WorksheetsInsurance Quiz 7
Total questions: 21
Worksheet time: 11mins
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
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?
7
10
20
31
What is considered to be a characteristic of a Conditionally Renewable Health Insurance policy?
Premiums may increase at time of renewal
Premiums may increase at any time
Policy may be renewed at the discretion of the insured
Policy may be amended by insurer at any time
Select the appropriate response: Which of the following statements describes what an Accident and Health policyowner may NOT do?
File a covered claim
Assign ownership
Cancel the coverage
Adjust the premium payments
With Optionally Renewable Health policies, the insurer may:
renew the policy only if no claims have been filed the previous year
renew the policy only with the insured's consent
review the policy whenever they please and determine whether or not to renew it
review the policy annually and determine whether or not to renew it
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 does this policy contain?
Guaranteed Assignable
Guaranteed Renewable
Optionally Cancellable
Noncancellable
Periodic health claim payments MUST be made at least:
monthly
weekly
daily
annually
Under a Guaranteed Renewable health insurance policy, the insurer
may refuse to continue coverage upon policy renewal
is permitted to require proof of insurability upon policy renewal
will typically decrease the premium upon policy renewal
may cancel the policy for nonpayment only
What is the initial requirement for an insured to become eligible for benefits under the Waiver of Premium provision?
Insured must be unemployed
Insured must be hospitalized
Insured must demonstrate financial need
Insured must be under a physician's care
Under an individual Health Insurance policy, the Time Limit of Certain Defenses provision states that nonfraudulent misstatements first become incontestable two years
from the date that the policy was issued
from the date that the application was signed
from the date initial premium was collected
from the date of the sales appointment
If an individual is covered under an Accidental Death Policy and dies, an autopsy can be performed in all these situations, EXCEPT:
When the cause of death is unknown
When the state prohibits this by law
When consent for the autopsy is not obtained
When foul play was a contributing factor
which health policy clause specifies the amount of benefits to be paid
insuring
payment mode
free look
Consideration
