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”.
What is considered to be a characteristic of conditionally renewable health insurance policy?
What is considered to be a characteristic of a Conditionally Renewable Health Insurance policy ? A Conditionally Renewable Health Insurance policy can increase premiums at time of renewal. The purpose of the Time of Payment of Claims provision is to prevent the insurance company from delaying claim payments.
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 .)
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.
Which optionally renewable health policies the insurer may?
With an Optionally Renewable policy, the insurance company may review the policy annually and choose whether or not to renew it. What is the purpose of the Time of Payment of Claims provision? The purpose of the Time of Payment of Claims provision is to prevent the insurance company from delaying claim payments.
What does it mean if a health policy is conditionally renewable?
A conditionally renewable insurance policy provision allows the insurer to not allow a policy to be renewed under certain conditions. A conditionally renewable policy can be renewed unless the conditions outlined in the policy occur.
What does it mean if a health policy is optionally renewable?
Optionally Renewable — a provision in a health policy , for example, that gives the insurer the right to renew the contract or not at its option on the policy’s anniversary date; midterm cancellation is not permissible.
What is included in the policy face?
Following the insurance company name, the face page should include specific details of the policy . This should include the following information: the name of the insured and the name of the policyholder, the face amount of the policy , the policy number and the policy date.
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 a reinstatement condition?
A reinstatement clause is an insurance policy clause that states when coverage terms are reset after the insured individual or business files a claim due to previous loss or damage. Reinstatement clauses don’t usually reset a policy’s terms, but they do allow the policy to restart coverage for future claims.
What does the legal actions provision in health insurance do?
The legal actions provision prohibits insureds from taking legal action against the insurer due to a claim for 60 days from the date of proof of loss if the claim is disputed.
What is the maximum period of time for which the premium collected during policy reinstatement can be applied?
within 4 years
Which of the following policy provisions prohibits an insurance company from incorporating?
( An Entire Contract policy provision prohibits an insurance company from incorporating external documents into an insurance policy . )
What is the initial requirement for an insured to become eligible for benefits under the waiver?
In most cases, you must be less than 60 years of age when the disability begins in order to qualify for Waiver of Premium. The provision amount in force on the date of disability is then maintained until the age listed in the policy (typically age 65) without the payment of premium.