An insuring clause is a part of insurance policies that defines how much risk will be taken on by the insurance company. Health Provisions Flashcards | Chegg.com You can learn more about the standards we follow in producing accurate, unbiased content in our. A) 90 B) 15 C) 20 D) 10 Answer C is correct. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. The policy would retain a cash value component, but it would grow at a reduced rate. An insured intentionally did not disclose a material fact on an application for insurance. Which one of these is NOT considered to be an element of an insurable risk. Conditions of an Insuring Cause. Cash value life insurance is permanent life insurance with a cash value savings component. Which of the following insurance principles has the insurer violated? This would be considered, The section of an insurance policy that details what perils are no insured against and what persons are not insured is known as the. If you need help understanding the insuring clause, you can post your legal needs on UpCounsel's marketplace. Cash surrender value b. Accumulation at interest c. Extended term d. None of the above Accumulation at interest is a dividend option. The security requirements must allow work to be accomplished while One is the insuring clause, in which the insurer agrees to pay on behalf of the insured all sums that the insured shall become legally obligated to pay as damages because of bodily injury, sickness or disease, wrongful death, or injury to another person's property. Chapter 2 Flashcards | Chegg.com These expenses can include damages awarded Under the assignment provision, what is most likely? If the notice does not contain an explanation for the cancellation, the company is often required toprovide such an explanation in writingupon receipt of a written request from the policyholder. Insuring clauses are used to prevent a profit from a loss that is insured, which is required by the Learn more about what cash value life insurance is and how it works. A cancellation provision clause is a provision in an insurance policy that permits an insurer to cancel a policy at any time before its expiration date. The part of the insurance contract that describes the covered perils and the nature of coverage of the contractual agreement between the insurer and the insured is called the, Which of the following is a statement that is guaranteed to be true, and if untrue, may breach an insurance contract a. concealment b. indemnity c. representation d. warranty, All of the following are found in the declarations section of a policy EXCEPT the a. Exclusions b. review the policy annually and determine whether or not to renew it ( "review the policy annually and determine whether or not to renew it". perils such as: Multiple-choice 30 seconds 1 pt For example, when the policyholder intends to file a claim, they are required to immediately notify the insurer. 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Universal life (UL) insurance is permanent life insurance with an investment savings component. Even if it is a caesarean section or complication due to pregnancy, insurers do not consider pregnancy as a condition to be included in a health insurance plan. With the cash surrender value option, the policy owner terminates the policy and receives the remaining cash value within six months. For example, most insuring clauses Which Accident and Health policy provision addresses preexisting conditions? Generally, a cancellation provision clause requires that whenever a party chooses to cancel the policy, that party must send a written notice to the other involved party. Mass customization is a marketing and manufacturing technique that Essie S. asked 10/04/16 Hi, everyone. A health insurance contract is valid only if the insured provides consideration in the form of the full minimum premium and the statements made in the application. Nonforfeiture options/values are guarantees that are required by law to be part of life insurance policies that build cash value. In 10 days for sickness and immediately for accidental injuries. Before issuing payment to the policy owner, outstanding loan amounts are satisfied with the cash value. The insuring agreement or insuring clause, The conditionally renewable provision in an insurance policy allows an insurance company to, If your health insurer refuses to pay a claim or ends your coverage, you have the right to. With the cash payment dividend option, the policyholder is sent a check for the amount of the dividend, which does not increase the policy's cash value. The word team gets bandied about so loosely that many managers are oblivious to its real meaningor its true potential. Feel free to get in touch with us via email. Which of the following best describes a short term medical expense policy? Insurance clauses, also called general insurance clauses and insurance provisions, are the limitations of liability policy conditions and general liability risks an insurance provider takes. A conditionally renewable insurance policy contains a provision that permits the insurer to not allow a policy to be renewed under certain conditions. Click the card to flip Incontestable clause Click the card to flip 1 / 34 Flashcards Test Match Created by smtess211 Terms in this set (34) non-compensatory damages after a lawsuit, these issues will also be excluded. Is Minecraft discontinued on Nintendo Switch? These provisions vary from case to case, and the amount of loss that is apportioned depends on the language of the policy. All of the following are Optional Provisions, except: Which provision is an Optional Uniform Provision. Which of these statements accurately describes the waiver of premium? These usually have increasing premiums. Which of the following is not included in the insuring clause quizlet? This exclusion can also apply when there is reasonable suspicion that fraud or some other crime has been committed. 2003-2023 Chegg Inc. All rights reserved. Consideration b. competent parties c. beneficiary's consent d. offer and acceptance, An insurer neglects to pay a legitimate claim that is covered under the terms of the policy. A few weeks later, E suffers a heart attack and is hospitalized without completing the medical history questions and paying the initial premium. a. arbitration b. small claims court c. independent audit d. appraisal hearing. Every Health and Disability Income Policy must express the conditions and provisions for _______. Business Income coverage may provide protection against certain financial losses that are sustained while the business is unable to operate. The Time Limit on Certain Defenses provision limits the period during which an insurer can deny a claim on the basis of a preexisting condition. I think it has something to do with weight force. An insurer must provide an insured with claim forms within __ days after receiving notice of a loss. The Health Insurance Practice Test (National) helps familiarize you with the test-taking experience. The neck injury was never disclosed to the insurer at the time of application. P is a Major Medical policyowner who is hospitalized as a result of injuries sustained from participating in a carjacking. Chapter 5.5 : Options Flashcards | Chegg.com When is coverage effective for sickness and accident? Under the professional liability loss settlement provision, what must an insurer do before offering to pay a claimant to settle a claim? And mass customization are forcing companies to find flexible ways to meet customer demand. A statement by the applicant that, upon discovery, would affect the underwriting decision of the insurance company. 7 days for weekly, 10 days for monthly, 31 for all others. a. An insurance grace period is a defined amount of time after the premium is due in which a policyholder can make a premium payment without coverage lapsing. Multiple-choice 30 seconds 1 pt According to the entire contract provision, the entire contract includes all of the following EXCEPT: the insurance policy the premium payment 2. A few weeks later E suffers a heart attack and is hospitalized without completing the medical history questions and paying the initial premium. If an insurer changes any of these provisions, it must make sure that the change does not: Create a meaning that is less favorable to the insured than the original wording. Which of the following may Eddie not use? For example, if 80% coinsurance applies to your building, the limit of insurance must be at least 80% of the buildings value. Which of the following may Eddie not use? Term 1 / 7 Section A: Incident Response Costs Click the card to flip Definition 1 / 7 we will pay on YOUR behalf any reasonable sums incurred by YOU or on YOUR behalf as a direct result from a CYBER EVENT first DISCOVERED by YOU during the policy period: - access to our 24/7 cyber incident response line Which type of renewability best describes a Disability Income policy that covers an individual until the age of 65, but the insurer has the right to change the premium rate? Notice of claim is required within _____ days of loss. Which of the following is a Case Management Provision used by insurers to monitor hospital stays? Beth has a contract stating she must be disabled for 3 months before benefits will begin to be paid. It states the insurer's promise to pay the death benefit upon the insured's death. Insurers have the right to take over the settlement of a claim on behalf of the policyholder, although this is not required. For traditional whole-life policies, the policyholder decides how they would like to access the policys cash value. The ABC Corporation has $100,000 of coverage on its building from insurance company A, and $50,000 of identical coverage on the same building through insurance company B. a) A client with amyotrophic lateral sclerosis (ALS) tells the nurse, "Sometimes I feel so frustrated. The liability policy. The policyis calculatedfrom the insureds attained age. Rick can use his dividends to purchase paid-up additions, without adding significantly to his costs. AILife.com. Payment of Claims is considered a mandatory provision and directs where the claim benefits will go. B. the application given to the prospective insured. Later, she lost that job and her salary was reduced to $2,000 a month. will be divided when there are multiple policies in place. In some cases, no coverage is provided, and in others, the different insurance companies share the loss evenly. True or false? The policy will be construed as if it conformed to the law, Mandatory Second Surgical Opinion is when the physician submits claim information prior to treatment, to determine in advance if the procedure is covered. Only one policy will pay, the premiums for the other contracts will be returned. Basics of an Insuring Clause Insurers take on a certain amount of risk when providing an insurance policy, and the risk the company assumes is stipulated in an insuring clause.