Disposiciones de Pólizas A&SPregunta 518 de 716
The insuring clause of a health insurance policy:
a.Names the producer who sold the policy and states the commission the insurer will pay to that producer
b.Sets the schedule of dates on which the policyowner's premiums must be paid to keep coverage
c.States the insurer's promise to pay benefits for covered losses and defines the basic scope of coverage
d.Lists the specific conditions, injuries, and treatments that the policy will not cover and for which no benefits are paid
Explicación
The insuring clause is the insurer's core promise: it states that the insurer will pay benefits for the losses the policy covers and broadly defines the coverage being provided. Listing what is not covered is the function of the exclusions. Setting the premium schedule is a separate provision, and naming the producer is not part of the insuring clause. The insuring clause establishes the fundamental agreement to provide coverage, from which the rest of the policy elaborates.
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Preguntas relacionadas de este tema
- Under the misstatement of age provision in a health policy, if the insured's age was understated on the application, the benefits are:
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- 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:
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Revisado por John Zihao Zhang — California-Licensed Life Insurance Agent (CA Dept. of Insurance License #4396095 — verificar)