1755 Individual Health Insurance Policy And General Provisions

Front 1

10 Day Free Look Provision

Back 1

Time period when the policyholder may return the policy to the company for a full refund

Front 2

Riders

Back 2

Provisions that can be attached to a policy that will provide enhancements

Hint 2

Add-On

Front 3

12 Mandatory Provisions

Back 3

Required by law to be included in all individual health policies

Front 4

G BENT CLIPPER (letter G)

Back 4

Grace Period - 7/10/31 days (weekly, monthly, all other)

Front 5

G BENT CLIPPER (letter B)

Back 5

Beneficiary - (Change of) revocable/irrevocable

Front 6

G BENT CLIPPER (letter 1E)

Back 6

Entire Contract

Front 7

G BENT CLIPPER (letter N)

Back 7

Notice of Claim - 20 days from onset of loss

Front 8

G BENT CLIPPER (letter T)

Back 8

Time of payment of claims - immediate upon proof of loss being confirmed

Front 9

G BENT CLIPPER (letter C)

Back 9

Claim forms - 15 days after receiving notice of claim

Front 10

G BENT CLIPPER (letter L)

Back 10

Legal action - 60 days after proof of loss filed and no longer than 3 years

Front 11

G BENT CLIPPER (letter I)

Back 11

Incontestable Clause/Time limit on certain defenses-2 years to raise issues, except fraud

Front 12

G BENT CLIPPER (letter 1P)

Back 12

Payment of claims - describes who receives benefits - (Insured/provider)

Front 13

G BENT CLIPPER (letter 2P)

Back 13

Proof of loss - 90 days from onset of loss (Doctor/claim form/bills, etc)

Hint 13

90 proof

Front 14

G BENT CLIPPER (letter 2E)

Back 14

Exam/Autopsy - Company's expense

Front 15

G BENT CLIPPER (letter R)

Back 15

Reinstatement - Up to 1 year, 45 days (10 day probationary period-sickness)

Front 16

Change of Occupation Provision

Back 16

Allows the insurer to make an adjustment in the policy if the insured changes jobs

Front 17

Misstatement of Age

Back 17

Allows the insurer to make an adjustment in the policy if the insured's age is misstated on the application

Front 18

Coordination of Benefits

Back 18

Designed to limit overpayments

Front 19

Cancellation Policy

Back 19

Can cancel anytime w/o reason as long as 5 days written notice is given

Front 20

Recurrent Hospitalization

Back 20

If the insured is re-hospitalized within 6 months for the same or related cause, the second hospital stay will be considered a continuation of the first stay

Hint 20

Combines 2 benefit periods into 1

Front 21

Age 19 Physically Handicapped

Back 21

If a child is dependent on their parents for support, they can stay on their plan

Front 22

Optionally Renewable Policy

Back 22

Insurer can only renew policy or raise premiums on their anniversary date if 30 days written notice is given

Front 23

Conditionally Renewable Policy

Back 23

The insurer can only terminate the policy on conditions stated in the policy

Front 24

Guaranteed Renewable Policy

Back 24

The insurer must guarantee to renew the policy until a stated age in the policy

Front 25

Medical Expenses Policies (Insurers with other insurers)

Back 25

80/20 rule comes into effect, or whoever birthday comes first (Insurers with other insurers)

Front 26

Disability Policies (Insurers with other insurers)

Back 26

Insurers with other insurers - Companies split payments

Front 27

Disability Policies (Relation of Earnings)

Back 27

Designed to prevent insured from receiving more money from insurance than they'd make at work (Relation of Earnings)

Front 28

11 Optional Policy Provisions

Back 28

Policy Provisions to protect the company

Front 29

Medical Expenses Policies

Back 29

The insurer has all the renewal rights

Front 30

Disability Policies

Back 30

The insured has all the renewal rights