Health Insurance Policy Provisions, Clauses, and Riders - Questions (9)

In respect to the consideration clause, which of the following is consideration on the part of the insurer?

Promising to pay in accordance with the contract terms

The free-look provision allows for which of the following?

A right to return the policy for a full premium refund.

A deductible is

A specified dollar amount that the insured must pay first before the insurance company will pay the policy benefits.

While a claim is pending, an insurance company may require

An independent examination as often as reasonable required.

What type of policy allows the insurance comapny to cancel a policy at any time?

Cancellable

What is the main difference between coinsurance and copayments?

Copayments is a set dollar amount

Which of the following rider would NOT increase the premium for a policyowner?

Impairment Rider

An insured pays a monthly premium of $100 for her health insurance. What would be the duration of the grace period under her policy?

10 days

The provision that states that both the printed contract and a copy of the application form the contract between the policyowner and the insurer is called the

Entire contract

An insured submitted a notice of claim to the insurer, but never received claims forms. He later submits proof of loss, and explains the nature and extent of loss in a hand-written letter to the insurer. Which of the following would be true?

The insured was in compliance with the policy requirements regarding claims.

Which of the following will vary the length of the grace period in health insurance policies?

The mode of the premium payment.

Which of the following statements is true regarding coinsurance?

The larger the percentage that is paid by the insured, the lower the required premium will be.

A Health insurance policy lapses but is reinstated within an acceptable timeframe. How soon from the reinstatement date will coverage for accidents become effective?

Immediately

A guaranteed renewable disability insurance policy

Is renewable at the insureds option to a specified age

How soon following the occurrence of a covered loss must an insured submit written proof of such loss to the insurance company?

Within 90 days or as soon as reasonably possible, but not to exceed 1 year

Which provision allows the policyholder a period of time, while coverage is in force, to examine a health insurance policy and determine whether or not to keep it?

Free Look Period

Which of the following is NOT a feature of a guaranteed renewable provision?

The insurer can increase the policy premium on an individual basis.

An insured wants to name her husband as the beneficiary of her health policy. She also wishes to retain all of the rights of ownership. The insured should have her husband named as what type of beneficiary?

Revocable

An insured has endured multiple surgeries and hospitalizations for an illness during the summer month. Her insurer no longer bills her for medical expenses. What term best describes the condition she has met?

Stop-Loss Limit

Which of the following entities has the authority to make changes to an insurance policy?

Insurer's executive officer

In a group health policy, a probationary period is intended for people who

Join the group after the effective date.

The provision which prevents the insured from bringing any legal action against the company for at least 60 days after proof of loss is known as

Legal actions

An insured pays he Major Medical Insurance premium annually on March 1. Last March she forgot to mail her premium to the company. On March 19, she has an accident and broke her leg. The insurance company would

Pay the claim

With respect to the Consideration Clause, which of the following would be considered consideration on the part of the applicant for insurance?

Payment of Premium

An insured purchased a noncancellable health insurance policy 1 year ago. Which of the following circumstance would NOT be a reason for the insurance company to cancel the policy?

The insured is in an accident and incurs a large claim

Under the Physical Exam and Autopsy provision, how many times can an insurer have the insured examined, at its own expense, while a claim is pending?

Unlimited

If the insured under a disability income insurance policy changes to a more hazardous occupation after the policy has been issued, and a claim is filed, the insurance company should do which of the following?

Adjust the benefit in accordance with the increased risk

The premium charged for exercising the Guaranteed Insurability Rider is based upon the insured's

Attained Age

What type of policy allows the insurance company to cancel a policy at any time?

Cancellable

The provision in a health insurance policy that ensures that the insurer cannot refer to any document that is not contained in the contract is the

Entire contract clause