Life, Accident and Health Pearson Final Exams - Exam 5 with Complete Solutions.

Which of the following health insurance policy provisions allows an insurer to deny a claim that does not occur during the policy period? AReinstatement provision BInsuring clause COwnership provision DConsideration clause - ANSWER-B insuring clause The insuring clause specifies the time frame of the policy period which is generally one year. Therefore, accidents or illnesses occurring prior to the policy's inception date are not covered. (1416) Which of the following statements is true with regard to limited health policies? ALimited policies protect against gaps in coverage that exist in other plans BLimited policies provide benefits for cancer only CLimited policies must state clearly what coverage they provide DLimited policies cover scheduled surgical expenses if not covered by major medical plans - ANSWER-c limited policies must state clearly what coverage they provide Limited policies pay benefits for an individual illness or an accident. These policies must state prominently that they are limited in nature. Cancer only or dread disease plans are two common types of limited health insurance policies. (1175) AD&D coverage provides all of the following benefits, EXCEPT: ADeath as a result of an accident BCapital sum benefits CBenefits for loss of sight due to an illness DLoss of use of limbs caused by an accident - ANSWER-c benefits for loss of sight due to an illness Accidental death and dismemberment coverage, whether provided as a rider or an individual policy, does not provide benefits for an insured as a result of an illness. (1318) To be eligible for coverage under Part C of Medicare, an individual does not have to prove that he or she is insurable if enrollment occurs during what period of time following the attainment of age 65? AOne month BThree months CSix months DTwelve months - ANSWER-c six months No evidence of insurability is required if enrollment occurs during a six-month period