Insurance Quiz 7

Which of these is considered a mandatory provision?

• Payment of Claims

• Insurance with Other Insurers

• Misstatement of Age

• Change of Occupation

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.

• immediately

• within 6 months

• at the insurer's discretion

• within 3 months

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

Which Accident and Health policy provision addresses preexisting conditions?

• Proof of Loss

• Legal Actions

• Time Limit on Certain Defenses

• Payment of Claims

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?

• Claim will be denied and policy terminated

• Claim will be partially paid

• Claim will be paid

• Claim will be denied

Which of the following BEST describes a short-term medical expense policy?

• Conditionally renewable

• Noncancellable

• Guaranteed renewable

• Nonrenewable

J, an Accidental Death and Dismemberment (AD&D) policy holder, dies after injuries sustained in an accident. J's age, as stated on the application five years ago, was found to be understated by ten years. Which of the following actions will the insurance company take?

• The insurer will pay the original benefit stated in the policy

• The insurer will adjust the benefit to what the premiums paid would have purchased at the insured's actual age

• The insurer will pay the original face amount minus any premium deficiencies owed

• The insurer will deny the claim and refund premiums paid

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

The provision that defines to whom the insurer will pay benefits to is called:

• Entire Contract

• Proof of Loss

• Claim Forms

• Payment of Claims

In health insurance policies, a waiver of premium provision keeps the coverage in force without premium payments:

• Whenever an insured is unable to work

• During the time an insured is confined in a hospital

• Following an accidental injury, but not during sickness

• After an insured has become totally disabled as defined in the policy