5 - (Questions) Health Insurance Policy Provisions

A health insurance policy paid on a quarterly basis has a grace period of

31 days The grace period on a quarterly-paid health insurance policy is typically 31 days.

Which type of health insurance policy cannot be canceled by the insurer nor increase the premiums?

A noncancellable policy cannot be cancelled nor can its premium rates be increased under any circumstances.

Which of the following is NOT a required uniform provision in individual health policies? Change of occupation Legal Actions Notice of claim Reinstatement

Change of occupation An insured's change of occupation is not a required uniform provision in individual health insurance policies.

Under the Payment of Claims provision, when are benefits typically payable after proof of loss is received?

Generally, all claims other than those for periodic installments should be paid immediately after the insurer has received proof of loss.

What type of changes can be made to a guaranteed renewable health insurance policy?

Guaranteed renewable policies normally have increasing premiums after renewal.

The misstatement of age provision in a health policy states that if an insured gives the wrong age at the time of application, what action can the insurance company take?

If the insured's age or sex is misstated in an application for insurance, the benefit payable is adjusted to reflect the actual age or sex of the insured.

Christine has a health insurance policy that has been in force beyond the incontestable period. The insurer has discovered that a fraudulent statement was made on the application. What would the insurer have to pay on a claim, assuming this wasn't a guaranteed renewable policy?

Nothing will be paid because fraud was committed during the application process, which is grounds for contest at any time with a health insurance policy.

The insurer has the option of terminating a health insurance policy on a date stated in the contract. What type of policy is this?

The renewability provision in an optionally renewable policy gives the insurer the option to terminate the policy on a date specified in the contract. Furthermore, this provision allows the insurer to increase the premium for any class of optionally renewable insureds.

In what situation does a waiver of premium provision keep a health insurance policy in force without premium payments?

The waiver of premium provision keeps the coverage in force without premium payments if the insured has become totally disabled as defined in the policy.

The conditions, times, and circumstances under which an insured is NOT covered by a health policy are called

exclusions Exclusions are specified hazards listed in a policy for which benefits will not be paid.