Disposiciones de Pólizas A&SPregunta 520 de 716
The optional provision addressing 'other insurance in this insurer' is concerned with:
a.The dollar size of the medical expense deductible the insured must satisfy before any benefits start
b.Situations where an insured holds multiple policies with the same insurer, limiting total benefits to prevent overinsurance
c.The insured's separate life insurance policies held with other insurers and the way their death benefits are coordinated at claim time
d.The length of the elimination period that must pass before the policy's disability benefits become payable
Explicación
This optional provision applies when an insured has more than one policy of the same kind with the same insurer; it lets the insurer limit the total benefits payable (often refunding the premium for the excess coverage) so the insured cannot be overinsured and profit from a loss. It does not concern separate life insurance, the deductible, or the elimination period. The provision reflects the principle that health coverage should reimburse loss, not create a gain from duplicate policies.
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Preguntas relacionadas de este tema
- The free-look provision in a health insurance policy allows the policyowner to:
- The insuring clause of a health insurance policy:
- An impairment (exclusion) rider attached to a health insurance policy:
- The mandatory 'notice of claim' provision generally requires the insured to notify the insurer of a claim within:
- 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:
- The 'proof of loss' mandatory provision typically requires the insured to furnish written proof within:
Última revisión: · proceso editorial
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Revisado por John Zihao Zhang — California-Licensed Life Insurance Agent (CA Dept. of Insurance License #4396095 — verificar)