Chapter 16: Health Insurance Policy Provision Quiz

the insuring clause

which of the following is not included in the policy face

which of the following health insurance policy provisions specifies the health care services a policy will provide

x is insured with a disability income policy that provides coverage until age 65. this policy allows the insurer to change the premium rate for the overall risk class assigned. which of these renewability features doe this policy contain

what type of renewability guarantees premium rates and renewability

with accidental death and dismemberment policies what is the purpose of the grace period?

with optionally renewable health policies the insurer may

when an insurance company sends a policy to the insured with an attached application, the elemnet that makes the application part of the contract between the insured and the insurer is called the

an insured must notify an insurer of a medical claim within _______ days after an accident

what must the policyowner provide to the insurer for validation that a loss has occurred

which of the following provision specifies how long a policyowners health coverage will remain in effect if the policyowner does not pay the premium when its due

which type of renewability best describes a disability income policy that covers an individual until the age of 65, but the insurer has the right to change the premium rate for the overall risk class

T sends proof of loss to her insurer for an acceptable medical expense claim under her individual health insurance policy. upon receipt the insurer must pay the benefits

what is the initial requirement for an insured to become eligible for benefits under the waiver of premium provision

insurers may request a hearing within. ________ if their policy is rejected

P is a major medical policyowner who is hospitalized as a result of injuries sustained from participation in a carjacking. how will the insurer most likely handle this claim

T files a claim on his accident and health policy after being treated for an illness. the insurance company believes that T misrepresented his actual health on the initial insurance application and is therefore disputing the validity of the claim. the provision that limits the time period during which the company may dispute a claims validity is called

K failed to pay a renewal premium within the time granted by the insurer. K then sends in a payment which the insurer subsequently accepts. which policy specifies that coverage may be restored in this situation

S filed a written proof of loss for a disability income claim on Sept 1. The insurance company did not respond to the claim. S can take legal action against the insurer beginning

the insured and insurance company will share the cost of covered losses under which health policy

an insured pays premiums on an annual basis for an individual health insurance policy. what is the minimum amount of days for the grace period provision

the clause in an accident and health policy which defines the benefit amounts the insurer will pay is called the

an insurance company normally has 2 years to contest information provided on an accident and health applicaiton. this 2 year period begins on the date that the

which of the following statments best describes what the legal actions provision of an accident and health policy requirements

which of the following health insurance policy provisions specifies the health care services a policy will provide

health insurance benefits not covered due to an act of war are

which health policy clause specifies the amount of benefits to be paid

which of the following policy provisions prohibits an insurance company from incorporating external documents into an insurance policy

an insurer must provide an insured with claim forms within ____ days after receiving notice of loss

which of the following best describes a short term medical expense policy

what should an insured do if the insurer does not send claims forms within the time period set forth in a health policys claim forms provision

the notice of claims provision requires a policyowner to