Three years ago, Charles purchased a health policy from the QRS Company; he has purchased two additional contracts from the same insurer since. Each contract contains the Other Insurance With This Insurer Provision. What happens if Charles has a claim?

Other Insurance With This Insurer (an Optional Uniform Provision) stipulates that if insured has more than one policy of the same type with the same insurer, the insured may elect policy to be used, and excess prem for excess coverage will be returned.

Managed Health Care attempts to contain costs by controlling the behavior of participants in all of the following ways, except:

Partial Case Management Comprehensive Case Management is employed as opposed to partial.

One of your clients just reinstated an Accident and Health policy. When is coverage effective?

In 10 days for sickness and immediately for accidental injuries

All states have adopted the Uniform Individual Accident and Sickness Policy Provision Law. If an insurer changes any of these provisions, they must make sure it does not:

Create a meaning that is less favorable to the insured than the original wording

Guaranteed Renewable means:

Renewable with adjustable premiums, by classification only

Which of these is a Mandatory Uniform Provision? A Conformity with State Statutes B Legal Actions C Misstatement of Age D Illegal Occupation

The only choice which is a Mandatory Uniform Provision is Legal Actions. All other responses are Optional Uniform Provisions.

If an insurer makes a payment for a claim but the insured is dissatisfied with it, he/she must wait _____ days after proof of loss before he/she might take any legal action.

According to the Legal Actions Provision (a Mandatory Uniform Provision), the insured must wait at least 60 days after proof of loss before legal action can be brought against the insurer.

Which provision states that the insurance company must pay claims immediately?

Time of Payment of Claims (a Mandatory Uniform Provision) stipulates that claims are to be paid immediately upon written proof of loss.

Harry was hospitalized and in a coma for 6 months. When does proof of loss for this claim have to be submitted?

Within 1 year, unless he suffers legal incapacity

Help

Options

focusNode

Didn't know it?
click below

Knew it?
click below

Don't Know

Remaining cards (0)

Know

retry

shuffle

restart

0:00

Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

Normal Size Small Size show me how

L&H 12

Question	Answer
Three years ago, Charles purchased a health policy from the QRS Company; he has purchased two additional contracts from the same insurer since. Each contract contains the Other Insurance With This Insurer Provision. What happens if Charles has a claim?	Other Insurance With This Insurer (an Optional Uniform Provision) stipulates that if insured has more than one policy of the same type with the same insurer, the insured may elect policy to be used, and excess prem for excess coverage will be returned.
Managed Health Care attempts to contain costs by controlling the behavior of participants in all of the following ways, except:	Partial Case Management Comprehensive Case Management is employed as opposed to partial.
One of your clients just reinstated an Accident and Health policy. When is coverage effective?	In 10 days for sickness and immediately for accidental injuries
All states have adopted the Uniform Individual Accident and Sickness Policy Provision Law. If an insurer changes any of these provisions, they must make sure it does not:	Create a meaning that is less favorable to the insured than the original wording
Guaranteed Renewable means:	Renewable with adjustable premiums, by classification only
Mandatory uniform provisions found in health insurance policies are designed to protect the:	Insured
Which of these is a Mandatory Uniform Provision? A Conformity with State Statutes B Legal Actions C Misstatement of Age D Illegal Occupation	The only choice which is a Mandatory Uniform Provision is Legal Actions. All other responses are Optional Uniform Provisions.
If an insurer makes a payment for a claim but the insured is dissatisfied with it, he/she must wait _____ days after proof of loss before he/she might take any legal action.	According to the Legal Actions Provision (a Mandatory Uniform Provision), the insured must wait at least 60 days after proof of loss before legal action can be brought against the insurer.
Which provision states that the insurance company must pay claims immediately?	Time of Payment of Claims (a Mandatory Uniform Provision) stipulates that claims are to be paid immediately upon written proof of loss.
Harry was hospitalized and in a coma for 6 months. When does proof of loss for this claim have to be submitted?	Within 1 year, unless he suffers legal incapacity

Created by: rachel krystopowicz

"Know" box contains:
Time elapsed:
Retries: