Ch. 6 Exam - Health Insurance Policies: Health Insurance Policy Provisions

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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

If an insurance company issues a Disability Income policy that it cannot cancel or for which it cannot increase premiums, the type of renewability that best desribes this policy is called

noncancelable

a disability income policy that only the policyowner can terminate and which the rates will never go up is considered to be

noncancelable

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

premiums may increase at the time of renewal

With Optionally Renewable Health policies, the insurer may

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

claims forms MUST be provided to an insured within ______ after receiving notice of a loss

15 days

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

What type of renewability guarantees premium rates and renewability?

Noncancelable Policies

What type of renewability best describes a disability income police that covers an individual until the age o f65, but the insurer has the right to change premium rates for the overall class?

guaranteed renewable

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

insuring

insurers may request a hearing within _____ if their policy is rejected

20 days

Under an individual health policy Time Limit of Certain Defenses Fraudulent misstatements first become incontestable two years

from the date the policy was issued

the policy provision that entitles the insurer too establish conditions the insured must meet while a claim is pending is?

time limit on certain defenses

What type of rider would be added to an Accident and Health policy if the policyowner wants to ensure the policy will continue if he/she ever becomes totally disabled?

waiver of premium rider


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