H6 - Health Insurance Policy Provisions

What is considered to be a characteristic of a Conditionally Renewable Health Insurance policy?

A Conditionally Renewable Health Insurance policy can increase premiums at time of renewal.

An insurance company receives E's application for an individual health policy. E did not complete all of the medical history questions because she could not remember the exact dates. E signed the policy and submitted it to the insurance company anyway. A few weeks later, E suffers a heart attack and is hospitalized without completing the medical history questions and paying the initial premium. E is not insured. Which clause details the conditions that E did not meet?

Consideration Clause. A health insurance contract is valid only if the insured provides consideration in the form of the full minimum premium and the statements made in the application.

Which of the following provisions specifies how long a policyowner's health coverage will remain in effect if the policyowner does not pay the premium when it is due?

The grace period is the additional period of time after a premium payment is due that will allow the policy to remain in force in the event of nonpayment.

With Accidental Death and Dismemberment policies, what is the purpose of the Grace Period?

The purpose of the Grace Period is to give the policyowner additional time to pay overdue premiums.

The Notice of Claims provision requires a policyowner to

The Notice of Claims provision spells out the insured's duty to provide the insurer with reasonable notice in the event of a loss.

The provision that defines to whom the insurer will pay benefits to is called

The Payment of Claims provision in a Health Insurance policy states to whom claims will be paid.

Health insurance benefits NOT covered due to an act of war are

excluded by the insurer in the contract provisions.

What is the purpose of the Time of Payment of Claims provision?

The purpose of the Time of Payment of Claims provision is to prevent the insurance company from delaying claim payments.