Which of the following statements best describe what the legal actions provision of an accident and health policy requires?
Which of the following statements BEST describes what the Legal Actions provision of an Accident and Health policy requires ? “An insured must wait at least 60 days after Proof of Loss has been submitted before a lawsuit can be filed”.
Which is considered a mandatory provision?
Payment of Claims is considered a mandatory provision and directs where the claim benefits will go. The others are considered optional provisions . n an Accident & Health policy, the insuring clause states the amount of benefits to be paid.
Which of the following health policy provisions states that the producer?
Which of the following health policy provisions states that the producer does NOT have the authority to change the policy or waive any of its provisions ? Entire Contract. (The Entire Contract provision states that the producer does NOT have the authority to change the policy or waive any of its provisions .)
Which provision allows the insured to restore the lapsed policy as long as certain conditions have been met?
A nonforfeiture clause is an insurance policy clause stipulating that an insured party can receive full or partial benefits or a partial refund of premiums after a lapse due to non-payment. Permanent life insurance , long -term disability, and long -term care insurance policies may have nonforfeiture clauses.
What is the insuring clause in an insurance policy?
One is the insuring clause , in which the insurer agrees to pay on behalf of the insured all sums that the insured shall become legally obligated to pay as damages because of bodily injury, sickness or disease, wrongful death, or injury to another person’s property.
Which is true concerning a variable universal life policy?
Which statement is true concerning a Variable Universal Life policy ? With Variable Universal Life , the policyowner controls the investment of cash values and selects the timing and amount of premium payments. In a Limited-Pay Life policy , premium payments are limited to a specified number of years.
What provisions are mandatory for health insurance policies?
a physical exam and autopsy provision – allows an insurance company to request regular physical exams or an autopsy. a legal actions clause – the minimum and maximum amount of time the policyholder can take legal action after providing proof of loss.
What is the time limit on certain defenses provision?
” TIME LIMIT ON CERTAIN DEFENSES : (a) After two years from the date of issue of this policy no misstatements except fraudulent misstatements, made by the applicant in the application for such policy shall be used to void the policy or to deny a claim for loss incurred or disability (as defined in the policy) commencing
What provision states that claims must be paid immediately upon written proof of loss?
Roger writes his company and notifies them that he has become disabled. What provision states that claims must be paid immediately upon written proof of loss ? A statement that is sufficiently clear to identify the insured and the nature of the claim.
What is an assignment of benefits of a health policy?
Assignment of benefits : An arrangement by which a patient requests that their health benefit payments be made directly to a designated person or facility, such as a physician or hospital.
Which of the following statements best describes the intent of a coinsurance clause in a major medical policy?
Which of the following statements BEST describes the intent of a Coinsurance clause in a Major Medical policy ? A purpose of the Coinsurance clause in a Major Medical Policy is to discourage overutilization of the insurance coverage .
What should the insured do if the insurer fails to send the correct forms under the claims forms provision of a health policy?
If the insurer does not supply claim forms to the insured for submitting proof of loss within 15 days of receiving notice of the claim , the insured may submit proof of loss on any piece of paper or in any manner the insured wishes. The insurer will be required to accept this as proof of loss.
What does it mean when a policy lapses?
Definition : The policy for which all benefits to the policy holder cease and is terminated due to non payment of premium amount on the due date or even after the grace period is called a lapsed policy . Description: Excessive delay in payments and servicing of the policy leads to the policy being dead or lapsed .
Can you get money back from a lapsed life insurance policy?
Some insurance policies include a nonforfeiture clause, which means that if you stop paying premiums, you still receive some sort of benefit. You can think of this as a lapsed policy refund . If your coverage lapses , the insurance company will refund part of your premium payments and/or pay you the policy’s cash value.
What is the grace period of an insurance policy?
An insurance grace period is a defined amount of time after the premium is due in which a policyholder can make a premium payment without coverage lapsing. The insurance grace period can vary depending on the insurer and policy type.