Pre-Licensing Insurance Course Chapter 13
The facility of payment clause: a. States benefits are payable to an individual who is related to the deceased insured by blood or marriage b. States claims must be paid immediately upon receipt of proof of loss c. States benefits are paid to the insured's estate d. Is a required uniform provision
a. States benefits are payable to an individual who is related to the deceased insured by blood or marriage
According to the claims form provision in a health insurance policy, what is the insured entitled to do if the insurance company does not send out the claim forms within the specified time period? a. Submit the claim on any form, which the insurance company must accept as proof of loss b. Receive a refund of one month's premium c. Nothing d. Wait 30 days, and then resubmit claim notification to the insurer
a. Submit the claim on any form, which the insurance company must accept as proof of loss
Which of the following best describes the Reduction in Coverage provision of a health policy? a. The Reduction in Coverage Provision sets the terms and conditions under which the amount of coverage can be reduced. b. The Reduction in Coverage Provision sets the exact date coverage will be reduced in the future. c. The Reduction in Coverage Provision prevents the insurer from ever reducing insurance coverage. d. The Reduction in Coverage Provision prevents the insured from ever reducing insurance coverage.
a. The Reduction in Coverage Provision sets the terms and conditions under which the amount of coverage can be reduced.
Which of the following best describes coinsurance? a. The agreed upon proportion for which the insurer and insured share payment of benefits under coverage b. Payments the insured makes for benefits or services provided under policy coverage c. The amount owed by the insured for benefits or services received before the insurer will pay benefits d. Types of benefits provided by the policy
a. The agreed upon proportion for which the insurer and insured share payment of benefits under coverage
The consideration clause in an accident and health policy states that: a. The applicant pays the initial premium b. Insurable interest must exist between the parties involved c. Any attachments to the policy constitute the entire contract of insurance d. Certain claims will be excluded under the policy
a. The applicant pays the initial premium
All of the following statements are true about the elimination period, EXCEPT: a. The elimination period is the time between the effective date of the policy and the date coverage begins. b. The elimination period is the period of time from the date of accident, illness or disability, until benefits are paid. c. Benefits are not paid during the elimination period. d. The elimination period is common in disability income and long-term care policies.
a. The elimination period is the time between the effective date of the policy and the date coverage begins.
For individual health insurance policies, who is responsible for paying the cost of autopsy or examination of an insured, according to the physical examination and autopsy provision? a. The insurance company b. The insured c. The beneficiary d. The physician/mortician performing the medical service
a. The insurance company
What will the insurer do if an insured submits a claim for treatment of an injury incurred while the insured was under the influence of non-prescription narcotics? a. The insurer may deny payment of the claim b. The insurer may void the policy c. The insurer may increase the insured's premiums d. The insurer may adjust the insured's benefits
a. The insurer may deny payment of the claim
Which of the following answers best describes the Interest on Claims Proceeds provision? a. The insurer must pay interest on late claim payments to the insured. b. The insurer does not have to pay interest on any claim payments to the insured. c. The insurer must pay interest on all claim payments to the insured. d. The insurer is exempt from interest charges on late claim payments to the insured.
a. The insurer must pay interest on late claim payments to the insured.
The average earnings clause for health insurance policies states that an insurer may not reduce total monthly benefits to less than: a. $100 b. $200 c. $1,000 d. $2,000
b. $200
How long is the grace period for health insurance policies with monthly-due premiums? a. 7 days b. 10 days c. 31 days d. 60 days
b. 10 days
How long is the grace period for individual health insurance coverage paid on a monthly basis? a. 7 days b. 10 days c. 30 days d. 31 days
b. 10 days
If a company decides to reinstate a policy, when does coverage begin for losses caused by sickness? a. Immediately b. 10 days c. 14 days d. 30 days
b. 10 days
Upon receipt of a notice of claim, the insurer must provide the potential claimant the proper claims form within how many days? a. 10 days b. 15 days c. 20 days d. 30 days
b. 15 days
For individual health insurance policies, legal action may be taken against the insurer for up to ____ years from the date proof of loss is provided to the insurer. a. 1 b. 3 c. 5 d. 7
b. 3
This clause or provision requires the insured to pay a set or fixed dollar amount each time a particular medical service is used: a. A co-pay clause b. A co-insurance clause c. A deductible clause d. A maximum benefit clause
a. A co-pay clause
Under this clause, the insured's health plan might not cover medication unless the insured's physician obtains approval from the health plan to prescribe a specific medication or perform a specific procedure. a. A pre-authorization clause b. An exclusion clause c. Usual, reasonable, and customary (URC) charges d. A probationary clause
a. A pre-authorization clause
Which health insurance provision allows the insurer to adjust policies so they are in alignment with state laws? a. Conformity with state statutes b. Illegal occupation c. Intoxicants and narcotics d. Average earnings clause
a. Conformity with state statutes
What is the purpose of coinsurance and deductibles? a. Cost-sharing b. Prevent adverse selection c. Prevent malingering d. Coordination of benefits
a. Cost-sharing
Of the following health insurance provisions, which states that an insurance agent may not waive any provision or make any change in an insurance contract? a. Entire contract b. Grace period c. Legal actions d. Illegal occupation
a. Entire contract
If a company decides to reinstate a policy, when does coverage begin for losses caused by accident? a. Immediately b. 10 days c. 14 days d. 30 days
a. Immediately
Insurers manage risk through a variety of policy provisions and clauses. Which of the following is NOT used to manage risk? a. Insuring clause b. Pre - existing Conditions c. Probationary Period d. Elimination Period
a. Insuring clause
The policy face of a health insurance contract contains: a. Insuring clause, name of the insured, insurer and a summary of the policy coverage b. Only the insuring clause c. Only the free look and insuring clause d. Health insurance policies do not have a policy face.
a. Insuring clause, name of the insured, insurer and a summary of the policy coverage
When periodic claim payments are required under a long-term disability income policy, an insurer must make payments to an insured at least once every: a. Month b. Three months c. Six months d. Year
a. Month
Which of the following provisions designates the person to whom claim payments are to be made? a. Payment of claims b. Notice of claims c. Entire contract d. Time of payment of claims
a. Payment of claims
"Indemnities payable under this policy for any loss will be paid immediately upon receipt of due written proof of loss." This statement appears in the: a. Payment of claims provision b. Insuring agreement c. Time limit on certain defenses provision d. Time of payment of claims provision
a. Payment of claims provision
Which of the following is not an optional provision under the NAIC Uniform Provisions Law? a. Physical examination and autopsy b. Change of occupation c. Conformity with state statutes d. Intoxicants and narcotics
a. Physical examination and autopsy
Which of the following terms best describes conditions for which prior medical advice or treatment was received? a. Pre-existing conditions b. Probationary period c. Recurrent disability d. Benefit payment clause
a. Pre-existing conditions
The period of time between an employee's coming to work at a firm that offers group health insurance to its employees and the time when he or she is covered by that insurance is called: a. Probation period b. Grace period c. Waiver period d. Elimination period
a. Probation period
Which of the following health insurance provisions prevents malingering? a. Relation of earnings to insurance _ average earnings clause b. Insurance with other insurers _ expense-incurred c. Unpaid premium d. Change of occupation
a. Relation of earnings to insurance _ average earnings clause
Erin cancels her individual health insurance policy before the end of the policy term. The insurer will: a. Return a portion of Erin's unearned premiums on a short rate basis b. Return all of Erin's earned premiums on a short rate basis c. Return a portion of Erin's unearned premiums on a pro rata basis d. Return all of Erin's earned premiums on a pro rata basis
a. Return a portion of Erin's unearned premiums on a short rate basis
While investigating a current claim, an insurance company learns the insured claimant had not included their full medical history on the application and that the current claim results from a condition that was probably pre-existing 4 years ago, when the application was approved. The company will: a. Reduce the percentage of payment for the current claim b. Pay the current claim, but void the policy, based on misrepresentation c. Deny payment of the claim and cancel the policy, based on misrepresentation d. Pay the claim
d. Pay the claim
Steven, age 53, purchased a disability income policy when he was 33. When he applied for the policy, he stated his age as 23 on the application. Steven submits a claim and the insurance company discovers the error. What action will the insurance company take? a. Pay the full claim b. Deny the claim and void the policy for misrepresentation and fraud c. Pay the full claim and void the policy for concealment and misrepresentation d. Pay the claim, but a decreased amount of benefits based on the premiums Steven should have paid, had his correct age been stated in the application
d. Pay the claim, but a decreased amount of benefits based on the premiums Steven should have paid, had his correct age been stated in the application
Adam fails to pay his premium for his health insurance policy before the end of the grace period. A couple months later, Adam decides he wants to reinstate his policy. He submits a policy application to the insurance company. Adam does not receive a reply from the insurer. If his application is accepted, when will the policy be reinstated? a. 20 days after the reinstatement application is submitted to the insurer b. 45 days after the reinstatement application is submitted to the insurer c. 60 days after the reinstatement application is submitted to the insurer d. 90 days after the reinstatement application is submitted to the insurer
b. 45 days after the reinstatement application is submitted to the insurer
According to the cancelation provision for health insurance policies, the insurer has ____ days from the date written notice is delivered to the insured, to cancel a policy. a. 1 b. 5 c. 15 d. 31
b. 5
The insurer discovers that Veronica misstated her age on the health insurance policy application. What will the insurer do? a. Void her policy b. Adjust the policy benefits c. Increase her premiums d. Decrease her premiums
b. Adjust the policy benefits
Which health insurance provision/clause describes the promises exchanged between the insured and the insurer, as evidenced by premium payments and the insured's statements in the application, and the insurer's promise to pay benefits, as stated in the policy? a. Insuring clause b. Consideration clause c. Policy face d. Benefit payment clause
b. Consideration clause
Josh works as a firefighter. He decides to quit his dangerous job to become an administrative assistant for Samantha, the head of a top advertising firm. According to the change of occupation provision, the insurance company will: a. Increase his health insurance premium b. Decrease his health insurance premium c. Adjust the benefits under his health insurance policy d. Adjust both the benefits and premium under his health insurance policy
b. Decrease his health insurance premium
In which of the following types of health insurance policies is the change of occupation provision particularly important? a. Accidental death and dismemberment b. Disability income c. Comprehensive health plan d. Dental
b. Disability income
To which type of health insurance policies does the NAIC Uniform Provisions Law apply? a. Group disability income policies b. Individual health insurance policies c. Annuities d. Life and health policies
b. Individual health insurance policies
Which health provision states, "The insurer is not liable for any loss or injury in consequence of the insured's being intoxicated or under the influence of any narcotic unless administered on the advice of a physician?" a. Misstatement of age b. Intoxicants and narcotics c. Conformity with state statutes d. Illegal occupation
b. Intoxicants and narcotics
Bob works as a coal miner. He decides to change jobs and become an insurance agent. He notified his insurance company about his job change. According to the change of occupation provision, the insurer will: a. Raise his premiums b. Lower his premiums c. Adjust the benefits d. Adjust the benefits and the premiums
b. Lower his premiums
All of the following are required provisions for health and accident policies, EXCEPT: a. Claims form b. Misstatement of age c. Consent of beneficiary d. Entire contract and changes
b. Misstatement of age
The following provisions are required in individual accident and health insurance policies issued, EXCEPT: a. Change of beneficiary b. Misstatement of age c. Time limit on certain defenses d. Change of beneficiary
b. Misstatement of age
The entire contract provision in a health and accident policy includes two basic parts. These are: a. Application and endorsements b. Policy and any attached papers c. Policy and application d. Policy and exclusions
b. Policy and any attached papers
For health insurance policies, the insuring clause is contained in the: a. Consideration clause b. Policy face c. Benefit payment clause d. Free look
b. Policy face
What is the primary purpose of the "other insurance with this insurer" health insurance provision? a. Prevent overutilization of policy benefits b. Prevent the insured from making a profit from health insurance claims c. Adjust the policy benefits or premiums if the insured's age is misstated in the application d. Prevent malingering
b. Prevent the insured from making a profit from health insurance claims
If the insurer cancels a health insurance policy during the middle of the policy term, how will the premiums be returned to the policyholder? a. Short rate return b. Pro rata return c. Full return of all premiums d. Unearned premiums are not returned.
b. Pro rata return
All of the following are true regarding recurrent disability, EXCEPT: a. Recurrent disability occurs when the insured becomes disabled from the same or related event or condition that caused a prior disability. b. Recurrent disability means that the insured has a total disability and returns to work, but can only perform some of the duties they could perform prior to the disability. c. Disability income policies may consider a recurrent disability a new or existing claim, depending on the policy. d. Waiting periods for a recurrent disability must be noted in the policy.
b. Recurrent disability means that the insured has a total disability and returns to work, but can only perform some of the duties they could perform prior to the disability.
For individual health insurance policies, an insurer may not request which of the following for a policy reinstatement? a. Reinstatement application b. Reinstatement fee c. Up to 60 days of back due premiums d. Proof of insurability
b. Reinstatement fee
Marcy cancels her health insurance policy during the middle of the policy term. What will the insurer do? a. Return all of Marcy's earned premiums on a pro rata basis b. Return a portion of Marcy's unearned premiums on a short rate basis c. Return all of Marcy's earned premiums on a short rate basis d. Return a portion of Marcy's unearned premiums on a pro rata basis
b. Return a portion of Marcy's unearned premiums on a short rate basis
Joel cancels his health insurance policy. How will the insurer return his unearned premium? a. Pro rata b. Short rate c. Full refund d. Will not refund premiums
b. Short rate
All of the following are characteristics of the reinstatement provision for individual health insurance, EXCEPT: a. Accidents are covered once a policy is reinstated. b. Sicknesses are covered once a policy is reinstated. c. A policy will be reinstated on the 45th day after the conditional receipt unless denied. d. The insurer may require 60 days of back due premium and proof of insurability.
b. Sicknesses are covered once a policy is reinstated.
The consideration clause in a health insurance policy: a. States the insurer's promise to pay benefits b. States the promises exchanged between the insured and the insurer c. Contains the scope of coverage d. States how benefits will be paid
b. States the promises exchanged between the insured and the insurer
According to the Physical Examination and Autopsy provision, who is responsible for paying the cost of examining the insured? a. The insured b. The insurer c. The policyowner d. The medical provider
b. The insurer
Ben has a past due premium of $387 and a pending claim of $642. Which of the following is true? a. The insurer may add the pending claim to the past due premium and invoice Ben for the combined amount of $1,029. b. The insurer may deduct the amount of the past due premium from the pending claim, thereby reducing Ben's claim payment to $255. c. Ben will be required to pay a subsequent premium as penalty for not paying the premium prior to incurring a claim. d. None of the above
b. The insurer may deduct the amount of the past due premium from the pending claim, thereby reducing Ben's claim payment to $255.
Mary submits a claim for an injury that she incurred while under the influence of non-prescription narcotics. What will her insurer do? a. The insurer may void the policy. b. The insurer may deny payment of the claim. c. The insurer may adjust the insured's benefits. d. The insurer may increase the insured's premiums.
b. The insurer may deny payment of the claim.
Which of the following best describes the claims forms provision? a. The insured must submit notice of claim to the insurer within 20 days of the date of loss. b. The insurer must supply claim forms to the insured within 15 days. c. The insured must only submit the proof of loss on specific forms supplied by the insurer. d. The insurer may require the insured to submit claims electronically.
b. The insurer must supply claim forms to the insured within 15 days.
An insured's disability insurance plan has a recurrent disability provision for six months. If the insured is disabled, this plan will: a. Not pay for more than one disability in a period of six months b. Waive the elimination period for a disability claim made within six months of a previous claim c. Waive the elimination period for a disability claim made more than six months after a previous claim d. Waive the elimination period for any disability claim occurring in the first six months of the policy period
b. Waive the elimination period for a disability claim made within six months of a previous claim
Samuel Johnson pays his health insurance premium quarterly. If he fails to make payment on April 1, when will his grace period expire? a. 30-Jun b. 1-Jul c. 1-May d. 1-Jun
c. 1-May
Notice of claim must be provided to the insurer within: a. 5 days of the date of loss b. 10 days of the date of loss c. 20 days of the date of loss d. 31 days of the date of loss
c. 20 days of the date of loss
For how many days must an insured wait after filing a claim with an insurance company before filing a legal suit against the company? a. 30 days b. 45 days c. 60 days d. 90 days
c. 60 days
For individual health insurance policies, how soon must the insured submit proof of loss to the insurer? a. 15 days b. 20 days c. 90 days d. 120 days
c. 90 days
Which of the following best describes the purpose of the incontestability provision? a. Prevents the insurer from "buying a claim" by imposing pre-existing conditions exclusions b. Allows the insured to return the policy for a full refund of initial premium c. Allows the insurer to contest misrepresentations in the application during the first two policy years d. Prohibits the time period during which a policy may be reinstated
c. Allows the insurer to contest misrepresentations in the application during the first two policy years
If an individual misstates their age on the application and the company chooses to cover an illness, it will base coverage on the: Select one: a. Age stated in the policy b. Amount of coverage in the policy c. Amount of coverage the policy would provide at the individual's true age d. Amount of coverage the policy would provide at the individual's stated age
c. Amount of coverage the policy would provide at the individual's true age
All of the following are provisions that relate to the filing of claims and payment of benefits in health insurance, EXCEPT: a. Claims form b. Notice of claim c. Grace period d. Proof of Loss
c. Grace period
The NAIC Uniform Provisions Law applies to: a. Group and individual health insurance policies b. Group health insurance policies c. Individual health insurance policies d. Life and health insurance policies
c. Individual health insurance policies
All of the following are required provisions under the NAIC Uniform Provisions Law, EXCEPT: a. Entire contract b. Reinstatement c. Misstatement of age d. Change of beneficiary
c. Misstatement of age
All of the following are optional provisions under the NAIC Uniform Provisions Law, EXCEPT: a. Change of occupation b. Intoxicants and narcotics c. Physical examination and autopsy d. Conformity with state statutes
c. Physical examination and autopsy
For health insurance policies, the consideration clause is contained in the: a. Free look b. Benefit payment clause c. Policy face d. Insuring clause
c. Policy face
Which of the following is a way that insurers manage risk? a. Benefit Payment Clause b. Consideration Clause c. Probationary Period d. Insuring clause
c. Probationary Period
The purpose of a pre-existing condition exclusion on a health insurance policy is to: a. Prevent over insurance b. Prevent the insured from profiting from a claim c. Protect against adverse selection d. Void the policy
c. Protect against adverse selection
The benefit payment clause for health insurance policies is best described as the: a. Promises exchanged between the insured and the insurer b. Scope of coverage, promise to pay benefits, conditions and definitions c. Provision that describes how and when benefits are paid d. Summary of coverage, conditions, exclusions, policy term and expiration date
c. Provision that describes how and when benefits are paid
An insurer may require all of the following to reinstate a health policy, EXCEPT: a. Proof of insurability b. Reinstatement application c. Reinstatement application fee d. Up to 60 days of back due premiums
c. Reinstatement application fee
An insured requests a claim form from their insurer for a covered loss. The health insurer fails to send out claims forms to the insured within the time period required by the claims form provision. Under the claims form provision, the insured should: a. Request intervention of the state Department of Insurance b. Request a full refund of premium plus interest from the insurer c. Submit the claim using any form, which the insurer is obliged to accept as proof of loss d. Do nothing until the claim forms arrive
c. Submit the claim using any form, which the insurer is obliged to accept as proof of loss
Under the claim forms provision, what is the insured allowed to do, if the insurer does not provide claim forms within 15 days? a. The insured must submit the claim electronically. b. The insured may wait until the insurer send the claim forms. c. The insured may submit the proof of loss on any form or manner to the insurer. d. None of the above
c. The insured may submit the proof of loss on any form or manner to the insurer.
Who does the "other insurance in this insurer" provision protect? a. The policyowner b. The insured c. The insurer d. No one
c. The insurer
Harold has a past due premium of $150 and a pending claim of $375. Which of the following is true? a. Harold's claim will be denied because he has a past due premium. b. Harold must pay the premium in order to receive policy benefits. c. The insurer may deduct the amount of the past due premium from the claim. d. The insurer may cancel Harold's policy.
c. The insurer may deduct the amount of the past due premium from the claim.
Which health insurance provision allows an overdue premium to be subtracted from a claim? a. Insurance with other insurers _ not expense-incurred b. Cancelation c. Unpaid premium d. Conformity with state statutes
c. Unpaid premium
When does the probationary period of a health insurance policy begin? a. When the producer collects the completed application b. When the insurer approves the application c. Upon the policy effective date d. Upon the date that coverage begins
c. Upon the policy effective date
Which health insurance provision provides for continuation of coverage without payment of premiums, if the insured becomes totally and permanently disabled? a. Coinsurance b. Copayment c. Waiver of premium d. Elimination period
c. Waiver of premium
For individual health insurance policies, how soon must the insured/claimant provide the insurance company with notice of claim? a. Within 5 days of the date of loss b. Within 10 days of the date of loss c. Within 20 days of the date of loss d. Within 31 days of the date of loss
c. Within 20 days of the date of loss
How soon after a loss must an insured under a health insurance policy provide notice of claim to the insurer? a. 5 days b. 7 days c. 15 days d. 20 days
d. 20 days
Marilyn Woodson has always paid her health insurance premium quarterly. She recently changed the payment period to weekly. What will the grace period be on the new cycle? a. 60 days b. 30 days c. 15 days d. 7 days
d. 7 days
Which of the following statements regarding the elimination period is false? a. It is the period of time before benefits are payable. b. It is often used for LTC and disability income policies. c. The elimination period begins on the date of the insured's disability. d. A policy only has one elimination period.
d. A policy only has one elimination period.
All of the following are false regarding the reinstatement provision for individual health policies, EXCEPT: a. Accidents and sicknesses are covered from the date of policy reinstatement. b. After a health insurance policy is reinstated, the insured must fulfill a 45-day waiting period before losses will be covered. c. When a health insurance policy is reinstated, only sicknesses are covered. d. Accidents are covered immediately upon reinstatement, and sicknesses are covered after a 10-day waiting period.
d. Accidents are covered immediately upon reinstatement, and sicknesses are covered after a 10-day waiting period.
What action will the insurer take if the insured has misstated their age on a health insurance application? a. Void the policy and not return any premiums b. Cancel the policy and return any unearned premiums pro rata c. Adjust the premiums d. Adjust the benefits accordingly
d. Adjust the benefits accordingly
The entire contract includes: a. Policy b. Endorsements c. Application d. All of the above
d. All of the above
How are grace periods established for health insurance policies? a. Grace periods are the same for every type of health insurance policy. b. Grace periods are based on the premium payment amount. c. Grace periods are based on the premium payment type. d. Grace periods are based on the premium payment mode.
d. Grace periods are based on the premium payment mode.
What happens to Jacob's policy if he does not pay the premium by the end of the grace period? a. Jacob must pay an additional premium to keep his policy in force. b. Jacob may, at the option of the insurer, renew his policy. c. Jacob's policy continues in force without penalty. d. Jacob's policy will lapse.
d. Jacob's policy will lapse.
Which of the following is not a mandatory NAIC health insurance provision? a. Payment of claims b. Change of beneficiary c. Reinstatement d. Misstatement of age
d. Misstatement of age
Before paying a claim, an insurance company asks an insured to have a medical examination, at its expense. The insured: a. Has no legal obligation to comply with the request b. Must comply with the request because the physical examination and autopsy clause requires it c. Must comply with the request because the payment of claims clause requires it d. Must comply with the request because the pre-existing conditions clause requires it
d. Must comply with the request because the pre-existing conditions clause requires it
Which of the following best describes the entire contract-changes provision? a. The insurer writes the contract, but the insured may make changes to the contract. b. No change may be made to an insurance contract under any circumstances. c. The agent may make changes to an insurance contract. d. Only an executive officer of the insurer may make changes to an insurance contract.
d. Only an executive officer of the insurer may make changes to an insurance contract.
Eric, an executive assistant, has a disability income policy with the change of occupation provision. Eric quits his office job and becomes a construction worker. What would happen to Eric's policy if he becomes disabled after the job change? a. The insurance company would void the policy. b. The insurance company would refund the premiums paid and void the policy. c. The insurance company would pay the full amount of disability income benefits. d. The insurance company would pay the amount of disability income benefits that the premium purchased would have covered for Eric's more hazardous occupation.
d. The insurance company would pay the amount of disability income benefits that the premium purchased would have covered for Eric's more hazardous occupation.
Betty accidentally misstates her age on her application for an individual health insurance policy. The insurer discovers this error after the incontestability period. What will the insurer do? a. Nothing _ the insurer cannot contest misstatements made on the policy application after the incontestability period ends. b. The insurer will void Betty's policy. c. The insurer will increase her premiums. d. The insurer will adjust her policy benefits.
d. The insurer will adjust her policy benefits.
How much time does an insured have after filing a claim with an insurance company in which to file a legal suit against the insurer? a. One year from the date proof of loss is furnished b. One year from the date the loss occurred c. Two years from the date the loss occurred d. Three years from the date proof of loss is furnished
d. Three years from the date proof of loss is furnished
The probationary period of a health insurance policy begins: a. When the applicant submits the application to the insurer b. When the policy is approved by the insurer c. When the policy is delivered d. Upon the policy effective date
d. Upon the policy effective date
For individual health insurance policies, how soon must the insured/claimant submit proof of loss to the insurance company? a. Within 10 days of the date of loss b. Within 45 days of the date of loss c. Within 60 days of the date of loss d. Within 90 days of the date of loss
d. Within 90 days of the date of loss
