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Which of the following health insurance policy provisions specifies the health care services a policy will provide? |
Insuring clause |
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Which Accident and Health policy provision addresses preexisting conditions? |
the Time Limit on Certain Defenses provision limits the period during which an insurer can deny a claim on the basis of a preexisting condition |
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According to the Time Payment of Claims provision, the insurer must pay Disability Income benefits no less frequently than which of the following options? |
Monthly. the time of payment for claims is usually specified in different policies as 60 days, 45 days, or 30 days. However, if the claim involves disability income benefits, the benefits must be paid not less frequently than monthly. |
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When an insurance company sends a policy to the insured with an attached application, the element that makes the application part of the contract between the insured and the insurer is called the |
The Entire Contract provision states that the application and policy contain all provisions and constitute the entire contract. |
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With Accidental Death and Dismemberment policies, what is the purpose of the Grace Period? |
Gives the policyowner additional time to pay past due premiums |
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Which of these is considered a mandatory provision? |
"Payment of Claims". Payment of Claims is considered a mandatory provision and directs where the claim benefits will go. The others are considered optional provisions. |
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Which health policy clause specifies the amount of benefits to be paid |
n an Accident & Health policy, the insuring clause states the amount of benefits to be paid. |
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Periodic health claim payments MUST be made at least |
monthly |
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An insured must notify an insurer of a medical claim within how many days after an accident |
20 |
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After an insured gives notice of loss, what must he/she do if the insurer does not furnish forms? |
The insured may file written proof of loss in any form |
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