CH7 VA State and Health Exam, Questions with accurate answers. 100% verified. Graded A

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CH7 VA State and Health Exam, Questions with accurate answers. 100% verified. Graded A The provision in a health insurance policy that ensures that the insurer cannot refer to any document that i ... s not contained inthe contract is the A) Legal action against us clause. B) Entire contract clause. C) Time limit on certain defenses clause. D) Incontestability clause. - ✔✔B) Entire contract clause. The provision which states that both the printed contract and a copy of the application for the contract between the policyowner and the insurer is called the A) Aleatory contract B) Complete contract C) Entire contract D) Total contract - ✔✔C) Entire contract Which of the following will vary the length of the grace period in health insurance policies? A) The length of any elimination period B) The length of time the insured has been insured C) The term of the policy D) The mode of the premium payment - ✔✔D) The mode of the premium payment Which is true regarding the Uniform Individual Accident and Sickness Policy Provision Law? A) There are twelve optional policy provisions. B) Provisions may be reworded by the insurer C) The purpose of the provision is to define the right of the policyholder; there is a separate law outlining the rights of insurers D) There are ten mandatory provisions - ✔✔B) Provisions may be reworded by the insurer A Health insurance policy lapses but is reinstated within an acceptable time frame. How soon from the reinstatement date will coverage for accidents become effective? A) Immediately B) After 14 days C) After 31 days D) After 31 days - ✔✔A) Immediately A policy with a 31-day grace period implies A) The policyholder has a 31-day free look B) The policy lapses if premium is not paid 31 days before it is due C) If something happens within 31 days of the policy issue, the insurer will not pay D) The policy continues for 31 days if premiums are not paid - ✔✔D) The policy continues for 31 days if premiums are not paid Marsha pays her Major Medical Insurance annually on March 1, each year. Last Marsh she forgot to mail her premium to the company. On March 19, Marsha had an accident and broke her leg. Her insurance company would A) Deny the claim B) Pay half of her claim because she had an outstanding premium C) Pay the claim D) Hold the claim as pending until the end of the grace period. - ✔✔C) Pay the claim Under the mandatory uniform provision Notice of Claim, the first notice of injury or sickness covered under an accident and health policy must contain A) A complete physicians statement B) A statement that is sufficiently clear to identify the insured and the nature of the claim C) A statement from the insured's employer showing that the insured was unable to work. D) An estimate of the total amount of medical and hospital expense for the loss - ✔✔B) A statement that is sufficiently clear to identify the insured and the nature of the claim All of the following are correct about the required provisions of a health insurance policy EXCEPT A) A grace period of 31 days if found in annual pay policy B) The entire contract clause means the signed application, policy, endorsements, and attachments constitute the entire contract C) A reinstated policy provides immediate coverage for an illness. D) Proof-of-loss forms must be sent to the insured within 15 days of notice of claim - ✔✔C) A reinstated policy provides immediate coverage for an illness. An insured wants to name her husband as the beneficiary of her health policy. She also wishes to retain all of the rights of ownership. The insured should have her husband named as what type of beneficiary? A) Irrevocable B) Revocable C) Primary D) Contingent - ✔✔B) Revocable Which of the following entities has the authority to make changes to an insurance policy? A) Broker B) Producer C) Insurer's executive officer D) Department of Insurance - ✔✔C) Insurer's executive officer Which of the following statements is most correct concerning the changing of an irrevocable beneficiary? A) They can never be changed B) They may be changed only on the anniversary date of the policy C) They can be changed only with the written consent of that beneficiary D) They may be changed at any time - ✔✔C) They can be changed only with the written consent of that beneficiary An insured paya a monthly premium of $100 for her health insurance. What would be the duration of the grace period under her policy? A) 7 days B) 10 days C) 31 days D) 60 days - ✔✔B) 10 days What provision concerns the insured's duty to provide the insurer with reasonable notice in the event of a loss? A) Loss Notification B) Claims Initiation C) Consideration D) Notice of Claim - ✔✔D) Notice of Claim When Linda suffered a broken hip, she notified her agent, in writing, within 12 days of the loss. However, her agent did not notify the insurance company until 60 days after the loss. Which of the following statements correctly explains how this claim would be handled? A) The insurer may deny the claim since it was not notified within the required 20-day time frame B) The insured is considered to be notified since the notification to agent equals notification to the insurer C) The insurer may delay the payment of this claim for up to 6 months D) The insurer may settle this claim for less than it otherwise would have had the notification been provided in atimely manner - ✔✔B) The insured is considered to be notified since the notification to agent equals notification to the insurer An insured submitted a notice of claim to the insurer, but never receive claims forms. He later submits proof of loss, and explains the nature and extent of loss in a hand-written letter to the insurer. Which of the following would be true? A) The insured was in compliance with the policy requirements regarding claims B) The claim most likely will not be paid since the official claims for m was not submitted. C) The insurer will be fined for not providing th claims forms D) the insured must submit proof of loss the Department of Insurance - ✔✔A) The insured was in compliance with the policy requirements regarding claims An insured notifies the insurance company that he has become disabled. What provision states that claims bust be paid immediately upon written proof of loss/? A) Physical Exam and Autopsy B) legal Actions C) Time of Payment of Claims D) Incontestability - ✔✔C) Time of Payment of Claims Under an individual disability policy, the MINIMUM schedule of time which claim payments must be made to an insured is A) Weekly. B) Biweekly C) Monthly [Show More]

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