意外与健康保单条款第 508 / 716 题
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:
a.Immediately file a lawsuit against the insurer without first submitting any proof of the loss
b.Automatically receive double the benefit
c.Submit written proof of the loss in their own words and still be considered compliant
d.Cancel the policy and demand a refund
解析
If the insurer does not supply claim forms within the stated period after notice, the insured is allowed to submit written proof of the loss in their own words (describing the nature and extent of the loss) and is treated as having complied with the proof requirement. The insured is not entitled to sue immediately, cancel for a refund, or collect double benefits. This provision keeps the insurer's delay from defeating an otherwise valid claim.
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同考点相关题目
- 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:
- The mandatory 'notice of claim' provision requires the insured to notify the insurer of a claim within:
- 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:
- The mandatory 'payment of claims' provision specifies:
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审核人 John Zihao Zhang — California-Licensed Life Insurance Agent (CA Dept. of Insurance License #4396095 — 核实)