Health Insurance Policy Provisions

Front 1

The conditions , times, and cirumstances under which an insured is NOT covered by a health policy are called?

Back 1

exclusions

Front 2

the insurer has the option of terminating a health insurance policy on a date stated in the contract . What type of policy is this?

Back 2

optionally renewable

Front 3

Under a health insurance policy, the provision that states the kind of benefits provided and the circumstances under which they will be paid is called the ?

Back 3

insuring clause

Front 4

The misstatement of age provision in a health policy states that if an insured gives the wrong age at the time of application, what action can the insurance company take ?

Back 4

benefits can be adjusted

Front 5

which type of health insurance policy cannot be cancled by the insurer nor increase the premiums ?

Back 5

noncancellable

Front 6

under a noncancallable health insurance policy, an insurer can

Back 6

cancel the policy for nonpayment of premium

Front 7

Under the payment of claims provision , when are benfits typically payable after proof of loss is recieved

Back 7

immediately

Front 8

what type of changes can be made to a guaranteed renewable health insurance policy ?

Back 8

the premium rates of the policyowner

Front 9

Bruce is involved in an accident and becomes totally and permately diabled. His insurance plicy continues in force without payment of further premiums. Which policy provision is repsonsible for this?

Back 9

wavier of premium proivison

Front 10

which is not required unifrom provision in indivdual health polices ?

Back 10

change of occupation

Front 11

christine has a health insurance policy that has been in force beyond the incontestable period. The insuer has discovered that a fradulent statemnt was made on the application. What would the insurer have to pay on a claim, assuming this was'nt a guaranteed renewable policy?

Back 11

nothing

Front 12

A health insurance policy paid on a quarterly basis has a grace period of

Back 12

31 days

Front 13

In whatsituation does a waiver of premium provision keep a health insurance policy in force without premium payments ?

Back 13

when an insured becomes totally diabled

Front 14

In group health care, what is the purpose of the coordination of benefits provision?

Back 14

determines what is paid by the primary and secontary insurers is the event of a claim

Front 15

This MANDATORY health policy provision states that the policy, including endorsements and attched papers, constitues

Back 15

the entire contract provision state the policy, including endorsements and attached papers, constitutes the entire insurance contract between the parties .