Podcast
Questions and Answers
Which provision allows for the reassessment of coverage limits after a specified period?
Which provision allows for the reassessment of coverage limits after a specified period?
What is the primary purpose of the 'grace period' in an insurance contract?
What is the primary purpose of the 'grace period' in an insurance contract?
What does the 'waiver of premium' provision typically allow for?
What does the 'waiver of premium' provision typically allow for?
Which of the following is addressed by the 'legal actions' provision in an insurance contract?
Which of the following is addressed by the 'legal actions' provision in an insurance contract?
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Which rider provides coverage for future increases in the insured's benefit amounts without additional medical underwriting?
Which rider provides coverage for future increases in the insured's benefit amounts without additional medical underwriting?
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Flashcards
Mandatory Provisions
Mandatory Provisions
Provisions that life insurance policies must include, ensuring essential consumer protection.
Free Look
Free Look
A period during which the insured can examine the policy and return it for a full refund, typically 10 days.
Probationary Period
Probationary Period
A period after the policy's effective date during which coverage is limited or excluded for certain conditions.
Insuring Clause
Insuring Clause
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Guaranteed Insurability Rider
Guaranteed Insurability Rider
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Study Notes
Mandatory and Optional Provisions
- Entire Contract: Covers all aspects of the agreement.
- Time Limit on Certain Defenses (Incontestable): Period after which certain claims can't be contested.
- Grace Period: Time allowed after premium due date for payment.
- Reinstatement: Process for renewing coverage after lapse.
- Notice of Claim: Procedures for reporting a claim.
- Claim Forms: Specific forms for filing claims.
- Proof of Loss: Required documentation to support a claim.
- Time of Payment of Claims: Timing for claim settlements.
- Payment of Claims: Process for distributing claim payouts.
- Physical Examination and Autopsy: Possible requirements for medical evaluations.
- Legal Actions: Procedures for resolving disputes.
- Change of Beneficiary: Process to modify who receives benefits.
- Misstatement of Age or Gender: Consequences of providing inaccurate information.
- Change of Occupation: Effects on coverage due to job changes.
- Illegal Occupation: Exclusions for high-risk occupations.
- Relation of Earning to Insurance: Guidelines relating income to coverage.
Other Provisions and Clauses
- Insuring Clause: Defines what the insurance covers.
- Free Look: Period allowing the insured to cancel without penalty.
- Consideration Clause: Outlines the exchange of value between parties.
- Probationary Period: Initial period when coverage may be limited.
- Elimination Period: Time before benefits start after a claim.
- Waiver of Premium: Situations where premiums are waived.
- Exclusions and Limitations: Aspects of coverage that are not included.
- Preexisting Conditions: Coverage for conditions present before the policy.
- Coinsurance: Percentage of costs shared between policyholder and insurer.
- Deductibles: Amounts the insured pays before benefits apply.
- Eligible Expenses: Types of costs covered under the policy.
- Copayments: Fixed amounts the insured pays for certain services.
- Pre-Authorizations and Prior Approval Requirements: Procedures for getting prior approval.
- Usual, Reasonable, and Customary (URC) Charges: Guidelines for reimbursement based on normal costs.
- Lifetime, Annual, or Per Cause Maximum Benefit Limits: Coverage caps.
Riders
- Impairment/Exclusions: Specific conditions or injuries potentially excluded or limited.
- Guaranteed Insurability: Option to buy more coverage without proof of health.
- Future Increases: Potential for future coverage enhancements.
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Description
This quiz covers essential insurance provisions including the entire contract, grace periods, and claims process. Test your understanding of mandatory and optional elements that shape insurance agreements. Gain insights into critical topics like proof of loss and beneficiary changes.
