Chapter 5 Health Flashcards
With Accidental Death and Dismemberment policies, what is the purpose of the Grace Period?
Gives the policyowner additional time to pay past due premiums
Which of the following statements about a Guaranteed Renewable Health Insurance policy is CORRECT?
Premiums normally decrease at time of renewal
Premiums normally increase at time of renewal
Policy can renewed at any time by the company
Policy can be cancelled at any time by the company
Premiums normally increase at time of renewal
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
Which of these statements accurately describes the Waiver of Premium provision in an Accident and Health policy?
Past due premiums on a lapsed policy are waived and coverage is restored
The insured is paid a monthly benefit to keep insurance premiums current in the event of total disability
Premiums are waived after the insured has been unemployed for a specified time period
Premiums are waived after the insured has been totally disabled for a specified time period
Premiums are waived after the insured has been totally disabled for a specified time period
An insurer receives proof of loss for an acceptable medical expense claim under an Individual Health Insurance Policy. Under the Time of Payment of Claims provision, the insurer MUST pay the benefits
Immediately
An assignment of benefits of a Health Policy:
transfers payments to someone other than the policyowner
is prohibited by state law
is allowed only on policies dates after 1992
transfers rights from the company to the policyholder
transfers payments to someone other than the policyowner
The clause identifying which losses resulting from an accident or sickness are insured by the policy is called the
Insuring clause
According to the Time Limit of Certain Defenses provision in an Individual Health Insurance Policy, nonfraudulent misstatements first become incontestable
two years from the date of the policy was issued
Which of the following policy provisions prohibits an insurance company from incorporating external documents into an insurance policy?
Waiver
Exceptions and Reductions
Incontestable
Entire Contract
Entire Contract
J purchased a Disability Income Policy that ONLY J can terminate and on which the rates will never increase about those illustrated in the policy. Which of the following types of policies did J purchase?
Guaranteed Renewable
Noncancelable
Optionally Renewable
Conditionally Renewable
Noncancelable
According to the Time Payment of Claims provision, the insurer must pay Disability Income benefits no less frequently than which of the following options?
Annually
Semiannually
Quarterly
Monthly
Monthly
Which of the following statements describes the purpose of the Insuring clause in Health and Accident policies?
Specifies the additional time given to pay past due premiums
States the scope and limits of the coverage
Specifies a claim will be paid immediately upon receipt of proof of loss
Prohibits the insured from suing the insurer for at least 60 days after filing a written proof of loss
States the scope and limits of the coverage
What is the purpose of the Time of Payment of Claims provision?
Prevents delayed claim payments made by the insure
Which health policy clause specifies the amount of benefits to be paid?
Insuring
