue of this policy no misstatements, except fraudulent misstatements, made by the applicant in the application for such policy shall be used to void the policy or to deny a claim for loss incurred or disability (as defined in the policy) commencing after the expiration of such two-year period." 
 

"(2) No claim for loss incurred or disability (as defined in the policy) commencing after two years from the date of issue of this policy shall be reduced or denied on the ground that a disease or physical condition not excluded from coverage by name or specific description effective on the date of loss had existed prior to the effective date of coverage of this policy." 

(b)  Effect of provision.- The first provision set forth in subsection (a) of this section does not: 

(1) affect a legal requirement for avoidance of a policy or denial of a claim during the initial two-year period after the issuance of the policy; or 

(2) limit the application of §§ 15-219 through 15-223 of this subtitle if there is a misstatement with respect to age, occupation, or other insurance. 

(c)  Policy incontestable after 2 years.-  

(1) This subsection applies only to a policy that the insured may continue in effect subject to its terms by the timely payment of premiums: 

(i) until the insured is at least 50 years old; or 

(ii) if the policy is issued after the insured is 44 years old, for at least 5 years after its date of issue. 

(2) A policy subject to this subsection may omit the first provision set forth in subsection (a) of this section and substitute the following provision under the caption "incontestable": 

"After this policy has been in force for a period of two years during the lifetime of the insured (excluding any period during which the insured is disabled), it shall become incontestable as to the statements contained in the application." 

(3) In the provision set forth in paragraph (2) of this subsection, an insurer may omit the clause "excluding any period during which the insured is disabled". 
 

[An. Code 1957, art. 48A, § 441; 1997, ch. 35, § 2.] 
 

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PDFRCW 48.20.052

Standard provision No. 3—Time limit on certain defenses.

There shall be a provision as follows:

"TIME LIMIT ON CERTAIN DEFENSES: (a) After two years from the date of issue of this policy no misstatements except fraudulent misstatements, made by the applicant in the application for such policy shall be used to void the policy or to deny a claim for loss incurred or disability (as defined in the policy) commencing after the expiration of such two year period."

(The foregoing policy provision shall not be so construed as to affect any legal requirement for avoidance of a policy or denial of a claim during such initial two year period, nor to limit the application of RCW 48.20.050, 48.20.172, 48.20.192, 48.20.202, and 48.20.212 in the event of misstatement with respect to age or occupation or other insurance.)

(A policy which the insured has the right to continue in force subject to its terms by the timely payment of premium (1) until at least age 50 or, (2) in the case of a policy issued after age 44, for at least five years from its date of issue, may contain in lieu of the foregoing the following provision (from which the clause in parentheses may be omitted at the insurer's option) under the caption "INCONTESTABLE":

"After this policy has been in force for a period of two years during the lifetime of the insured (excluding any period during which the insured is disabled), it shall become incontestable as to the statements contained in the application.")

"(b) No claim for loss incurred or disability (as defined in the policy) commencing after two years from the date of issue of this policy shall be reduced or denied on the ground that a disease or physical condition not excluded from coverage by name or specific description effective on the date of loss had existed prior to the effective date of coverage of this policy."

(More stringent provisions may be required by the commissioner in connection with individual disability policies sold without any application or with minimal applications.)

NOTES:

Severability—1975 1st ex.s. c 266: See note following RCW 48.01.010.

Severability—1973 1st ex.s. c 152: See note following RCW 48.05.140.

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