A&H Policy ProvisionsQuestion 614 of 716
Under the 'claim forms' mandatory provision, if the insurer fails to furnish claim forms within a set time (often 15 days) after notice, the insured may:
a.Submit written proof of loss in their own words describing the occurrence, character, and extent of loss
b.Wait indefinitely with no consequence
c.Sue the insurer immediately without further steps
d.Lose the right to the claim entirely, since proof of loss cannot be submitted without the insurer's official forms
Explanation
If the insurer does not send claim forms promptly, the insured satisfies the requirement by submitting proof of loss in their own words. The claim is not forfeited, nor does this provision authorize immediate suit.
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Related questions on this topic
- An impairment (exclusion) rider attached to a health insurance policy:
- The optional provision addressing 'other insurance in this insurer' is concerned with:
- The mandatory 'notice of claim' provision generally requires the insured to notify the insurer of a claim within:
- The 'proof of loss' mandatory provision typically requires the insured to furnish written proof within:
- The 'time of payment of claims' provision requires the insurer to pay claims:
- The 'legal actions' mandatory provision states that an insured may not sue the insurer until a set time after proof of loss, and no later than a stated outer limit. Those periods are commonly:
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PrepPass team · Verified against California Life & Health Insurance License Exam · How we review
Reviewed by John Zihao Zhang — California-Licensed Life Insurance Agent (CA Dept. of Insurance License #4396095 — verify)