Insurance Quiz 6

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?

• Accidental Death and Dismemberment rider

• Disability Income rider

• Guaranteed Insurability rider

• Waiver of Premium rider

C is the policyowner of a Comprehensive individual Major Medical policy. C pays an annual premium which is due September 1. If C forgets to pay the premium and is hospitalized September 10, how will the insurer handle this claim?

• Pay half the claim and keep remaining balance until premium is paid

• Deny the claim

• Cancel the policy and deny the claim

• Pay the claim in full minus the premium due

What type of renewability guarantees premium rates and renewability?

• Optionally renewable

• Conditionally renewable

• Noncancellable

• Warranted renewable

Which of the following provisions specifies how long a policyowner's health coverage will remain in effect if the policyowner does not pay the premium when it is due?

• Grace Period

• Consideration

• Waiver of Premium

• Reinstatement

The policy provision that entitles the insurer to establish conditions the insured must meet while a claim is pending is:

• Grace Period

• Physical Examination and Autopsy

• Entire Contract

• Time Limit on Certain Defenses

Which of the following statements BEST describes what the Legal Actions provision of an Accident and Health policy requires?

• An insured must settle a claim within 60 days after Proof of Loss is submitted

• An insured must wait at least 30 days after Proof of Loss has been submitted before a lawsuit can be filed

• An insured must wait at least 60 days after Proof of Loss has been submitted before a lawsuit can be filed

• An insured must settle a claim within 30 days after Proof of Loss is submitted

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

• Subrogation clause

• Assignment provision

• Share clause

• Payment of Claims provision

According to the Mandatory Uniform Policy Provisions, what is the maximum amount of time after the premium due date during which the policy remains in force even though the premium has not been paid?

• 7 days

• 10 days

• 31 days

• 60 days

Select the appropriate response: The sections of an insurance contract which limit coverage are called:

• waivers

• riders

• exclusions

• limitations

The Notice of Claims provision requires a policyowner to:

• provide proof of loss to an insurer within a specified time

• notify an insurer of a claim within a specified time

• wait 60 days after filing a claim to initiate a lawsuit against an insurer

• notify their physician of a claim within a specified time