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Questions and Answers
Richard owns an insurance policy that is renewable only at the option of the insurance company. His policy is considered to be:
Richard owns an insurance policy that is renewable only at the option of the insurance company. His policy is considered to be:
- Guaranteed renewable
- Conditionally renewable
- Cancelable
- Optionally renewable (correct)
An insurer must furnish to a claimant forms for filing proof of loss within ___ days upon receiving a notice of claim.
An insurer must furnish to a claimant forms for filing proof of loss within ___ days upon receiving a notice of claim.
- 10
- 25
- 15 (correct)
- 20
All of the following are functions of an insuring clause EXCEPT?
All of the following are functions of an insuring clause EXCEPT?
- Primarily describes the free-look period (correct)
- States the conditions under which the policy will pay
- Outlines the kind of benefits provided
- Provides the policy's scope and limits of coverage
In contrast to a guaranteed renewable policy, a noncancellable policy?
In contrast to a guaranteed renewable policy, a noncancellable policy?
When an insured changes to a more hazardous occupation, which disability policy provision allows an insurer to adjust policy benefits and rates?
When an insured changes to a more hazardous occupation, which disability policy provision allows an insurer to adjust policy benefits and rates?
Which of the following is NOT a common exclusion for a medical expense policy?
Which of the following is NOT a common exclusion for a medical expense policy?
In group health care, what is the purpose of the coordination of benefits provision?
In group health care, what is the purpose of the coordination of benefits provision?
The entire contract includes the actual policy and the:
The entire contract includes the actual policy and the:
Kathy pays a monthly premium on her health insurance policy. How long is her grace period?
Kathy pays a monthly premium on her health insurance policy. How long is her grace period?
The type of policy where the insurer can send a notice to the insured that the policy has been cancelled in the middle of the term is called:
The type of policy where the insurer can send a notice to the insured that the policy has been cancelled in the middle of the term is called:
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Study Notes
Insurance Policy Types
- An optionally renewable policy can only be renewed at the insurance company's discretion.
- A guaranteed renewable policy assures renewal under specified conditions, while a noncancellable policy guarantees that premiums will not increase during the policy term.
Claims Processing
- Insurers must provide claimants with forms for proof of loss within 15 days of receiving a notice of claim.
- Coordination of benefits in group health care determines payments between primary and secondary insurers during a claim.
Insuring Clauses
- Insuring clauses outline benefits provided, conditions for payment, and the scope and limits of coverage.
- Common exclusions in medical expense policies often include acts of war, on-the-job injuries, and self-inflicted injuries, but physical therapy is typically not excluded.
Disability Insurance Provisions
- The change of occupation provision allows insurers to adjust benefits and rates when an insured takes on a more hazardous job.
- Policies may be cancelable, meaning the insurer can cancel them midway through the term by sending a notice.
Contract Components
- The entire insurance contract consists of the actual policy document alongside the application filled out by the insured.
Grace Periods
- The grace period for a health insurance policy where premium payments are missed is typically 10 days, providing a buffer for policyholders.
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