EXAMFX Health Policy Provisions 2

Question 1

Under the Entire Contract provision, which documents must be included to form the complete insurance contract?

Accepted Answer

The policy, application, and all attached riders and endorsements

Answer

The policy and all attached riders and endorsements

Answer

The policy and the application only

Answer

The policy, application, and agent's notes

Question 2

A health policy's Grace Period provision typically allows how many days for an individual policy after a missed premium?

Accepted Answer

31 days

Answer

7 days

Answer

10 days

Answer

60 days

Question 3

Which provision prevents an insurer from denying a claim by citing a misrepresentation in the application after the policy has been in force for two years?

Accepted Answer

Time Limit on Certain Defenses provision

Answer

Incontestability provision

Answer

Entire Contract provision

Answer

Reinstatement provision

Question 4

If an insured submits a proof of loss for a health claim, within how many days must the insurer pay the claim under a standard Claim Settlement provision?

Accepted Answer

60 days

Answer

30 days

Answer

45 days

Answer

90 days

Question 5

The Reinstatement provision in a health policy requires that a reinstated policy cover which type of loss immediately?

Accepted Answer

Accidental injury only

Answer

All losses including sickness

Answer

Both injury and sickness after a 30-day waiting period

Answer

Only losses that were previously approved

Question 6

Under the Change of Beneficiary provision, who generally has the right to change a revocable beneficiary?

Accepted Answer

The policyowner without the beneficiary's consent

Answer

The beneficiary only

Answer

Both the policyowner and the beneficiary jointly

Answer

The insurer upon written request from either party

Question 7

When a health policy contains a Misstatement of Age provision and the insured's age was understated, the insurer will typically:

Accepted Answer

Adjust the benefit to what the correct premium would have purchased

Answer

Void the policy immediately

Answer

Pay the claim in full without adjustment

Answer

Refund all premiums paid and cancel the policy