Chapter Exam 6

K has a health policy that must be renewed by the insurer and the premiums can only be increased if applied to the entire class of insureds. This type of policy is considered

guaranteed renewable

Which accident and health policy provision addresses preexisting conditions?

Time Limit on Certain Defenses

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

15

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

20

M's insurance company denied a reinstatement application for her lapsed health insurance policy. The company did not notify M of this denial. How many days from the reinstatement application date does the insurance company have to notify M of the denial before the policy will be automatically placed back in force?

45 days

Which of the following statements describes what an Accident and Health policyowner may NOT do?

Adjust the premium payments

P is a Major Medical policyowner who is hospitalized as a result of injuries sustained from participating in a carjacking. How will the insurer most likely handle this claim?

Claim will be denied

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

Entire Contract

After an insured gives notice of loss, what must he/she do if the insurer does not furnish forms?

File written proof of loss

What is the initial requirement for an insured to become eligible for benefits under the Waiver of Premium provision?

Insured must be under a physician's care

What type of renewability guarantees premium rates and renewability?

Noncancellable

Which of the following BEST describes a short-term medical expense policy?

Nonrenewable

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

Which of these statements accurately describes the Waiver of Premium provision in an Accident and Health policy?

Premiums are waived after the insured has been totally disabled for a specified time period

What is considered to be a characteristic of a Conditionally Renewable Health Insurance policy?

Premiums may 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 insured

T files a claim on his Accident and Health policy after being treated for an illness. The insurance company believes that T misrepresented his actual health on the initial insurance application and is, therefore, disputing the claim's validity. The provision that limits the time period during which the company may dispute a claim's validity is called?

Time Limit on Certain Defenses

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

exclusions

An insurance company normally has 2 years to contest information provided on an accident and health application. This 2 year period begins on the date that the:

insurer dates the policy

With optionally renewable health policies, the insurer may:

review the policy annually and determine whether or not to renew it