FREE INSURANCE AND STUDY GAMES ABOUT COMMON

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FREE INSURANCE AND STUDY GAMES ABOUT COMMON

PROVISIONS EXAM QUESTIONS

Actual Qs and Ans Expert-Verified Explanation

This Exam contains:

-Guarantee passing score -21 Questions and Answers -format set of multiple-choice -Expert-Verified Explanation

Question 1: Insuring Clause

Answer:

INCLUDED ON THE FIRST PAGE OF THE POLICY! It states the insurer's promise to pay a specified amount of benefit if a certain event occurs. DESCRIBES THE TYPE AND SCOPE OF COVERAGE, provides definitions used in the policy, and states the conditions.

Question 2: Noncancellable Provision

Answer:

The insurer guarantees that it will NOT "CANCEL" the policy nor increase the premium.

Question 3: Automatic Increase Option

Answer:

SIMILAR to the Cost-Of-Living-Adjustment provision, this OPTION "INCREASES" benefit amounts by a specified amount.

Question 4: Other Common Policy Provisions

Answer:

In addition to the mandatory and optional provisions, health insurance policies have other standard provisions and clauses that exist for practical purposes. These "COMMON" provisions define the policy's features, benefits, and limitations.

Question 5: Elimination Period

Answer:

The waiting period AFTER a loss occurs BEFORE benefits begin.

(DURING THIS TIME BENEFITS ARE NOT PAID!)

Question 6: Conditionally Renewable Provision

Answer:

The insurer cannot cancel coverage as long as the insured meets the required "CONDITIONS". The insurer can increase the premiums.

Question 7: 5 Types Of Renewal Provisions

Answer:

• Noncancellable

• Guaranteed Renewable

• Conditionally Renewable

• Optionally Renewable

• Cancellable

Question 8: Renewable At Option Of Insurer Provision

Answer:

With an "OPTIONALLY RENEWABLE" provision, the insurer holds the right to cancel the policy or increase premiums on a date specified in the contract.

(This usually happens on the policy anniversary date)

Question 9: Pre-Existing Conditions

Answer:

A health "CONDITION" that e before an insurance policy was issued and is not covered for some period of time.

Question 10: Provisions For Renewability

Answer:

The rights of the insurer to increase premiums or cancel the policy and also defines the policy owners right to "RENEW" the policy's coverage beyond the current coverage period.

Question 11: 1.) Offer

2.) Acceptance 3.) Consideration

Answer:

As a contract, a health insurance policy requires 3 things...

Question 12: Pre-Existing Conditions

Answer:

A health "CONDITION" that existed before an insurance policy was issued and is not

Question 13: Term Policy Provision

Answer:

Special class of health insurance written specifically to cover ONLY LIMITED periods, such as 6 months.

(i.e life events)

Question 14: Benefit Integration

Answer:

To prevent over insuring the insured, prevent malingering, and keep premiums as low as possible, some health policies "INTEGRATE" the benefits they pay with similar benefits the insured may be receiving from other sources.

Question 15: Cancellable Provision

Answer:

Allows the insurer to "CANCEL OR END" the policy at any time simply by providing written notification.

(Insurer must refund any premiums paid in advance.)

Question 16: Guaranteed Renewable Provision

Answer:

The insurer "GUARANTEES" that it will not cancel the policy, though IT DOES HAVE THE RIGHT TO

INCREASE PREMIUMS.

Question 17: Consideration Clause

Answer:

States the "CONSIDERATION" terms.

(The applicant's CONSIDERATION in the health insurance contract is the application and the first premium payment.)

Question 18: Policy Exclusions (Conditions that are NOT covered.)

Answer:

• Self-Inflicted Injuries

• War & Military Actions

• Sickness or injury while on active duty in the armed forces

• Cosmetic Surgery

• Infertility Treatments
• Noncommercial Airline Travel
• Injuries or sickness for which workers' compensation

Question 19: Probationary Period

Answer:

THE PERIOD THAT MUST PASS "BETWEEN" the policy's effective DATE and the TIME when losses will be covered.

(Exists for a "LIMITED TIME" AFTER a policy is FIRST ISSUED.)

Question 20: Waiver Of Premium

Answer:

Provides that the policy's PREMIUM will be "WAIVED" if the insured is disabled.