XCEL: Chapter Exam (Health Provisions)

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

Gives the policyowner additional time to pay overdue premiums

Which health policy clause specifies the amount of benefits to be paid?

Insuring

According to the Time Payment of Claims provision, the insurer must pay Disability Income benefits no less frequently than which of the following options?

Monthly

A Disability Income policy that only policyowner can terminate and which the rates will never go up is considered to be

Noncancelable

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

November 1

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

Payment of claims

Which of these is considered a mandatory provision?

Payment of claims

The insured and insurance company will share the cost of covered losses under which health policy feature?

Payment of claims provision

S is the policyowner of a Major Medical policy. The premiums are paid monthly and due on the 1st of each month. S fails to make September's payment and is hospitalized October 15th. When S files the claim for this hospitalization, the insurer will likely:

deny the claim

Under a Guaranteed Renewable health insurance policy, the insurer

may cancel the policy for nonpayment only

Periodic health claim payments MUST be made at least

monthly

Which of the following statements about a Guaranteed Renewable Health Insurance policy is CORRECT?

premiums normally increase at time of renewal

Which of the following statements describes what an accident and health policyowner may NOT do?

Adjust the premium payments

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 of the following clauses details the conditions that E did not meet?

Consideration clause

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

What is the purpose of the Time of payment of claims provision?

Prevents delayed claim payments made by the insurer

What must the policyowner provide to the insurer for validation that a loss has occurred?

Proof of loss

The insuring clause

States the scope and limits of the coverage

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

excluded by the insurer in the contract provisions

The sections of an insurance contract which limit coverage are called:

exclusions