Section 6 Chapter exam / Health Insurance policy Provisions

According to the Mandatory Uniform Policy Provisions, what is the maximum amount of time after the premium due date during which of the policy remains in force even though the premium has not been paid?

31 days

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

Adjust the premium payments

What should an insured do if the insurer does not send claim forms within the time period set forth in a healthy policy's Claims Forms provision?

Submit the claim in any form

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

If an individual is covered under an Accidental Death Policy and dies, an autopsy can be performed in all these situations, EXCEPT:

When the state prohibits this by law

A(n)______ of benefits of a health policy transfers payments to someone other than the policy owner.

assignment

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

15

An insurance company receives E's application for an individual health policy. E did not complete all of the medical history questions because she could not remember the exact dates. E signed the policy and submitted it to the insurance company anyway. A few weeks later, E suffers a heart attack and is hospitalized without completing the medical history questions and paying the initial premium. E is not insured. Which of the following clauses details the conditions that E did not meet?

Consideration clause

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

Exclusions

Which of the following provisions specified how long a policyowner health coverage will remain in effect if the policyowner does not pay the premium when it is 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

X is insured with a disability income policy that provides coverage until age 65. This policy allows the insurer to change the premium rate for the overall risk class assigned. Which of these renewability features does this policy contain?

Guaranteed renewable

T owns an Accident & Health policy and notifies her insurance company that she has chosen a less hazardous occupation. Under the Change of Occupation provision, which of the following actions may her insurance company take?

Increase her policy's coverage amount

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

Insuring

The clause in an accident and health policy which defines the benefit amounts the insurer will pay is called the:

Insuring clause

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

Noncancellable

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

Nonrenewable

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

Premiums may increase at time of renewal

The Legal Actions provision of an insurance contract is designed to do all of the following, EXCEPT:

Protect the producer

Under an individual disability insurance policy, the Time Limit of Certain Defenses provision states that non fraudulent misstatements first become incontestable two years...

from the date the policy was issued