Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
12 Cards in this Set
- Front
- Back
|
Provision 1 : Entire contract; Changes |
The entire contract between the parties consists of the policy, any endorsements, and the application, if attached.
Any changes made must be by an executive officer of the insurer with the consent of all parties to the contract. No agent can make changes to the policy. |
|
|
Provision 2: Time Limit on Certain Defenses; Incontestability
|
The policy becomes incontestable and cannot be voided or claims denied after two years (three years in some states), except in the case of fraud.
The following defenses may not be used after the incontestable period for voiding a policy or denying or reducing a claim: -Misstatements, except fraud, made by a policy owner in the policy application -Sickness or physical condition, other than those specifically excluded in the policy, that existed prior to the effective date of coverage of the policy. Preexisting conditions cannot be excluded after 2 years from the date the policy is in force. |
|
|
Provision 3: Grace Period
|
7 days for a weekly premium policies. 10 days for a monthly premium policy. 31 days for all other policies. Grace periods are allowed after the first premium is paid on the policy. Policy is still active while in grace period. |
|
|
Provision 4: Reinstatement
|
If a policy lapses for failure to pay premiums, The insurer will reinstate the policy upon payment as long as the insurer does not require an application to reinstate the policy. If the insurer requires an application for reinstatement, the person must submit an application, which the insurer may approve or deny. Insurer may require up to a max of 60 days backed premium. Insurer will reinstate on the 45th day after the date of the conditional receipt, unless denied. covers accident immediately but sickness is 10 days after reinstatement date.. |
|
|
Provision 5: Notice of Claim
|
Written notice of a claim will be given to insurer within 20 days of loss. |
|
|
Provision 6: Claim Forms
|
If forms are not provided within 15 days, claimant has complied with policy requirements. |
|
|
7: Proof of Loss
|
Must be provided to insurer within 90 days after the date of loss. under no circumstance is proof of loss to be submitted later than 1 year from the date proof of loss was initially required. |
|
|
Provision 8: Time of Payment of Claims
|
All accrued claims for losses providing periodic payment will be paid at least monthly and any balance remaining upon the termination of liability is payable immediately upon receipt of written proof.
|
|
|
Provision 9: Payment of Claims
|
If there isn't a beneficiary designated, all payments will be made to insureds estate. |
|
|
Provision 10: Physical Examination and Autopsy
|
Insurer at their own expense can examine the person of autopsy when reasonably required while a claim is pending. |
|
|
Provision 11: Legal Actions
|
No legal action can be brought to recover on the policy until 60 days after the written proof of loss is provide to insurer. No legal action after the expiration of 3 years after the written proof of loss is required to be provided to the insurer. |
|
|
Provision 12: Change of Beneficiary
|
The right to change a beneficiary is reserved to the policy owner and does not require consent of the beneficiary. |
