Colorado Life & Health Insurance Test Questions & Answers Correct 100%

Mandatory Uniform Provisions - Answer Must be included in every individual accident policy, no additional provisions may be included which otherwise restrict or modify a uniform provision, designed to protect the insured's interest Entire Contract Clause- Mandatory Uniform - Answer Includes the policy and provisions, c a copy of the application and any riders, waivers, or endorsements Time Limit on Certain Defenses-Mandatory Uniform - Answer No statement or misstatement may be contested after 2 years, no time limit for fraud Grace Period-Mandatory Uniform - Answer Period after premium due date before policy lapse, (7-10-31) 7 days for weekly premium; 10 days for a monthly premium; 31 days of every thing else Reinstatement Provision- Mandatory Uniform - Answer Applies to the time frame that an insurer hasn't paid premium but wants the policy back, allows insured to reinstate by paying past due premiums, proof of insurability may be required, sickness begins after 10 days, accidents are covered immediately - If you haven't heard back in 45 days, then the policy has been reinstated Notice of Claim provision-Mandatory Uniform - Answer Policy owner must notify Insurer of loss either in writing, in person or by phone w/in 20 days. claim forms provision-Mandatory Uniform - Answer The insurer is required to send the insured a claim form within 15 days after notice is received Proof of Loss provision-Mandatory Uniform - Answer Policy owner has 90 days from date of loss to submit proof of loss to Insurer; valid claim must be paid immediately upon receipt. Time of Payment of Claims-Mandatory Uniform - Answer Provides for immediate payment of the claim after the insurer receives notification and proof of loss. Payment of Claims Provision-Mandatory Uniform - Answer Payment of claims to the policyowner unless otherwise specified or there is an assignment of benefits(required) defines how proceeds are to be paid out + requirements to initiate death benefit claim Physical Exam and Autopsy-Mandatory Uniform - Answer A provision that allows an insurer, at its own expense, to have an insured physically examined when a claim is pending or to have an autopsy performed where not prohibited by law. legal action - Answer Insured must wait 60 days but no later than 3 years after proof of loss (POL) before legal action may be brought against the isurer Change of Beneficiary Provision-Mandatory Uniform - Answer Stipulates that the policy owner may change the beneficiary at any time by providing a written request to the insurer, unless the beneficiary is designated as irrevocable. Optional Uniform Provisions - Answer These provisions are included at the insurer's option; however, if used they must conform to the state's insurance code. These provisions are designed to protect the insurer. Change of Occupation Provision-Optional - Answer If Insured changes to: more hazardous job - benefits reduced; less hazardous job - premiums reduce. Misstatement of Age-Optioanl - Answer This clause protects the insurance company against an applicant who lies about his age The insurance company has the right to adjust your face amount up or down to coincide with the face amount or policy limit the correct premium would have purchased if you had not lied about your age This is a separate clause from the Incontestability Clause and will not ever cause the policy to be voided Relation of Earnings to Insurance-Optional - Answer Amount of monies from premium payments the insurer received versus the loss the insurer suffered through claims payments Illegal Occupation-Optional - Answer If the insured is connected with a felony or has an illegal occupation and incurs injury, the insurance company is not held responsible Free Look Provision( Right to Examine )-other - Answer Generally 10 days after policy delivery to cancel policy w/ full refund, except 30 days for seniors or for replacement policies. Insuring Clause-other - Answer Appears on first page of contract has a summary of all the main points of the contract like the "promise to pay" death benefit Consideration Clause-other - Answer Payments and promise Preexisting condition-other - Answer A health problem that existed before the date your insurance coverage became effective. Prior Conditions which insured should have received medical advice or treatment.