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Insurance & Risk Management
13. Chapter 15: Healthcare Reform—Individual Health Insurance Coverages/Individual health insurance contractual provisions
13. Chapter 15: Healthcare Reform—Individual Health Insurance Coverages Illustration
Syllabus Slides

Individual health insurance contractual provisions

01.Core Concepts

The Uniform Individual Accident and Sickness Policy Provisions Act by the NAIC requires certain provisions for all individual health insurance policies: The entire contract consists of the policy, the application, and any riders The time limit on certain defenses states that after the policy has been in force for two years, the insurer cannot void the policy or deny a claim on the basis of misstatements in the application, except for fraudulent misstatements The grace period is a 31-day period after the premium due date to pay an overdue premium ‹#›