Điều khoản hợp đồng A&HCâu 507 / 716
The mandatory 'notice of claim' provision requires the insured to notify the insurer of a claim within:
a.Six months after the insured's entire course of treatment for the loss has ended
b.Exactly five days from the date of loss, with no exception allowed when notice was not reasonably possible
c.A stated period, typically 20 days after a loss or as soon as reasonably possible
d.One full year after the loss, measured from the date the insured first sought care
Giải thích
The notice of claim provision requires the insured to tell the insurer that a loss has occurred within a stated time, commonly 20 days after the loss or as soon as reasonably possible. A rigid five-day rule, six months, or a full year does not match the standard uniform provision. Prompt notice lets the insurer begin processing and, if needed, investigate the claim. This is the first step in the claims sequence, followed by claim forms and proof of loss.
Luyện miễn phí toàn bộ 716 câu hỏi — không cần đăng ký.
Own the complete California Life & Health Insurance Producer Exam guide — PDF + EPUB, $19.99 →
Câu hỏi liên quan cùng chủ đề
- Khi một công ty bảo hiểm sức khỏe California không trả hoặc tranh chấp một yêu cầu bồi thường SẠCH được nộp đúng cách trong thời hạn luật định (thường là 30 ngày làm việc cho giấy / 30 ngày dương lịch cho điện tử), hậu quả tài chính chính đối với công ty bảo hiểm là gì?
- Under the Uniform Provisions Law, the 'time limit on certain defenses' (incontestability) provision in an individual health policy generally prevents the insurer, after the policy has been in force for a stated period, from:
- A 'pre-existing condition' provision in a health policy generally allows the insurer to:
- Under the 'claim forms' provision, if the insurer fails to furnish claim forms within the required time (usually 15 days) after receiving notice of claim, the insured may:
- The mandatory 'proof of loss' provision generally requires the insured to submit proof of loss within:
- The mandatory 'time of payment of claims' provision requires the insurer to pay claims:
Cập nhật gần nhất: · quy trình kiểm tra
Đội ngũ PrepPass · Đối chiếu với California Life & Health Insurance License Exam · Quy trình kiểm tra
Người kiểm duyệt John Zihao Zhang — California-Licensed Life Insurance Agent (CA Dept. of Insurance License #4396095 — kiểm tra)