Chapter 6 Flashcards
Policy written on noncancellable with right to renew guaranteed
Irrevocable beneficiary
Guaranteed renewable
NAIC
Total disability
Guaranteed renewable
Beneficiary who has a vested interest in policy and therefore policyowner may not exercise certain rights without the consent of beneficiary
NAIC
Waiver
Total disability
Irrevocable beneficiary
Irrevocable beneficiary
National association of insurance commissioners an organization composed of ins commissioners from all 50 states the District of Columbia and the 5 US territories formed to resolve ins regulatory issues
Total disability
Waiver
Guaranteed renewable
Adhesion
NAIC
NAIC
Inability of insured to perform any occupation for which insured is reasonably suited by education training or experience
Guaranteed renewable
Irrevocable beneficiary
NAIC
Total disability
Total disability
Relinquishment of a right or interest
Waiver
Provision
Contract
Grace period
Waiver
Established standard provision that are to be included in all individual health ins policies
Grace period
Reinstatement
Uniform individual accident and sickness policy provisions law
Uniform individual accident and sickness policy provisions law
Insurers must include in individual health ins policies the standard provisions established under NAIC and
Uniform individual accident and sickness policy provision law
Office of security
Hmo homeland office
Uniform individual accident and sickness policy provision law
Provision in a health ins policy that ensures that insurer cannot refer to any document that is not contained in the contract is the
Legal action against us clause
Entire contract clause
Incontestability clause
Entire contract clause
Which is true regarding uniform individual accident and sickness policy provisions law
There are twelve optional policy provisions
Provisions may be reworded by insurer
Purpose of provision is to define right of policyholder; there is a separate law outlining rights of insurers
Provisions may be reworded by the insurer
Provisions that states that both printed contract and copy of app form contract between policyowner and insurer is called
Aleatory
Master policy
Entire contract
Entire contract
Which is true regarding the uniform individual accident and sickness policy provisions law
12 optional policy provisions
Te mandatory provisions
Provisions may be reworded by insurer
Provisions may be reworded by insurer
insured pays monthly premium of 100 for her health ins. What would be the duration of the grace period under her policy
7
10
31
60
10
7 if weekly
10 if monthly
31 all other models
Which has authority to make changes to ins policy
Broker
Producer
Insurer’s executive officer
Insurer’s executive officer
A policy with a 31 grace period implies
Policy is incontestable after 31 days of delivery
May return for full refund within 31 days
Policy will not lapse for 31 days if premium is not paid when due
Policy will not lapse for 31 days if premiums is not paid when due
Pays her major medical premiums annually 3/1. Last march she forgot to mail her premium. 3/19 she had an acccident and broke her leg. Ins would
Deny the claim
Pay half of her claim because insured had an outstanding premium
Pay the claim
Hold the claim as pending until end of grace period
Pay claim
Health ins policy lapses but is reinstated within an acceptable timeframe
How soon from reinstatement date will coverage for accidents become effective
Immediately
After 14 days
After 21 days
After 31 days
Immediately
Regarding changing of irrevocable beneficiary
Never be changed
May be changed only on anniversary date of policy
Changed at any time
Only changed with written consent of that beneficiary
Only only with written consent of beneficiary
Wants to name her husband as beneficiary of her health policy. Also wishes to retain rights of ownership. Husband named as what
Irrevocable
Revocable
Primary
Contingent
Revocable
All correct about required provisions of health ins policy except
Grace period is found in annual pay policy
Reinstated policy provides immediate coverage for an illness
Proof of loss forms must be sent to insured within 15 days of notice of claim
Reinstated policy provides immediate coverage for an illness
Policy lapses due to nonpayment of premium. Within how many days would policy be automatically reinstated once outstanding premium is paid
21
31
45
45 days
Which of the following will vary the length of grace period
Length of elimination period
Term of policy
Mode of premium payment
Mode of premium payment
Would prevent ins company from paying a reimbursement claim to someone other than policyowner
Change of beneficiary
Entire contract clause
Proof of loss
Payment of claims
Payment of claims
States that claims must be paid to policyowner unless death proceed need to be paid to beneficiary
Aleatory
Pays ment of claims
Change of beneficiary
Payment of claims
States that ins company must pay medical expense claims immediately
Payment of claims
Legal actions
Relation of earnings to ins
Time of payment of claims
Time of payment of claims
Under an individual disability policy the MIMIMUM sch of time in which claim must be made
Weekly
Biweekly
Monthly
45 days
Monthly
High concerns duty to provide insurer with reasonable notice in event of loss
Loss notification
Claims initiation
Consideration
Notice of claim
Notice of claim
First notice of injury or sickness covers under accident and health policy must contain
Complete physicians statement
Statement that is sufficiently clear to identify insured and nature of claim
Statement from employer showing that insured was unable to work
Statement that is sufficiently clear to identify the insured and the nature of the claim
Insurance code requires that each code requires each policy must include written notice…within 20 days after occurrence or commencement of any loss or
As soon thereafter as is reasonably possible
Under a health ins policy, benefits other than death benefits that have not otherwise been assigned will be paid to
Insured
Creditors
Spouse of insured
Insured
Claims other than death benefits are to be paid to
Insured or insured’s estate
