Accident & Sickness Policy Provisions, Clauses and Riders

An insured pays a monthly premium of $100 for her health insurance. What is the duration of the grace period under her policy?

10 days

When an insured purchased her disability income policy, she misstated her age to the agent. She told the agent that she was 30 years old, when in fact, she was 37. If the policy contains the optional misstatement of age provision....

Amounts payable under the policy will reflect the insured's correct age

What type of policy allows the insurance company to cancel a policy at any time?

Cancellable

A man is injured while robbing a convenience store. How dos his major medical policy handle the payment of his claim?

Claim is denied if his policy contains the Illegal Occupation provision

What is the contact provision allows the insurer to nonrenew health coverage if certain events occur?

Conditionally renewable

What is the main difference between coinsurance and copayments?

Copayment is a set dollar amount

Items stipulated in the contract that the insurer will not provide coverage for are found in the...?

Exclusions

What rider would NOT increase the premium for a policyowner?

Impairment rider

What rider will provide benefits above the base policy amount?

Multiple indemnity rider

Insurers may change what on a guaranteed renewable health insurance policy?

Rates by class

Which provision states how much time must pass between two like illnesses in order for the second one to be covered under a new set of benefits?

Recurrent Disability Provision

What is the term that describes the specified dollar amount beyond which the insured no longer participates in the sharing of expenses?

Stop-Loss Limit

Insured Z's health insurance policy year begins in January. His policy contains a carry-over provision. In November, he has a small claim which is less than his deductible. What is true?

The insured may carry over the amount of this year's expenses to next year, which will help satisfy next year's deductible

What statement is most correct concerning the changing of an irrevocable beneficiary?

They can be changed only with the written consent of that beneficiary

According to the rights of renewability rider for cancellable policies, what is not correct about the cancellation of the individual insurance policy?

Unearned premiums are retained by the insurance company