Chapter 5 Health Flashcards Preview

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Flashcards in Chapter 5 Health Deck (14):
1

With Accidental Death and Dismemberment policies, what is the purpose of the Grace Period?

Gives the policyowner additional time to pay past due premiums

2

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

3

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

4

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

5

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

6

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

7

The clause identifying which losses resulting from an accident or sickness are insured by the policy is called the

Insuring clause

8

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

9

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

10

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

11

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

12

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

13

What is the purpose of the Time of Payment of Claims provision?

Prevents delayed claim payments made by the insure

14

Which health policy clause specifies the amount of benefits to be paid?

Insuring