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Accident and Heath

AZ Accident and Health General Policy Provisions

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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