Ch 6 - Test

the reinstatement provision in a health insurance policy is 1. mandatory 2. optional 3. voluntary 4. discretionary

1. mandatory

Which of the following is NOT a common exclusion for a medical expense policy? 1. physical therapy 2. act of war 3. on the job injury 4. self inflicted injury

1. physical therapy

An insurer must furnish to a claimant forms for filing proof of loss within _________ days upon receiving a notice of claim.

15

Written notice for a health claim must be given to the insurer ___ days after the occurrence of the loss.

20 days

All of the following are functions of an insuring clause EXCEPT; 1. States the conditions under which the policy will pay 2. Outlines the kind of benefits provided 3. Primarily describes the free-look period 4. provides the policy's scope and limits of coverage

3. Primarily describes the free-look period

which of the following is NOT a required provision in an accident and health insurance policy? 1. legal actions 2. grace period 3. change of occupation 4. reinstatement

3. change of occupation

Which of the following actions may an insurance company NOT do in a health policy that contains a guaranteed renewable premium benefit ? 1. stop renewing policy when the insured reaches a specified age 2. cancel policy if premiums are not paid 3. increase the premiums on an individual basis 4. increase the premiums on the basis of an entire classification

3. increase the premiums on an individual basis

in which of the following situations would the insurer be liable for a loss? 1. the insured skipped a pmt beyond the 31 day grace period 2. the insured was injured while participating in an illegal occupation 3. the insured was given a notice of cancellation from the insurer 4. the insured suffered an injury as an Innocent bystander during a bank robbery

4. the insured suffered an injury as an Innocent bystander during a bank robbery

Disability Income plans which require that the insurer can NEVER CHANGE or alter premium rates are usually considered:

Noncancellable

Craig submits a $500 claim for medical expenses. With a past due premium of $100, the insurer pays $400. Which of the Uniform Optional Provisions covers this situation?

Unpaid premium

An accident and health insurer has just received written proof of loss from one of its insureds. The insured must now wait 60 days before

bringing legal action against the insurer

The type of policy where the insurer can send a notice to the insured that the policy has been cancelled in the middle of the term is called

cancelable

When an insured changes to a more hazardous occupation, which disability policy provision allows an insurer to adjust policy benefits and rates?

change of occupation provision

the time limit for filing claim disputes is addressed in which provision of an accident and health policy?

legal actions

the reinstatement provision in a health insurance policy is....

mandatory

In contrast to a guaranteed renewable policy, a noncancellable policy

may never raise premiums

A beneficiary change can occur

normally at any time during the policy term

This MANDATORY health policy provision states that the policy, including endorsements and attached papers, constitutes

the entire insurance contracts between the parties