A&H Policy ProvisionsQuestion 632 of 716
Subrogation in a health or medical policy allows the insurer, after paying a claim caused by a third party, to:
a.Retain all of the insured's future premiums
b.Deny the claim it already paid and demand that the insured personally return all of the benefit money received
c.Recover the amount paid from the responsible third party or from the insured's recovery against that party
d.Increase the insured's benefits going forward
Explanation
Subrogation lets the insurer step into the insured's shoes to recover its payment from the at-fault party. It does not undo the claim, seize premiums, or raise benefits.
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Related questions on this topic
- A pre-existing condition provision allows the insurer to:
- The coordination of benefits (COB) provision in group health coverage is designed to:
- Under COB, when a child is covered by both parents' group plans, the 'birthday rule' usually makes the primary plan the one belonging to the parent whose:
- The main purpose of subrogation is to:
- A recurrent disability provision states that if an insured returns to work but becomes disabled again from the same cause within a stated time (such as 6 months), it is treated as:
- An impairment (exclusion) rider on a health policy:
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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)