Exam Questions And Correct Answers
All of the following are correct about the required provisions of a health insurance
policy EXCEPT
A. The entire contract clause means the signed application, policy, endorsements, and
attachments constitute the entire contract.
B. A reinstated policy provides immediate coverage for an illness.
C. Policies become incontestable after being in force for 3 years.
D. A grace period of 31 days is found in an annual pay policy.
B. A reinstated policy provides immediate coverage for an illness.
Accidental injury is covered immediately, but to protect the insurer against adverse
selection, losses resulting from sickness are covered only if the sickness occurs at least
10 days after the reinstatement date.
An insured pays a monthly premium of $100 for health insurance. What would be the
duration of the grace period under the policy?
A. 15 days
,B. 30 days
C. 60 days
D. 7 days
B. 30 days
The grace period is 30 days for all health insurance policies in Louisiana.
An applicant for an individual health policy failed to complete the application properly.
Before being able to complete the application and pay the initial premium, she is
confined to a hospital. This will not be covered by insurance because she has not met
the conditions specified in the
A. Insuring Clause.
B. Pre-existing Conditions Clause.
C. Eligibility Clause.
D. Consideration Clause.
D. Consideration Clause.
,The consideration clause specifies that both parties to the contract must give some
valuable consideration. The payment of the premium is the consideration given by the
applicant. Because the applicant had not paid an initial premium, she is not covered by
insurance.
Under the mandatory uniform provision Notice of Claim, the first notice of injury or
sickness covered under an accident and health policy must contain
A. An estimate of the total amount of medical and hospital expense for the loss.
B. A complete physician's statement.
C. A statement that is sufficiently clear to identify the insured and the nature of the
claim.
D. A statement from the insured's employer showing that the insured was unable to
work.
C. A statement that is sufficiently clear to identify the insured and the nature of the
claim.
The Insurance Code requires that each policy must include, "Written notice of claim
must be given to the insurer within 20 days after the occurrence or commencement of
any loss covered by the policy, or as soon thereafter as is reasonably possible".
The expense for an autopsy covered under the physical exam and autopsy provision is
paid by
, A. The estate of the insured.
B. The insurer.
C. The state's autopsy fund.
D. The limits of coverage under the health insurance policy.
B. The insurer
Where not forbidden by state law, the insurer, at its own expense, may cause an
autopsy to be performed on a deceased insured.
An insured notifies the insurance company that he has become disabled. What provision
states that claims must be paid immediately upon written proof of loss?
A. Time of Payment of Claims
B. Incontestability
C. Physical Exam and Autopsy
D. Legal Actions
A. Time of Payment of Claims