Health Insurance Policy Provisions

The Notice of Claims provision requires a policyowner to

notify an insurer of a claim within a specified time

Which of these is considered a mandatory provision? -Payment of Claims -Insurance with Other Insurers -Misstatement of Age -Change of Occupation

Payment of Claims

An insured must notify an insurer of a medical claim within how many days after an accident?

20

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

31 days

After an insured gives notice of loss, what must he/she do if the insurer does not furnish forms?

File written proof of loss

Which of the following statements BEST describes what the Legal Actions provision of an Accident and Health policy requires? -An insured must settle a claim within 60 days after Proof of Loss is submitted -An insured must wait at least 30 days after Proof of Loss has been submitted before a lawsuit can be filed -An insured must wait at least 60 days after Proof of Loss has been submitted before a lawsuit can be filed -An insured must settle a claim within 30 days after Proof of Loss is submitted

An insured must wait at least 60 days after Proof of Loss has been submitted before a lawsuit can be filed

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