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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

Some contractual provisions address claims: Notice of claim provision: The insured must give written notice to the insurer within 20 days after a covered loss occurs Claim forms provision: The insurer is required to send the insured a claim form within 15 days after notice is received Proof-of-loss provision: The insured must send written proof of loss to the insurer within 90 days after a covered loss occurs Time of payment of claims provision: The insurer must pay all claims immediately after receiving proof of loss. ‹#›