Insurance Policy Provisions Quiz

Components of your policy that outline specific benefits, terms, conditions, or other important features

The policy, including the application, riders, and amendments, constitutes the entire contract. No prior statements can alter the contract.

The time period after a premium is due during which the policyholder can make a payment without losing coverage (Less than 30 days)

<p>It limits the time during which the insurer can deny a claim or void the policy due to a misstatement by the insured.</p> Signup and view all the answers

<p>Payment of overdue premiums and proof of insurability</p> Signup and view all the answers

<p>Typically within 20 days of the occurrence</p> Signup and view all the answers

<p>The insurer must provide claim forms to the insured within a specified time frame, usually 15 days.</p> Signup and view all the answers

<p>A statement of facts about a loss for which the insured is making a claim, generally 90 days.</p> Signup and view all the answers

<p>45 days</p> Signup and view all the answers

<p>It specifies to whom claims payments are to be made.</p> Signup and view all the answers

<p>It allows an insurer, at its own expense, to have an insured physically examined when a claim is pending or to have an autopsy performed where not prohibited by law.</p> Signup and view all the answers

<p>At least 60 days from the time the insured submits proof of loss.</p> Signup and view all the answers

<p>The insured, as policyowner, may change the beneficiary designation at any time unless a beneficiary has been named irrevocably.</p> Signup and view all the answers

<p>Benefits or premiums may be adjusted.</p> Signup and view all the answers

<p>The insurer may adjust benefits or premiums.</p> Signup and view all the answers

<p>The insurer is not liable for coverage on injuries that are sustained during illegal activities.</p> Signup and view all the answers

<p>The insurer to change policy benefit if insured's income has decreased, portion of the premium will be refunded</p> Signup and view all the answers

<p>The scope and limits of the coverage</p> Signup and view all the answers

<p>It permits Policy owners 30 days in which to examine their new policy at no obligation (Like a Free Trial of a game)</p> Signup and view all the answers

<p>The amount and frequency of premium payments</p> Signup and view all the answers

<p>The period of time between the effective date of a health insurance policy and the date coverage for all or certain conditions begins. No benefits are payable during it.</p> Signup and view all the answers

<p>Amount of time that lapses after a disabling event before the insurance company begins to pay benefits. Around 30 days.</p> Signup and view all the answers

<p>Waives premium payments during a period of total disability, allowing the policy to remain in force without cost to the insured.</p> Signup and view all the answers

<p>Conditions or circumstances not covered by the policy</p> Signup and view all the answers

<p>Medical conditions that existed before the policy's start date, which may be excluded or subject to a waiting period.</p> Signup and view all the answers

<p>The percentage of costs shared by the insured and insurer, typically after the deductible is met.</p> Signup and view all the answers

<p>Amount the insured pays first before benefits are paid by the plan.</p> Signup and view all the answers

<p>Medical expenses covered by the policy</p> Signup and view all the answers

<p>A fixed amount the insured pays for covered services, often at the time of service.</p> Signup and view all the answers

<p>Certain procedures or services require prior approval from the insurer to be covered</p> Signup and view all the answers

<p>Charges deemed reasonable for services in a geographical area, used to determine the amount covered by the insurer.</p> Signup and view all the answers

<p>Caps on the benefits payable by the insurer over the policyholder's lifetime, annually, or per incident.</p> Signup and view all the answers

<p>Adds something to a policy. Whether the policy's conditions are expanded and additional coverage added or a coverage of conditions is waived.</p> Signup and view all the answers

<p>Specified hazards listed in a policy for which benefits will not be paid.</p> Signup and view all the answers

<p>Allows a policyholder to purchase specified amounts of additional insurance with out the evidence of insurability. AKA GIB</p> Signup and view all the answers

<p>Provides the option to increase coverage amounts at future dates without additional medical exams.</p> Signup and view all the answers

<p>Type of Health Insurance policy that the company may not cancel, but must renew to a certain age with no change in premium. Affords the greatest degree of continuation protection to the insured</p> Signup and view all the answers

<p>Policy that can be terminated</p> Signup and view all the answers

<p>The policy must be renewed (as long as premiums are paid) until the insured reaches a specified age, such as 60 or 65.</p> Signup and view all the answers