Twelve mandatory policy provisions Flashcards
State the insurance policy itself any Riders and endorsements amendments and the application comprise the entire contract between all parties
Entire contract
States the policy is incontestable after it has been in for a certain. Of time usually two years
Time limit on certain defenses
Period After the due date of a premium during which the policy remains in force without penalty
Grace period
Putting a lapsed policy back and force by producing satisfactory evidence of INSURABILITY and any past due premiums required
Reinstatement
A policy provision that describes the policy owners obligation to provide notification of a plane to the insurer within a reasonable period of time typically the. Is 20 days after Appliance are a commencement of the laws are as soon thereafter as is reasonably possible
Notice of claim
Specifies the formal request to an insurance company asking for a payment based on the terms of the insurance policy
Claim form provision
A mandatory health insurance provision stating that the insured must have bought a completed claim form to the insured within days of the date of loss
Proof of loss
Provision that requires claims be paid immediately or within an stated number of days
Time of payment of claims
In a insurance contract specifies how and to whom claim payments are to be made
Payment of claims provision
Standard health insurance policy provision allowing the insurer to examine the insured when I claim is pending and in the event of death perform an autopsy we’re not prohibited by law
Physical exam in a autopsy provision
States the insured cannot take legal action against the company in a claim dispute until after 60 days from the time the insured submit proof of loss at least give us 2 months before you can take us to court
Legal actions provision
A provision that permits the insurer to change the beneficiary as often and he or she wishes except in policy with a beneficiary is irrevocable
Change of beneficiary
Allows the insurer to reduce the maximum benefits payable under the policy if
The insured switch to a more hazardous occupation or reduce premium rate
Change of occupation provision