Ch. 17/18 Health Insurance Policy Provisions

An insurer must provide an insured with claim forms within __ days after receiving notice of a loss.

15

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?

31 days

An insured pays premiums on an annual basis for an individual health insurance policy. What is the MINIMUM number of days for the Grace Period provision?

31 days

When an insured changes to a more hazardous occupation, which disability policy provision allows an insurer to adjust policy benefits and rates?

Change of occupation provision

With AD&D policies, what is the purpose of the Grace Period?

Gives the policyowner additional time to pay overdue premiums

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 its due?

Grace period

Which type of renewability best describes a Disability Income policy that covers an individual until the age of 65, but the insurer has the right to change the premium rate for the overall risk class?

Guaranteed Renewable

The clause in an Accident and Health policy which defines the benefit amounts the insurer will pay is called the

Insuring clause

Which of these is considered a mandatory provision?

Payment of Claims

What is true about a guaranteed renewable health insurance policy?

Premims normally increase at time of renewal

What is considered to be a characteristic of a conditionally renewable health insurance policy?

Premiums may increase at time of renewal

Which health policy clause stipulates that an insurance company must attach a copy of the application to the policy to ensure that it is part of the contract?

entire contract

Which of the following policy provisions prohibits an insurance company from incorporating external documents into an insurance policy?

entire contract

Which of the following is not included in the policy face?

exclusions

The legal actions provision of an insurance contract is designed to do all of the following, except:

protect the producer

An assignment of benefits of a Health Policy

transfers payments to someone other than the policyowner