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Insurance Quiz 6

Total questions: 21

Worksheet time: 11mins

Name
Class
Date
1.

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)

Accidental Death and Dismemberment rider

b)

Disability Income rider

c)

Guaranteed Insurability rider

d)

Waiver of Premium rider

2.

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?

a)

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

b)

Deny the claim

c)

Cancel the policy and deny the claim

d)

Pay the claim in full minus the premium due

3.

What type of renewability guarantees premium rates and renewability?

a)

Optionally renewable

b)

Conditionally renewable

c)

Noncancellable

d)

Warranted renewable

4.

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?

a)

Grace Period

b)

Consideration

c)

Waiver of Premium

d)

Reinstatement

5.

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

a)

Grace Period

b)

Physical Examination and Autopsy

c)

Entire Contract

d)

Time Limit on Certain Defenses

6.

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

a)

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

b)

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

c)

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

d)

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

7.

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

a)

Subrogation clause

b)

Assignment provision

c)

Share clause

d)

Payment of Claims provision

8.

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?

a)

7 days

b)

10 days

c)

31 days

d)

60 days

9.

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

a)

waivers

b)

riders

c)

exclusions

d)

limitations

10.

The Notice of Claims provision requires a policyowner to:

a)

provide proof of loss to an insurer within a specified time

b)

notify an insurer of a claim within a specified time

c)

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

d)

notify their physician of a claim within a specified time

11.

What is the purpose of the Time of Payment of Claims provision?

a)

Requires the insured to wait 60 days after submitting Proof of Loss before filing a lawsuit

b)

Prevents delayed claim payments made by the insurer

c)

Requires a probation period for each claim filed by the insured

d)

Protects the insurer from frivolous lawsuits

12.

"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

a)

Grace Period

b)

Incontestable

c)

Entire Contract

d)

Time Limit on Certain Defenses

13.

What must the policyowner provide to the insurer for validation that a loss has occurred?

a)

Proof of Coverage

b)

Proof of Claim

c)

Proof of Loss

d)

Proof of Payment

14.

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.

a)

File a lawsuit

b)

Submit the claim in any form

c)

Wait for the claim form to arrive

d)

Resubmit the request for a claim form

15.

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?

a)

Conditionally Renewable

b)

Noncancellable

c)

Guaranteed Renewable

d)

Optionally Renewable

16.

Select the appropriate response: The ______ clause identifies which losses resulting from an accident or sickness are insured by the policy.

a)

Identification

b)

Benefit

c)

Payment

d)

Insuring

17.

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:

a)

medical examination is given

b)

producer completes the application

c)

insurer dates the policy

d)

the first premium is paid

18.

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)

10 days

b)

30 days

c)

45 days

d)

60 days

19.

An insurer must provide an insured with claim forms within __ days after receiving notice of a loss. Select the appropriate response.

a)

5

b)

10

c)

15

d)

20

20.

Which of the following is NOT included in the policy face?

a)

Free Look provision

b)

Name of the insured

c)

Name of the insurer

d)

Exclusions

21.

The clause in an accident and health policy which defines the benefit amounts the insurer will pay is called the

a)

insuring clause

b)

contestable clause

c)

consideration clause

d)

free look clause