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The effective date of a policy's coverage is crucial as it determines when the insured benefits begin. In most cases, coverage does not start until the insurer has received the initial premium payment, which indicates the applicant's commitment to the policy and allows the insurer to underwrite the risk properly. Therefore, the date of receipt of the first payment is generally when the policy becomes active and effective, ensuring that the insured is entitled to the benefits specified in the policy.

The policy issue date refers to the date the insurance document is formally issued but does not necessarily mean coverage has begun. The date of the applicant's statement is related to the application process, but coverage is not effective until the first payment is made. Lastly, while the date of the last medical exam might be significant for underwriting purposes to assess risk, it does not trigger the start of the policy coverage. Overall, the first premium payment serves as the threshold for the commencement of coverage.