Health Insurance Policy Provisions Test Question and Answers Graded A+
Which of the following actions may an insurance company
NOT do in a health policy that contains a guaranteed
renewable premium benefit?
Stop renewing policy when the insured reaches a speci-
fied age Increase the premiums on an individual basis
Cancel policy if premiums are not paid
Increase the premiums on an individual basis
Increase the premiums on the basis of an entire classifi-
cation
All of the following are included as part of a contract in the
entire contract provision EXCEPT the:
riders
Changes made by the producer
application
changes made by the producer
policy
Written notice for a health claim must be given to the
insurer days after the occurrence of the loss.
10
20
20
31
60
An insurer must furnish to a claimant forms for filing proof
of loss within days upon receiving a notice of claim.
10
15
15
20
25
All of the following are functions of an insuring clause
EXCEPT: Primarily describes the Free-look period
States the conditions under which the policy will pay
1/7
, Health Insurance Policy Provisions Test Question and Answers Graded A+
Outlines the kind of benefits provided
Primarily describes the free-look period
Provides the policy's scope and limits of coverage
After an insured gives notice of loss, what must he/she do
if the insurer does not furnish forms?
File a lawsuit
File written proof of loss
Contact the insurer again requesting forms
Nothing
File written proof of loss
David submits a $500 claim for medical expenses. There
is a past-due amount owed for insurance premiums of
$200. As a result, the insurer only pays $300 for the claim.
This deduction came as a result of which provision?
Unpaid provision
Unpaid provision
Consideration clause
Waiver of premium provision
Reduced benefit clause
Which of the following is NOT a required provision in an
accident and health insurance policy?
legal actions
change of occupation
grace period
change of occupation
reinstatement
The time limit for filing claim disputes is addressed in
which provision of an accident and health policy?
Legal actions
Legal actions
Entire contract
Time of payment of claims
Payment of claims
2/7
Which of the following actions may an insurance company
NOT do in a health policy that contains a guaranteed
renewable premium benefit?
Stop renewing policy when the insured reaches a speci-
fied age Increase the premiums on an individual basis
Cancel policy if premiums are not paid
Increase the premiums on an individual basis
Increase the premiums on the basis of an entire classifi-
cation
All of the following are included as part of a contract in the
entire contract provision EXCEPT the:
riders
Changes made by the producer
application
changes made by the producer
policy
Written notice for a health claim must be given to the
insurer days after the occurrence of the loss.
10
20
20
31
60
An insurer must furnish to a claimant forms for filing proof
of loss within days upon receiving a notice of claim.
10
15
15
20
25
All of the following are functions of an insuring clause
EXCEPT: Primarily describes the Free-look period
States the conditions under which the policy will pay
1/7
, Health Insurance Policy Provisions Test Question and Answers Graded A+
Outlines the kind of benefits provided
Primarily describes the free-look period
Provides the policy's scope and limits of coverage
After an insured gives notice of loss, what must he/she do
if the insurer does not furnish forms?
File a lawsuit
File written proof of loss
Contact the insurer again requesting forms
Nothing
File written proof of loss
David submits a $500 claim for medical expenses. There
is a past-due amount owed for insurance premiums of
$200. As a result, the insurer only pays $300 for the claim.
This deduction came as a result of which provision?
Unpaid provision
Unpaid provision
Consideration clause
Waiver of premium provision
Reduced benefit clause
Which of the following is NOT a required provision in an
accident and health insurance policy?
legal actions
change of occupation
grace period
change of occupation
reinstatement
The time limit for filing claim disputes is addressed in
which provision of an accident and health policy?
Legal actions
Legal actions
Entire contract
Time of payment of claims
Payment of claims
2/7
