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Accident and Heath
AZ Accident and Health General Policy Provisions
| Question | Answer |
|---|---|
| What does the Uniform Individual Accident and Sickness Policy Provisions Law stipulate? | All basic provisions must be the same |
| What is the entire contract? | The policy, signed application and attached riders and amendments |
| Who has the authority to change a policy that is in effect? | The executive officer of the company |
| How quickly can a reinstated policy cover accidents? Sickness? | Accidents are covered immediately. Sickness is covered typically after 10 days. |
| How many days does the insured have to provide notice of loss to the insurer? | 20 days or ASAP |
| How many days do they have to submit proof of loss? | 90 days- 1 year |
| Does the insurer have the right to order an autopsy or physical exam? If so, how often? | Yes, as often as they deem necessary |
| How do you change an irrevocable beneficiary? | With the beneficiary's written permission |
| How many days written notice must an insurer give before cancelling a policy? | 30 days |
| Define Noncancellable. | The policy cannot be cancelled nor can premiums be increased |
| Define Guaranteed Renewable. | Policy cannot be cancelled however premiums may be increased on policy anniversary date on class basis |
| Define Conditionally Renewable. | The insurer can only terminate the policy if certain conditions are met. |
| Define Optionally Renewable. | The policy may be terminated for any reason on the policy anniversary or premium due date. |
| After group coverage ends, how many days does and insured have to file an application to HIPPA? | 63 Days |
| How long is the typical Free Look period? | 10 days |
| Will an insured be covered if injured whilst intoxicated? | No. Intoxicants and Narcotics provision prevents it. |
| If an insured is robbing a bank and is shot, will his insurance pay anything? | No. Illegal occupation provision stated that liability will be denied. |
| If a company buys group health insurance that would be in multiple states, which state would have jurisdiction? Must it conform to state statutes? | Policy delivery state. Yes, it would have to have a conformity with state statutes provision |
| If an insured misstates the wrong age/sex, what would happen? | The benefits would be adjusted to the correct amount |
Created by:
jgray2015
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