Health Insurance – Lesson 16 Flashcards Preview

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Flashcards in Health Insurance – Lesson 16 Deck (17)
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0
Q

Are insurance companies required to use the exact wording of the uniform policy provisions?

A

No, they are allowed to reword the provisions as long as the wording is not less favorable to insureds.

1
Q

The uniform individual accident and sickness policy provision law were developed by whom?

A

National Association of insurance commissioners

2
Q

How many mandatory and optional provisions are there?

A

12 mandatory and 11 optional provisions

3
Q

What is the minimum grace period for all disability policies other than monthly or weekly premium policies?

A

31 days

4
Q

If a person suffers a disability that is expected to last at least two years, the injured will need to give the insurer proof of the continuation of the disability every how often?

A

Every six months

5
Q

The insured has several disability income policies. The benefits from all policies exceed the insured’s monthly income when he suffers a disability. How will the claim be handled?

A

Each insurer is liable for a proportionate amount of benefits as the insured’s earnings are the total benefits under all contracts.

6
Q

A person is considering 2 individual disability income policies from the same company. The premiums on both are exactly the same. Which policy will be the best choice?

A

Non-cancelable

7
Q

A disability policy described as “guaranteed renewable” is one where the insurance company:

A

Surrenders the right to change any of its terms but may change the premiums.

8
Q

What is the grace period for a disability policy that has a quarterly premium payment?

A

31 days

9
Q

When an insured changes his occupation to a more hazardous one and his individual policy contains the optional change of occupation provisions; what will the insurer do?

A

The insurer will reduce the benefits.

10
Q

The insurer adjust premiums by class of individuals. True or false?

A

False

11
Q

The type of disability policy that is not favorable to the insured and, therefore, has the highest premium payment is:

A

Non-cancelable

12
Q

A secretary purchases a disability policy with a change of occupation provision. She later becomes a lying tamer. What can the company do?

A

Reduce the benefits.

13
Q

What happens if a disability policy has a provision that is in conflict with state law?

A

The provision in conflict will be amended to conform to state law.

14
Q

What type of disability policy allow the insurer to cancel the policy on any premium due date or the anniversary date of the policy?

A

Optionally renewable

15
Q

When can an insured bring legal action regarding disability insurance against an insurer?

A

No sooner than 60 days nor later than three years.

16
Q

What does the uniform policy provisions address?

A
  1. Notice of claim
  2. Proof of loss
  3. The entire contract