What condition must be met for an insurer to contest a health insurance policy based on statements made during application?

In order for an insurer to contest a health insurance policy based on statements made during the application process, it is essential that those statements are found to be fraudulent. This means that if the applicant knowingly provided false information or omitted critical facts that would affect the insurer's decision to issue the policy, the insurer has the right to contest the policy. This is significant because it protects insurers from being misled during the application process, allowing them to assess risk accurately.

The other options do not align with the standard conditions under which an insurer can contest a policy. The contestability period refers to a time frame during which an insurer can investigate and challenge claims based on misrepresentation or fraud, typically lasting for a set number of years after the policy is issued. Simply having the contestability period expired means the insurer might lose the right to contest, which contrasts with the requirement for fraudulent statements to be established. Coverage restoration and filing claims are related to the ongoing relationship between the insured and the insurer but do not directly pertain to the ability of an insurer to contest a policy based on application statements. Thus, the focus on fraudulent misrepresentation is crucial in understanding the criteria for contesting a health insurance policy.