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WorksheetsInsurance Quiz 6
Total questions: 21
Worksheet time: 11mins
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
What is the purpose of the Time of Payment of Claims provision?
Requires the insured to wait 60 days after submitting Proof of Loss before filing a lawsuit
Prevents delayed claim payments made by the insurer
Requires a probation period for each claim filed by the insured
Protects the insurer from frivolous lawsuits
"A producer does not have the authority to change a policy or waive any of its provisions." The health provision that best describes this statement is called the
Grace Period
Incontestable
Entire Contract
Time Limit on Certain Defenses
What must the policyowner provide to the insurer for validation that a loss has occurred?
Proof of Coverage
Proof of Claim
Proof of Loss
Proof of Payment
What should an insured do if the insurer does not send claims forms within the time period set forth in a health policy’s Claims Forms provision? Select the appropriate response.
File a lawsuit
Submit the claim in any form
Wait for the claim form to arrive
Resubmit the request for a claim form
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 for the overall risk class?
Conditionally Renewable
Noncancellable
Guaranteed Renewable
Optionally Renewable
Select the appropriate response: The ______ clause identifies which losses resulting from an accident or sickness are insured by the policy.
Identification
Benefit
Payment
Insuring
An insurance company normally has 2 years to contest information provided on an accident and health application. This 2 year period begins on the date that the:
medical examination is given
producer completes the application
insurer dates the policy
the first premium is paid
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?
10 days
30 days
45 days
60 days
An insurer must provide an insured with claim forms within __ days after receiving notice of a loss. Select the appropriate response.
5
10
15
20
Which of the following is NOT included in the policy face?
Free Look provision
Name of the insured
Name of the insurer
Exclusions
The clause in an accident and health policy which defines the benefit amounts the insurer will pay is called the
insuring clause
contestable clause
consideration clause
free look clause
