Claim will be paid and coverage will remain in force(Correct.) After a policy has been in force for 2 (sometimes 3) years, it enters the incontestable period, in which the insurer may not deny a claim based on information not disclosed at the time of application.
  • What type of rider would be added to an Accident and Health policy if the policyowner wants to ensure the policy will continue if he/she ever becomes totally disabled?
  • A Disability Income policyowner recently submitted a claim for a chronic neck problem that has now resulted in total disability. The original neck injury occurred before the application was taken 5 years prior. The neck injury was never disclosed to the insurer at the time of application. How will the insurer handle this claim?
  • An insurance company receives E's application for an individual health policy. E did not complete all of the medical history questions because she could not remember the exact dates. E signed the policy and submitted it to the insurance company anyway. A few weeks later, E suffers a heart attack and is hospitalized without completing the medical history questions and paying the initial premium. E is not insured. Which of the following clauses details the conditions that E did not meet?
  • P is a Major Medical policyowner who is hospitalized as a result of injuries sustained from participating in a carjacking. How will the insurer most likely handle this claim?
15("15". Under the Claims Forms provision, an insurer must provide an insured with claim forms within a MAXIMUM of 15 days after receiving notice of a loss.
  • What is the purpose of the Time of Payment of Claims provision?
  • When an insured changes to a more hazardous occupation, which disability policy provision allows an insurer to adjust policy benefits and rates?
  • In health insurance policies, a waiver of premium provision keeps the coverage in force without premium payments
  • An insurer must provide an insured with claim forms within __ days after receiving notice of a loss.
Entire Contract(Correct.) The Entire Contract provision states that the health insurance policy, together with a copy of the signed application and attached riders and amendments, constitutes the entire contract.
  • Which of the following statements BEST describes what the Legal Actions provision of an Accident and Health policy requires?
  • Which Accident and Health policy provision addresses preexisting conditions?
  • Which health policy clause stipulates that an insurance company must attach a copy of the application to the policy to ensure that it is part of the contract?
  • Which health policy clause specifies the amount of benefits to be paid?
Waiver of Premium rider("Waiver of Premium rider". If a policyowner covered under an accident and health policy wanted to ensure the policy will continue if they ever become totally disabled, they would want to add a waiver of premium rider.
  • 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?
  • When an insured changes to a more hazardous occupation, which disability policy provision allows an insurer to adjust policy benefits and rates?
  • P is a Major Medical policyowner who is hospitalized as a result of injuries sustained from participating in a carjacking. How will the insurer most likely handle this claim?
  • What type of rider would be added to an Accident and Health policy if the policyowner wants to ensure the policy will continue if he/she ever becomes totally disabled?
Insuring("Insuring". In an Accident & Health policy, the insuring clause states the amount of benefits to be paid.
  • Which health policy clause specifies the amount of benefits to be paid?
  • Which of the following is NOT included in the policy face?
  • Which Accident and Health policy provision addresses preexisting conditions?
  • Which health policy clause stipulates that an insurance company must attach a copy of the application to the policy to ensure that it is part of the contract?
review the policy annually and determine whether or not to renew it("review the policy annually and determine whether or not to renew it". With an Optionally Renewable policy, the insurance company may review the policy annually and choose whether or not to renew it.
  • With Optionally Renewable Health policies, the insurer may
  • Which of these is considered a mandatory provision?
  • What is the purpose of the Time of Payment of Claims provision?
  • Which of the following statements describes the purpose of the Insuring clause in Health and Accident policies?
Payment of Claims(Correct.) The Payment of Claims provision in a Health Insurance policy states to whom claims will be paid.
  • If an individual has an Accidental Death and Dismemberment policy and dies, an autopsy can be performed in all these situations EXCEPT
  • When does a Probationary Period provision become effective in a health insurance contract?
  • With Accidental Death and Dismemberment policies, what is the purpose of the Grace Period?
  • The provision that defines to whom the insurer will pay benefits to is called
Prevents delayed claim payments made by the insurer(Correct.) The purpose of the Time of Payment of Claims provision is to prevent the insurance company from delaying claim payments.
  • Which of the following statements describes the purpose of the Insuring clause in Health and Accident policies?
  • Which of these is considered a mandatory provision?
  • What is the purpose of the Time of Payment of Claims provision?
  • Which of the following is NOT included in the policy face?
The insured(Correct.) In this situation, the insured is liable for the medical bills.
  • Which of the following statements BEST describes what the Legal Actions provision of an Accident and Health policy requires?
  • P is a Major Medical policyowner who is hospitalized as a result of injuries sustained from participating in a carjacking. How will the insurer most likely handle this claim?
  • G is involved in an automobile accident as a result of driving while intoxicated and suffers numerous injuries. According to the Intoxicants and Narcotics exclusion in G's policy, who is responsible for paying the medical bills?
  • 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??
Adjust the premium payments(Correct.) The owner of an Accident and Health policy may not change the premium amount.
  • Which of the following statements describes what an Accident and Health policyowner may NOT do?
  • Which of the following is NOT included in the policy face?
  • Which of the following statements BEST describes what the Legal Actions provision of an Accident and Health policy requires?
  • Which of the following statements describes the purpose of the Insuring clause in Health and Accident policies?
45 days(
  • G is involved in an automobile accident as a result of driving while intoxicated and suffers numerous injuries. According to the Intoxicants and Narcotics exclusion in G's policy, who is responsible for paying the medical bills?
  • 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??
  • A Disability Income policyowner recently submitted a claim for a chronic neck problem that has now resulted in total disability. The original neck injury occurred before the application was taken 5 years prior. The neck injury was never disclosed to the insurer at the time of application. How will the insurer handle this claim?
  • An insurance company receives E's application for an individual health policy. E did not complete all of the medical history questions because she could not remember the exact dates. E signed the policy and submitted it to the insurance company anyway. A few weeks later, E suffers a heart attack and is hospitalized without completing the medical history questions and paying the initial premium. E is not insured. Which of the following clauses details the conditions that E did not meet?
At the policy's inception(Correct.) The probationary period begins when a policy goes into effect. During this period, no benefits will be paid under the policy.
  • With Accidental Death and Dismemberment policies, what is the purpose of the Grace Period?
  • The provision that defines to whom the insurer will pay benefits to is called
  • An insured pays premiums on an annual basis for an individual health insurance policy. What is the MINIMUM number of days for the Grace Period provision?
  • When does a Probationary Period provision become effective in a health insurance contract?
States the scope and limits of the coverage( "States the scope and limits of the coverage". The purpose of the insuring clause is to specify the scope and limits of the coverage provided.
  • Which of the following statements describes what an Accident and Health policyowner may NOT do?
  • Which of the following statements BEST describes what the Legal Actions provision of an Accident and Health policy requires?
  • Which of the following statements describes the purpose of the Insuring clause in Health and Accident policies?
  • Which of these statements accurately describes the Waiver of Premium provision in an Accident and Health policy?
31(Correct.) The grace period is a minimum of 31 days for policies that are paid for on an annual basis.
  • If an individual has an Accidental Death and Dismemberment policy and dies, an autopsy can be performed in all these situations EXCEPT
  • An insured pays premiums on an annual basis for an individual health insurance policy. What is the MINIMUM number of days for the Grace Period provision?
  • When does a Probationary Period provision become effective in a health insurance contract?
  • With Accidental Death and Dismemberment policies, what is the purpose of the Grace Period?
After an insured has become totally disabled as defined in the policy("After an insured has become totally disabled as defined in the policy". The waiver of premium provision keeps the coverage in force without premium payments if the insured has become totally disabled as defined in the policy.
  • Which of these statements accurately describes the Waiver of Premium provision in an Accident and Health policy?
  • In health insurance policies, a waiver of premium provision keeps the coverage in force without premium payments
  • When an insured changes to a more hazardous occupation, which disability policy provision allows an insurer to adjust policy benefits and rates?
  • Health insurance benefits NOT covered due to an act of war are
Claim will be denied("Claim will be denied". If a person is injured while committing an illegal act, health insurance will not cover the expense of the injury.
  • What type of rider would be added to an Accident and Health policy if the policyowner wants to ensure the policy will continue if he/she ever becomes totally disabled?
  • 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?
  • A Disability Income policyowner recently submitted a claim for a chronic neck problem that has now resulted in total disability. The original neck injury occurred before the application was taken 5 years prior. The neck injury was never disclosed to the insurer at the time of application. How will the insurer handle this claim?
  • P is a Major Medical policyowner who is hospitalized as a result of injuries sustained from participating in a carjacking. How will the insurer most likely handle this claim?
Consideration clause(Correct.) A health insurance contract is valid only if the insured provides consideration in the form of the full minimum premium and the statements made in the application.
  • 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??
  • A Disability Income policyowner recently submitted a claim for a chronic neck problem that has now resulted in total disability. The original neck injury occurred before the application was taken 5 years prior. The neck injury was never disclosed to the insurer at the time of application. How will the insurer handle this claim?
  • An insurance company receives E's application for an individual health policy. E did not complete all of the medical history questions because she could not remember the exact dates. E signed the policy and submitted it to the insurance company anyway. A few weeks later, E suffers a heart attack and is hospitalized without completing the medical history questions and paying the initial premium. E is not insured. Which of the following clauses details the conditions that E did not meet?
  • An insurer must provide an insured with claim forms within __ days after receiving notice of a loss.
Exclusions("Exclusions". The exclusions section is NOT included in the policy face (first page of an insurance policy).
  • Which of the following statements describes what an Accident and Health policyowner may NOT do?
  • Which of these is considered a mandatory provision?
  • Which of the following is NOT included in the policy face?
  • Which of the following statements describes the purpose of the Insuring clause in Health and Accident policies?
Change of occupation provision(Correct.) The change of occupation provision allows an insurer to adjust policy benefits and/or rates if the insured has changed to a more hazardous occupation.
  • Which of the following statements describes the purpose of the Insuring clause in Health and Accident policies?
  • What type of rider would be added to an Accident and Health policy if the policyowner wants to ensure the policy will continue if he/she ever becomes totally disabled?
  • When an insured changes to a more hazardous occupation, which disability policy provision allows an insurer to adjust policy benefits and rates?
  • In health insurance policies, a waiver of premium provision keeps the coverage in force without premium payments
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