Insurance policies

• Commercial insurance companies reimburse insureds for covered medical expenses through a reimbursement approach.
• Policyowners can seek medical treatment from any source they deem appropriate and then submit their charges to their insurer for reimbursement.
• A waiting period in a Group Health policy allows an insurance company to delay coverage for a covered sickness for a specified number of days after the policy's effective date.
• The Commissioner of Insurance is appointed by the governor to a two-year term and isn't elected in Texas.
• The Commissioner is authorized to conduct activities of the Texas Department of Insurance (TDI).
• An automatic premium loan provision is designed to avoid a policy lapse.
• If T and S are co-primary beneficiaries of a $500,000 Accidental Death and Dismemberment policy, their father is insured, their mother is the contingent beneficiary, S dies, and then the father dies, the mother receives $0 because T is still alive.
• Under the Time Payment of Claims provision, insurers payment for Disability Income benefits no less frequently than monthly.
• In Texas, a domestic insurance company is defined as a company that is incorporated and formed in Texas.
• Life insurance illustration is not required to include the company's mortality table.
• A Health Maintenance Organization (HMO) may issue an Evidence of Coverage form after it has been approved by the Commissioner of Insurance.
• If E and F are business partners with $500,000 life insurance policies on each other, they terminate their business, and E dies, the policy from E's life insurance policy will be directed to F, as insurable interest only needs to exist at the time of application.
• A true statement about Long Term Care insurance claims that pre-existing conditions must be covered after the coverage has been in force for six months.
• If laws prohibits it, an autopsy can no be performed if an individual has an Accidental Death and Dismemberment policy, even if the cause of death is unknown, consent isn't obtained, or foul play was a contributing factor.
• Comprehensive major medical health insurance policies typically all cover health care services except for experimental and investigative services.
• After the initial enrollment period, an HMO must hold an open enrollment period of at least 31 days once in every 12-month period.
• A decreasing term policy is needed when life insurance provides coverage for only a limited amount of time with a death benefit that changes regularly.
• With a revocable beneficiary designation, the policyowner can change the beneficiary at any time without notifying or getting permission from the beneficiary.
• With level premiums charges will be more than needed in early years.
• If an insured sustains a loss on a policy sold by an agent through an insurance company that is not authorized to do business in Texas, both the agent and the company would be liable.
• If a Disability Income policyowner suffers a disability from the same cause as a previous one within a five-month period, the insurer may cover the second disability without a new elimination period under the Recurrent Disability provision.
• Subrogation is the reimbursement of benefits for the treatment of a beneficiary's injuries caused by a third party.
• Subrogation is the right for an insurer to pursue a third party that caused an insurance loss to the insured, done as a recovery of the amount of the claim.
• An organization that solicits insurance only among its members is known as a fraternal benefit society.
• Insurance policies offered on a "take it or leave it" basis are considered Contracts of Adhesion.
• The purpose of the Grace Period with Accidental Death and Dismemberment policies is to give the policyowner additional time to pay past due premiums.
• Group life policies must include Ownership, Beneficiary Designation, and Conversion Privilege, but not Right to Loans.
• The insurer will pay the claim and coverage will remain in force if a Disability Income policyowner submits a claim for a chronic neck problem with an injury 5 years prior that was never disclosed to the insurer at the time of application.
• A policy may not deny a claim based on information not disclosed at the time of application after a policy has been in force for 2 (sometimes 3) years based on the incontestable period of the policy.
• The policyowner can change the beneficiary at any time with a revocable with a Change of Beneficiary provision.
• If a Hospital/Surgical Expense policy was purchased for a family of four in March of 2013 with a $500 deductible and a limit of four deductibles per calendar year and two claims were filed in Sept 2013, the family's out-of-pocket medical expenses for 2013 would be $1,000.
• Health Reimbursement Arrangements (HRA) are employer-funded.
• A Keogh Plan may be used by a sole proprietor only if the employees of the business are included.
• Upon delivery of a rated life insurance policy, the producer must obtain a signed amendment and signed statement of Good Health, but not a signed HIPAA disclosure.
• U.S.A. Patriot Act detects and deters terrorism.
• Valid sources to obtain underwriting information about an applicant does not include Rating Services.
• A newly licensed General Lines agent must complete a MINIMUM of 24 hours of continuing education within 24 months after initial licensure.
• After M completes a life insurance application but does not pay the initial premium, policy actions must occur except the expiration of the free-look period before M's policy goes into effect.
• Premium amounts can be lowered or raised, based on investment performance is not true.
• Equity Index Life Insurance is permanent life insurance that allows policyholders to tie accumulation values to a stock market index.
• A 15-year mortgage is best protected by a 15-year decreasing term.
• A student pilot can pay regular premium costs for her life insurance policy with the addition of Aviation exclusion.
• Annuity, type of contract liquidates an estate through recurrent payments.
• A foreign insurance company is one that is incorporated the laws of another state.
• Under the Common Disaster clause, the estate taxes in the beneficiary's estate may be reduced.
• Interest Only is settlement option does NOT involve the systematic liquidation of the death s.
• A Guaranteed Renewable Health Insurance policy can can have increasing premiums at the time of renewal.
• The Time Limit on Certain Defenses limits the time during which the insurance company may challenge the validity of an insurance claim on the basis of a misstatement made on the insured's application.
• The Legal Actions states an insured must wait at least 60 days after Proof of Loss has been submitted before a lawsuit can be filed.
• An individual life insurance policy issued in Texas must have a grace period for premium payment of 31 days.
• The insurer will treat an ailment treated 2 months prior to applying as a pre-existing condition that may not be covered for one year.
• Variable annuities may invest premiums each of the following except insurer's corporate business account.
• The features of a group Term Life policy that enables an individual to leave the group and continue his or her insurance without providing evidence of insurability is Conversion privilege.
• A creditor requiring a debtor to obtain insurance from a particular company is guilty of Coercion.
• Investor-Originated Life Insurance is the arrangement bypass insurable interest laws.
• An accident policy will pay a benefit for an on-the-job accident
• The Insurance Commissioner must give 30 days notice for a hearing regarding an agent's unfair or deceptive practice.
• The individual most likely to buy a Medicare Supplement policy is a 68-year-old male covered by Medicare.
• Conversion is that group term life feature permits an individual to depart from the group and continue to be covered is a conversion.
• Denying an insured's claim without indicating the basis of denial under the policy is an unfair claim settlement practice.
• insurance company must pay death benefits for suicide if the policy has been in forced for a minimum of two years.
• Benefits for drug and alcohol treatment under a group health policy must include all of the following services except transportation to and from an outpatient facility.
• the factor that limits the amount in a Disability Income policy is income.
• Legal reserve agents are the following may charge fees for insurance advice.
• To be to elgible for Social Security disability benefits, an employee must be unable to perform any occupation.
• Under Texas insurance law, the term "transacting business" includes collecting premiums.
• The Commissioner of insurance may suspend, revoke, or refuse to renew the license of an agent who is found guilty of misrepresentation or fraud in obtaining the license.
• Grace period is the provision specifies how long health coverage will remain in effect if the policyowner does not pay the premium when it is due.
• Insurance company agent appointments remain in force until terminated or withdrawn.
• Health insurance will automatically be placed back in force if the insurer fails to notify an applicant within 45 days that the reinstatement application was denied.
• The Consideration clause states that policyowner's consideration consists of a completed application and the first initial premium.
• Health insurance benefits not covered due to an excluded by the insurer in the contract provisions.
• "Medicare Supplement" best insurance provides for excess hospital expenses.
• You Forward the application to the insurer without the initial premium" if the initial premium is not submitted with the application.
• "12" months a long-term care policy must offer.
• "Deducted when the policy is discontinued" is how are surrender charges deducted in a life policy with a rear-end loaded provision.
• Boycott, coercion, and intimidation that result in the unreasonable restraint of trade prohibited under the Texas insurance code covering unfair methods of competition.
• The Misstatement of Age requires the premiums paid would have purchased at the current age or ages if the insured is misstated.
• "Contract requires an contract offer.
• pre-hospitalization authorization is considered an example of managed care. Blanket health policies do not issue certificates the "the difference between group insurance and blanket health policies. A fixed level premium is element of a varibale life policy. Policy is returned within the free-look period, premium will be fully refunded" policy was returne. A term rider covers children under their parents policy. deferred by months is the duration, if not paid cash serrender All of the followin statements except for one: coverage during the first year is limited to congenital. Services are reimbursed after insurer receives the invoice for dental indemnity plans. Its true corporate name an insurance company must must use in its advertising. other agent who is licensed in the same line of insurance.
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