Policy Provisions in Health Insurance

Under Uniform Policy Provisions, on of the minimum standards is proof of loss.  how many days is the insured obligated to file a proof of loss?
A. 15
B. 90
C. 20 
D. 180

Under the Uniform Policy provisions, on of the minimum standards is notice of a claim.  What is the period of time an insured is obligated to notify the insurance company after a claim?
a. 15
b. 20
c. 90
d. 180

What is the name of the provision that allows the insured to return a new policy to the insurance company and get a full refund?
A. probationary period
B. cancellation clause
C. free-look
D. renewability clause

Jane applied for a health policy 7 years ago, and misstated her age on the application.  At the time of a claim, the insurance company discovers Jane's true age.  The insurance company will take the following action:
A. pay full benefits because the policy is more than 2 years old
B. deny the claim due to material misrepresentation
C. pay Jane's claim with adjusted benefits
D. pay the claim and cancel because she lied on the application

Which provision in a health insurance policy guarantees renewability with constant premiums?
A. cancelable
B. guaranteed renewable
C. fixed-rate guranteed renewable
D. non-cancelable

Sandi has a guaranteed renewable health insurance policy and has just been informed by her doctor she has terminal cancer.  What can her insurance company do?
A. increase premium
B. add an impairment rider to exclude cancer
C. cancel
D. nothing

Under the Uniform Policy Provisions Law, all of the following are mandatory provisions, EXCEPT?
A. proof of loss
B. misstatement of age
C. physical exam and autopsy
D. notice of claim

Under the optional provision of illegal occupations, an insurer may void the coverage in the event of:
A. insured with numerous speeding tickets
B. insured committing suicide
C. insured in the act of committing any misdemenaor
D. insured involved in an illegal occupations

A health insurance policy which can't be cancelled but the premium may be increased for an entire class of policy owners is called:
A. guaranteed renewable
B. optionally renewable
C. conditionally renewable
D. non-cancelable

A non-cancellable policy can be cancelled under the following circumstances:
A. policy lapses due to non payment of premium
B. insured has claims on a frequent basis
C. can never be cancelled
D. can be shown in court the insured is accident prone

Which of the following best illustrates the difference between non cancellable and guaranteed renewable?
A. upon renewal the non-cancelable premium will change while the guaranteed renewable can increase
B. they are the same
C. both policies can't be cancelled by the insurance company
D. premium of non-cancelable can't be increased beyond current premium

What is the grace period for an individual health policy with a monthly mode of premium?
A. 7 days
B. 10 days
C. 60 days
D. 30 days

Doug is reading his desability insurance policy, what type of renewability clause in a health insurance policy allows the insurer to cancel for any reason?
A. guaranteed renewable
B. non-cancelable
C. non forfeiture
D. cancelable

All of the following are true regarding Minimum Standards in individual health insurance, EXCEPT?
A. insurer is obligated to send claim forms within 15 days, within receipt of the claim notice
B. insurer is NOT obligated to pay claims immediately upon receipt of the proof of loss
C. insured is obligated to file a proof of loss within 90 days of receipt of the claim form
D. insured is obligated to notify the insurer of claim within 20 days

Under the Minimum Standards Provisions, when is the insurer required to pay a claim after the proof of loss is submitted?
A. 10 days
B. 30 days
C. 15 days
D. immediately

If the optional provision, "change of occupation" is included in a disability policy, all of the following statements are correct, EXCEPT?
A. insured changes to a less hazardous occupation and then becomes disabled, he/she would receive more benefit
B. insured changes to a less hazardous occupation, he/she would be entitled to a premium reduction
C. insured changes to a more hazardous occupation and and then becomes disabled, he/she would receive less benefit
D. would not cost additional premium

After a disability policy has lapsed, which of the following is NOT a correct statement regarding reinstatement?
A. policy can be reinstated within 3 years with certain rules
B. allowed without proof of insurability
C. policy owner would be required to pay premium and interest to the insurer
D. reinstatement is a mandated uniform provision in every individual health insurance policy

Under the Time Limit on Certain Defenses all the following are true, EXCEPT?
A. fraud can be contested after 2 years
B. similar to the incontestability clause in life insurance
C.  is not concerned about adverse selection
D. makes the policy incontestable after 2 years