EXAMFX - Exam FX Insurance Health Policy Provisions Questions and Answers

Question 1

An insured with a health policy that is paid on a quarterly basis forgets to pay the premium.
Ten days after the due date, the insured has an accident and files a claim.
How will the insurance company likely handle this claim?

Accepted Answer

Pay the claim, minus the overdue premium.

Answer

Deny the claim because the policy has lapsed.

Answer

Pay the claim in full and issue a warning.

Answer

Deny the claim and require reinstatement of the policy.

Question 2

Which of the following mandatory health policy provisions prevents an insurer from voiding a policy for misstatements in the application after two years, except in cases of fraud?

Accepted Answer

Time Limit on Certain Defenses

Answer

Entire Contract

Answer

Reinstatement

Answer

Legal Actions

Question 3

An individual's health insurance policy lapses due to nonpayment of premium. If the insured applies for reinstatement and the insurer does not require a new application, when is the policy considered reinstated?

Accepted Answer

Automatically upon acceptance of the late premium by the insurer.

Answer

Immediately upon the insurer's approval.

Answer

After a 10-day waiting period for both sickness and accidents.

Answer

After the insured submits a new proof of insurability.

Question 4

Under the uniform policy provisions, an insured must provide written notice of a claim to the insurer within how many days of a loss?

Accepted Answer

20 days

Answer

10 days

Answer

15 days

Answer

30 days

Question 5

After an insurer receives a notice of claim, the Claim Forms provision requires the insurer to furnish the claimant with the necessary forms within how many days?

Accepted Answer

15 days

Answer

10 days

Answer

20 days

Answer

30 days

Question 6

An insured suffers a covered loss and submits a notice of claim on time. According to the Proof of Loss provision, how long does the insured typically have to submit written proof of the loss to the insurer?

Accepted Answer

90 days

Answer

30 days

Answer

60 days

Answer

120 days

An insured with a health policy that is paid on a quarterly basis forgets to pay the premium.Ten days after the due date, the insured has an accident and files a claim.How will the insurance company likely handle this claim?

An insured with a health policy that is paid on a quarterly basis forgets to pay the premium.
Ten days after the due date, the insured has an accident and files a claim.
How will the insurance company likely handle this claim?