Policy Provisions in Health Insurance

Card Set Information

Author:
hicksmix6
ID:
308530
Filename:
Policy Provisions in Health Insurance
Updated:
2015-09-25 19:59:12
Tags:
oklahoma
Folders:
insurance
Description:
Oklahoma Insurance Exam
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  1. Under Uniform Policy Provisions, on of the minimum standards is proof of loss.  how many days is the insured obligated to file a proof of loss?
    a. 15
    b. 20 
    c. 90
    d. 180
  2. c. 90
  3. Under the Uniform Policy provisions, on of the minimum standards is notice of a claim.  What is the period of time an insured is obligated to notify the insurance company after a claim?
    a. 15
    b. 20
    c. 90
    d. 180
    b. 20
  4. What is the name of the provision that allows the insured to return a new policy to the insurance company and get a full refund?
    A. renewability clause
    B. cancellation clause
    C. free-look
    D. probationary period
    C. free-look
    (this multiple choice question has been scrambled)
  5. Jane applied for a health policy 7 years ago, and misstated her age on the application.  At the time of a claim, the insurance company discovers Jane's true age.  The insurance company will take the following action:
    A. deny the claim due to material misrepresentation
    B. pay Jane's claim with adjusted benefits
    C. pay the claim and cancel because she lied on the application
    D. pay full benefits because the policy is more than 2 years old
    B. pay Jane's claim with adjusted benefits
    (this multiple choice question has been scrambled)
  6. Which provision in a health insurance policy guarantees renewability with constant premiums?
    A. cancelable
    B. non-cancelable
    C. guaranteed renewable
    D. fixed-rate guranteed renewable
    B. non-cancelable
    (this multiple choice question has been scrambled)
  7. Sandi has a guaranteed renewable health insurance policy and has just been informed by her doctor she has terminal cancer.  What can her insurance company do?
    A. add an impairment rider to exclude cancer
    B. cancel
    C. increase premium
    D. nothing
    D. nothing
    (this multiple choice question has been scrambled)
  8. Under the Uniform Policy Provisions Law, all of the following are mandatory provisions, EXCEPT?
    A. notice of claim
    B. physical exam and autopsy
    C. proof of loss
    D. misstatement of age
    D. misstatement of age
    (this multiple choice question has been scrambled)
  9. Under the optional provision of illegal occupations, an insurer may void the coverage in the event of:
    A. insured committing suicide
    B. insured in the act of committing any misdemenaor
    C. insured involved in an illegal occupations
    D. insured with numerous speeding tickets
    C. insured involved in an illegal occupations
    (this multiple choice question has been scrambled)
  10. A health insurance policy which can't be cancelled but the premium may be increased for an entire class of policy owners is called:
    A. non-cancelable
    B. guaranteed renewable
    C. optionally renewable
    D. conditionally renewable
    B. guaranteed renewable
    (this multiple choice question has been scrambled)
  11. A non-cancellable policy can be cancelled under the following circumstances:
    A. can be shown in court the insured is accident prone
    B. can never be cancelled
    C. policy lapses due to non payment of premium
    D. insured has claims on a frequent basis
    C. policy lapses due to non payment of premium
    (this multiple choice question has been scrambled)
  12. Which of the following best illustrates the difference between non cancellable and guaranteed renewable?
    A. they are the same
    B. both policies can't be cancelled by the insurance company
    C. premium of non-cancelable can't be increased beyond current premium
    D. upon renewal the non-cancelable premium will change while the guaranteed renewable can increase
    C. premium of non-cancelable can't be increased beyond current premium
    (this multiple choice question has been scrambled)
  13. What is the grace period for an individual health policy with a monthly mode of premium?
    A. 60 days
    B. 10 days
    C. 7 days
    D. 30 days
    B. 10 days
    (this multiple choice question has been scrambled)
  14. Doug is reading his desability insurance policy, what type of renewability clause in a health insurance policy allows the insurer to cancel for any reason?
    A. guaranteed renewable
    B. cancelable
    C. non-cancelable
    D. non forfeiture
    B. cancelable
    (this multiple choice question has been scrambled)
  15. All of the following are true regarding Minimum Standards in individual health insurance, EXCEPT?
    A. insured is obligated to notify the insurer of claim within 20 days
    B. insured is obligated to file a proof of loss within 90 days of receipt of the claim form
    C. insurer is obligated to send claim forms within 15 days, within receipt of the claim notice
    D. insurer is NOT obligated to pay claims immediately upon receipt of the proof of loss
    D. insurer is NOT obligated to pay claims immediately upon receipt of the proof of loss
    (this multiple choice question has been scrambled)
  16. Under the Minimum Standards Provisions, when is the insurer required to pay a claim after the proof of loss is submitted?
    A. immediately
    B. 30 days
    C. 10 days
    D. 15 days
    A. immediately
    (this multiple choice question has been scrambled)
  17. If the optional provision, "change of occupation" is included in a disability policy, all of the following statements are correct, EXCEPT?
    A. insured changes to a less hazardous occupation, he/she would be entitled to a premium reduction
    B. insured changes to a less hazardous occupation and then becomes disabled, he/she would receive more benefit
    C. insured changes to a more hazardous occupation and and then becomes disabled, he/she would receive less benefit
    D. would not cost additional premium
    B. insured changes to a less hazardous occupation and then becomes disabled, he/she would receive more benefit
    (this multiple choice question has been scrambled)
  18. After a disability policy has lapsed, which of the following is NOT a correct statement regarding reinstatement?
    A. reinstatement is a mandated uniform provision in every individual health insurance policy
    B. policy can be reinstated within 3 years with certain rules
    C. policy owner would be required to pay premium and interest to the insurer
    D. allowed without proof of insurability
    D. allowed without proof of insurability
    (this multiple choice question has been scrambled)
  19. Under the Time Limit on Certain Defenses all the following are true, EXCEPT?
    A. makes the policy incontestable after 2 years
    B.  is not concerned about adverse selection
    C. similar to the incontestability clause in life insurance
    D. fraud can be contested after 2 years
    B.  is not concerned about adverse selection
    (this multiple choice question has been scrambled)

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