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Individual Accident and Health Insurance Policy Provisions

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Created on May 15, 2023

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Transcript

Individual Accident and Health Insurance Policy Provisions

START

Question 1 of 10

Which of the following is not part of the uniform optional provisions? Select 1 option.

Illegal Occupation

Misstatement of Age and Sex

Physical Examination and Autopsy

Intoxicants and Narcotics

Question 1 of 10

Which of the following is not part of the uniform optional provisions? Select 1 option.

Illegal Occupation

Misstatement of Age and Sex

Physical Examination and Autopsy

Intoxicants and Narcotics

Question 2 of 10

Robert wants to seek recovery from his company under a policy. How many days must Robert wait after providing proof of loss, before legal action can be brought against his company? Select 1 option.

30 days

90 days

60 days

40 days

Question 2 of 10

Robert wants to seek recovery from his company under a policy. How many days must Robert wait after providing proof of loss, before legal action can be brought against his company? Select 1 option.

30 days

90 days

60 days

40 days

Question 3 of 10

What provision states that liability will be denied if the insured was committing an illegal act or is engaged in an illegal occupation? Select 1 option.

Intoxicants and Narcotics

Probationary Period

Elimination Period

Illegal Occupation

Question 3 of 10

What provision states that liability will be denied if the insured was committing an illegal act or is engaged in an illegal occupation? Select 1 option.

Intoxicants and Narcotics

Probationary Period

Elimination Period

Illegal Occupation

Question 4 of 10

Which of the following injuries or losses is not considered a common exclusion in health insurance policies? Select 1 option.

Substance abuse

Eye refractions

Dental expense

Self-inflicted injury

Question 4 of 10

Which of the following injuries or losses is not considered a common exclusion in health insurance policies? Select 1 option.

Substance abuse

Eye refractions

Dental expense

Self-inflicted injury

Question 5 of 10

What is the inability to perform any occupation for which the insured is reasonably suited by education, training, or experience? Select 1 option.

Partial disability

Residual disability

Total disability

Recurrent disability

Question 5 of 10

What is the inability to perform any occupation for which the insured is reasonably suited by education, training, or experience? Select 1 option.

Partial disability

Residual disability

Total disability

Recurrent disability

Question 6 of 10

What disability specifies the period that must lapse between two illnesses for a new set of benefits to be available for the second illness? Select 1 option.

Partial disability

Residual disability

Total disability

Recurrent disability

Question 6 of 10

What disability specifies the period that must lapse between two illnesses for a new set of benefits to be available for the second illness? Select 1 option.

Partial disability

Residual disability

Total disability

Recurrent disability

Question 7 of 10

If the insured is deceased and there is no beneficiary, to whom the pending claims will be paid? Select 1 option.

The state

The doctor who rendered the service

The deceased’s blood relatives

The deceased’s estate

Question 7 of 10

If the insured is deceased and there is no beneficiary, to whom the pending claims will be paid? Select 1 option.

The state

The doctor who rendered the service

The deceased’s blood relatives

The deceased’s estate

Question 8 of 10

In what situation can an insurer not conduct an autopsy at its own expense? Select 1 option.

When the cause of death is uncertain

When a state law forbids an autopsy

When the policy contains a provision allowing for an autopsy

When the deceased and their family object on religious grounds

Question 8 of 10

In what situation can an insurer not conduct an autopsy at its own expense? Select 1 option.

When the cause of death is uncertain

When a state law forbids an autopsy

When the policy contains a provision allowing for an autopsy

When the deceased and their family object on religious grounds

Question 9 of 10

What provision applies to new employees who must wait a certain period before they can enroll in the group plan? Select 1 option.

Consideration Clause

Insuring Clause

Probationary Period

Elimination Period

Question 9 of 10

What provision applies to new employees who must wait a certain period before they can enroll in the group plan? Select 1 option.

Consideration Clause

Insuring Clause

Probationary Period

Elimination Period

Question 10 of 10

What rider eliminates coverage for a specifically defined pre-existing condition, such as back injuries? Select 1 option.

Guaranteed Insurability Rider

Impairment Rider

Lifetime Benefit Rider

Rehabilitation Rider

Question 10 of 10

What rider eliminates coverage for a specifically defined pre-existing condition, such as back injuries? Select 1 option.

Guaranteed Insurability Rider

Impairment Rider

Lifetime Benefit Rider

Rehabilitation Rider

CONGRATS!

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