California Life-Only & Accident and Health AgentAccident and Health InsuranceEasy
A health insurance policy includes a provision stating that if the insured incurs a loss while committing a felony, the insurer is not liable for the loss. Which standard policy provision is this an example of?
- ALegal Actions
- BIllegal Occupation
- CProof of Loss
- DMisstatement of Age
Show answer & explanationAnswer & explanation
Correct answer: B. Illegal Occupation
The Illegal Occupation provision in a health insurance policy allows the insurer to deny a claim if the loss occurred while the insured was committing an illegal act, such as a felony.
Why the other options are wrong
- A. The Legal Actions provision specifies the time frame within which legal action can be taken against an insurer.
- C. The Proof of Loss provision outlines the requirements and timeframe for submitting evidence of a loss to the insurer.
- D. The Misstatement of Age provision addresses how benefits are adjusted if the insured's age was incorrectly stated on the application.
Illegal Occupation Provision
A standard health insurance policy provision that allows the insurer to deny claims for losses incurred while the insured was committing a felony or engaging in an illegal occupation.
- Protects insurers from liability for illegal acts.
- Standard in most individual health policies.
- Applies to felonies and illegal occupations.
Memory trick: Illegal acts mean no insurance pacts.