health provisions

If an insurance company issues a Disability Income policy that it cannot cancel or for which it cannot increase premiums, the type of renewability that best desribes this policy is called noncancellable conditionally renewable cancellable guaranteed renewable

noncancellable

The Legal Actions provision of an insurance contract is designed to do all of the following EXCEPT -provide the insurer adequate time to research a claim -protect the insured from having claim research delayed -protect the producer - give the insured guidelines for pursuing legal action against and insurer

protect the producer

Which of these is considered a mandatory provision? Payment of Claims Insurance with Other Insurers Misstatement of Age Change of Occupation

Payment of Claims

An insured must notify an insurer of a medical claim within how many days after an accident? 10 20 30 40

20

According to the Mandatory Uniform Policy Provisions, what is the maximum amount of time after the premium due date during which the policy remains in force even though the premium has not been paid? 7 days 10 days 31 days 60 days

31 days

Which of the following statements BEST describes what the Legal Actions provision of an Accident and Health policy requires? An insured must settle a claim within 60 days after Proof of Loss is submitted An insured must wait at least 30 days after Proof of Loss has been submitted before a lawsuit can be filed An insured must wait at least 60 days after Proof of Loss has been submitted before a lawsuit can be filed An insured must settle a claim within 30 days after Proof of Loss is submitted

An insured must wait at least 60 days after Proof of Loss has been submitted before a lawsuit can be filed

When an insured changes to a more hazardous occupation, which disability policy provision allows an insurer to adjust policy benefits and rates? - Relation of earnings to insurance provision -Change of occupation provision -Conformity of state statutes provision - Entire contract provisions

Change of occupation provision

Which of the following health policy provisions states that the producer does NOT have the authority to change the policy or waive any of its provisions? -Time Limit on Certain Defenses -Reinstatement - Entire Contract -Change of Beneficiary

Entire Contract

When an insurance company sends a policy to the insured with an attached application, the element that makes the application part of the contract between the insured and the insurer is called the -Entire Contract provision - Insuring clause -Time Limit on Certain Defense provision -Legal Contract clause

Entire Contract provision

Which of the following is NOT included in the policy face? Free Look provision Name of the insured Name of the insurer Exclusions

Exclusions

What is the initial requirement for an insured to become eligible for benefits under the Waiver of Premium provision? Insured must be unemployed Insured must be hospitalized Insured must demonstrate financial need Insured must be under a physician's care

Insured must be under a physician's care

Which health policy clause specifies the amount of benefits to be paid? Insuring Consideration Free-look Payment mode

Insuring

Which of the following health insurance policy provisions specifies the health care services a policy will provide? Insuring clause Usual, Customary, and Reasonable clause Consideration clause Benefit clause

Insuring clause

S filed a written Proof of Loss for a Disability Income claim on September 1. The insurance company did not respond to the claim. S can take legal action against the insurer beginning September 21 October 16 November 1 December 1

November 1

K failed to pay a renewal premium within the time granted by the insurer. K then sends in a payment which the insurer subsequently accepts. Which policy provision specifies that coverage may be restored in this situation? Free-look Reinstatement Grace Period Consideration

Reinstatement

The insuring clause -Specifies the additional time given to pay past due premiums -States the scope and limits of the coverage -States the amount of premium to be collected - Prohibits the insured from suing the insurer for at least 60 days after filing a written proof of loss

States the scope and limits of the coverage

The policy provision that entitles the insurer to establish conditions the insured must meet while a claim is pending is -Grace Period -Physical Examination and Autopsy -Entire Contract - Time Limit on Certain Defenses

Time Limit on Certain Defenses (This provision limits the period during which an insurer can deny a claim based on a misstatement made by the insured)

Which of the following statements about a Guaranteed Renewable Health Insurance policy is CORRECT? -Premiums normally decrease at time of renewal - Premiums normally increase at time of renewal -Policy can renewed at any time by the company -Policy can be cancelled at any time by the company

Premiums normally increase at time of renewal

G is involved in an automobile accident as a result of driving while intoxicated and suffers numerous injuries. According to the Intoxicants and Narcotics exclusion in G's policy, who is responsible for paying the medical bills? The reinsurer The insured The insurer The Guaranty Association

The insured

With Accidental Death and Dismemberment policies, what is the purpose of the Grace Period? Gives the policyowner additional time to pay overdue premiums Gives the policyowner additional time to file a lawsuit Gives the policyowner additional time to file a claim Gives the policyowner additional time to provide proof of loss

Gives the policyowner additional time to pay overdue premiums