Ch 6 Health Policy Provisions

An insurer must provide an insured with claim forms within____ days after receiving notice of a loss. -5 -10 -15 -20

15

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? -10 days -30 days -45 days -60 days

45 days

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 and policy terminated -claim will be partially paid -claim will be paid -claim will be denied

Claim will be denied

The clause identifying which losses resulting from an accident or sickness are insured by the policy is called the -entire contract provision -consideration clause -benefit clause -insuring clause

Insuring clause

J purchased a Disability Income Policy that only J can terminate and on which the rates will never increase above those illustrated in the policy. Which of the following types of policies did J purchase? -Guaranteed Renewable -Noncancelable -Optionally Renewable -Conditionally Renewable

Noncancelable

Which of the following best describes a short-term medical expense policy? -Conditionally renewable -Noncancellable -Guaranteed renewable -Nonrenewable

Nonrenewable

What is considered to be a characteristic of a Conditionally Renewable Health Insurance policy? -premiums may increase at time of renewal -premiums may increase at any time -policy may be renewed at the discretion of the insured -policy may be amended by insurer at any time

Premiums may increase at time of renewal

If an individual has an Accidental Death and Dismemberment policy and dies, an autopsy can be performed in all these situations except -When the cause of death is unknown -when the state prohibits this by law -when consent for the autopsy is not obtained -when foul play was a contributing factor

When the state prohibits this by law