Under which circumstances might an insurer refuse to pay a claim?

An insurer may refuse to pay a claim for specific reasons, particularly when the submission of a claim does not meet certain necessary criteria. One significant circumstance is when there is insufficient claim documentation. If a policyholder does not provide enough evidence or relevant documents to support the claim, the insurer may deem it invalid and refuse payment. This could include missing receipts, failure to provide necessary forms, or inadequate proof of loss.

Another critical reason for deny a claim is if it is filed after the coverage expiration date. Insurance policies typically have precise terms and conditions in which claims must be reported. If the policyholder attempts to file a claim after the coverage period has lapsed, the insurer will reject it because the coverage no longer applies.

Considering these two key factors—insufficient claim documentation and filing a claim after the coverage expiration date—they collectively justify an insurer's decision to refuse payment. Therefore, the option that includes both of these circumstances accurately reflects the conditions under which an insurer might refuse to honor a claim.