Key Concepts
Consideration Clause - Sets forth the amount of initial and renewal premiums and frequency of future payments.
Conversion Privilege - Allows the policyowner, before an original insurance policy expires, to elect to have a new policy issued that will continue the insurance coverage. Conversion may be effected at attained age (premiums based on the age attained at time of conversion) or at original age (premiums based on age at time of original issue).
Entire Contract Provision - A provision stating that the application and policy contain all provisions and therefore constitute the entire contract.
Free Look Period - Provision whereby policyholders have a specified number of days to examine their new policies at no obligation.
Grace Period - Period of time after the due date of a premium during which the policy remains in force without penalty.
Guaranteed Renewable - Health insurance contract that the insured has the right to continue in force by payment of premiums for a substantial period of time during which the insurer has no right to make unilaterally any change in any provision, other than a change in premium rate for classes of insureds.
Insuring Clause - Defines and describes the scope of the coverage provided and limits of indemnification.
Misstatement of Age Provision - If the insured's age is misstated in an application for insurance, the benefit payable usually is adjusted to what the premiums paid should have purchased.
Notice of Claims Provision - Describes the policyowner's obligations to provide notification of loss to the insurer within a reasonable period of time.
Optionally Renewable - Health insurance policy in which the insurer reserves the right to terminate the coverage at any anniversary or, in some cases, at any premium due date, but does not have the right to terminate coverage between such dates.
Proof of Loss - States that the insured must provide a completed claim form to the insurer within 90 days of the date of loss.
Reinstatement Clause - Putting a lapsed policy back in force by producing satisfactory evidence of insurability and paying any past due premiums required.
Time Limit on Certain Defenses Provision - States that an insurance policy is incontestable after it has been in force a certain period of time; and limits the period during which an insurer can deny a claim on the basis of a preexisting condition.
Familiarize yourself with the Key Concepts in the Florida study manual, Unit 22.
