Health Insurance Provisions Clauses and Riders
- Guarateed Renewable
- Irrevocable Beneficiary - policy owner not exercise certain rights.
NAIC - National Association of Insurance Comissioners - regulatory issues. - Total Disability
Health Insurance Provisions Clauses and Riders
Mandatory Provisions
Entire Contract
The policy, singled application, riders and amendments.
Only a executive officer of the company has the autorithy to make changes to the policy.
Grace Period
Reistatement
Takes 45 days if approved by the company.
Change of beneficiary
Claims Procedures
Physical Examination and Autopsy
Time Limit on Certain Defenses.
Legal Actions
Misstatement of Age
Change of Occupation.
Relation of Earnings to Insurance.
Other Provisions and Clauses
Insuring Clause
Free Look
Consideration Clause
Probationary Period
Elimination Period
Waiver of Premium
Pre Existing Conditions
Coinsurance
Copayment - Set dollar amount that the insured needs to pay everyt time he uses a medical service.
Deductibles
Eligible Expenses
Pre - authorization and Prior Approval Requirements
Usual, Reasonable and Customary URC Charges
Lifetime, Anual or Per cause maximum benefits limits
Exclusions and Limitations
Riders
Impairment Rider
Guaranteed Insurability
Rights of Rewewability
Incontestability Clause