A&H Policy ProvisionsQuestion 618 of 716
The mandatory 'physical examination and autopsy' provision allows the insurer, at its own expense, to:
a.Raise the policy's premium at any point while a claim is being investigated by the company's claims department
b.Deny all pending claims automatically
c.Cancel the coverage during a claim
d.Examine the insured while a claim is pending and require an autopsy where not forbidden by law
Explanation
This provision lets the insurer verify a claim by examining the insured or, in a death claim, ordering an autopsy where state law permits, all at the insurer's cost. It does not authorize automatic denial, premium hikes, or cancellation.
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Related questions on this topic
- 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:
- In individual health insurance, the length of the grace period usually depends on the:
- After an individual health policy has been in force for the period stated in the 'time limit on certain defenses,' a claim for a pre-existing condition that is NOT specifically excluded by name:
- Under the optional 'change of occupation' provision, if an insured changes to a MORE hazardous occupation, benefits will generally be:
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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)