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30 Cards in this Set
- Front
- Back
What does the free-look period allow the insured to do? |
Return the policy for a full refund of premium within a specified time period (usually 10 days) |
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Who decides what optional provisions would be included in a health policy? |
The insurance company |
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Under an individual disability income policy, the benefits must be paid on at least what schedule? |
Monthly |
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What will happen to a health insurance policy if the premium has not been paid by the end of the grace period? |
The policy will be canceled |
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What provision provides for the sharing of expenses between the insured and the insurance company? |
Coinsurance |
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After the elimination period, a totally disabled insured qualified for benefits from a disability income policy that has a waiver of premium rider. What will happen to the premium that was paid into the policy during the elimination period? |
Premium will be refunded |
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What health policy provision defines the insured’s duty to provide the insured with reasonable notice in the event of a loss? |
Notice of claim |
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How will changing one’s occupation to be more hazardous affect the health insurance policy in force? |
Claim benefits will be reduced to what the premium would have bought for a more hazardous occupation |
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What health policy provision allows the insured a period of time to examine the policy and determine whether to keep it? |
Free-look period |
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What health policy provision describes the insured’s right to cancel coverage? |
Renewability provision |
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What section of a health insurance policy list the services for which the insurer will not provide coverage? |
Exclusions |
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A waiver of premium provision may be included with what type of health insurance policies? |
Disability income |
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According to the reinstatement provision, once a lapsed policy is reinstated, how soon will the coverage be available for accidents? |
Immediately |
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When can an irrevocable beneficiary be changed? |
With the written consent of the beneficiary |
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What is the purpose of the coinsurance provision in health insurance policies? |
To prevent overutilization of the policy benefits |
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What is a probationary period in group health insurance? |
The period of time that must lapse before an employee is eligible for group health coverage |
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What is the main difference between coinsurance and co-pay? |
Co-pay is a set dollar amount; coinsurance is a percentage of the expenses |
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What is a deductible in health insurance policy? |
A specified dollar amount that the insured must pay before the insurer will pay the policy benefits |
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If a health insurance policy has a 31-day grace period, what does that mean? |
The policy remains in effect for 31 days after the premium is due and not paid |
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If the insured pays a monthly premium for health insurance, how long would the grace period be for the policy? |
10 days |
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Which health insurance provision describes the insured’s right to cancel coverage? |
Renewal provision |
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What is the name of the act by the insured to voluntarily give up insurance? |
Cancellation |
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What health policy provision states to whom the claim benefits must be paid? |
Payment of claims provision |
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According to the time limit on certain defenses provision in health insurance policies,when can an insurer contest fraudulent missstatements on a health insurance application? |
Anytime while the policy is in force |
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What health policy provision prevents the insured from bringing a lawsuit against the insurance company for at least 60 days after proof of loss is provided? |
Legal actions |
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The insured on a health policy misstated his age on the insurance application. If this misrepresentation is discovered, what will happen to the policy? |
The benefit amount payable under the policy will be adjusted to the insured’s correct age. |
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What will determine the length of the grace period in a health insurance policy? |
The mode of premium payment |
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Who pays the expense for an autopsy under the physical examination and autopsy provision? |
The insurer |
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What are usually/reasonable and customary charges based on? |
Average charge for a given procedure in a specific geographic area |
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Who decides which optional provisions would be included in a health policy? |
The insurance company |