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How soon after a loss must an insured under a health insurance policy provide notice of claim to the insurer?
Wiki User
∙ 13y ago
My husband had a policy withe Hearthstone Insurance Company of Massachusetts, am wondering how to claim from his policy which I just found in a compartment that I didn't know he had put away. He passed away as of Nov. 9, 1982 of an accident. His Name was Lawrence Pitre, address then Main St. Keegan, Maine 04785. His policy # is 008379258. Please let me know as soon as you can. Thank You. Sandra Pitre
Wiki User
∙ 13y ago
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Health insurance is a written contract between which two parties?
Between the insurer (the risk-bearing entity) and the insured.
What type of health insurance plan administered by a third party?
Health insurers often use entities called "third-party administrators" to administer their policies. Duties include providing those types of services that an insurer would normally provide, although the insurer bears the ultimate financial responsibility for the payment of claims. Self-insured health insurance plans also use third-party administrators.
Does my toddler have to have health insurance for a well child check up?
This assumed that you, as the parent has health insurance. If you notified the insurer of the child and paid the appropriate premium, the child will be insured under the same insurance policy that you are. Most health policies provide well baby care if only because it is a means of avoiding larger claims later were the child to become ill with a serious condition. Nonetheless, you are best advised to contact Customer Service of the insurer or the agent from whom you bought the policy.
Can you have health insurance?
In general, yes. However, the prospective insured must meet the underwriting guidelines of the insurer. Therefore, depending upon the state of health of the prospective insured, he/she may have difficulty obtaining health coverage. Naturally, the individual must have sufficient funds with which to pay the premium.
What is no claim bonus in health insurance?
When you do not claim on your health insurance during a particular year, the insurance company provides you with a no claim bonus. This increases your sum insured at the same premium or reduces your premium while maintaining the same sum insured - depending on the no-claim bonus feature offered by the chosen insurer. Sometimes, this bonus also comes as a discount on your premium at renewal.
Can health insurance base insurance premium on gender?
No, health insurance premia is not based on gender of the insured.
What are your job responsibilities as a health insurance agent?
Your job responsibility as health insurance agent should be two-fold. Your prime duty should be to look after the interest of the insured person and assist him from choosing the right policy to assist him in filing of claims. At the same time, you should be careful enough not to compromise with the interest of your insurer. You should be cautious enough so that no materials facts or information are concealed by the insured that might cause harm to the insurer in the long run.
Can you be insured if you have Hepatitus C?
Individual Health Insurance
Why is it important to no the difference between co-insurance and deductible?
A deductible is the initial amount that the insured must pay out of pocket before the insurer's obligation to pay anything is triggered. It might be best understood as the amount for which you have agreed to self-insure before seeking assistance from the insurer. For example, if you have a $1000 collision deductible on your auto insurance, and a collision results in repair costs of $650, you would not have met your deductible, and the collision insurer would not have an obligation to pay. In contrast, co-insurance is that percentage of a covered claim that you are obliged to pay. The context of health insurance probably provides the best example. A major medical policy may provide for a 20% copayment. This means that once any deductible is met, the insurer pays 80% of allowable charges, and the insured is responsible for the remaining 20%.
What does not accept assignment mean?
If a health care provider does not accept assignment, it means that you must pay the health care provider. Then you submit their bill to your health insurer, and your health insurer reimburses you according to your contact with your insurer. The health care provider does not get involved in billing insurance.
What types of claims does medical malpractice insurance cover?
Medical malpractice insurance is a type of liability insurance for physicians and similar kinds of health care professionals. Like other forms of liability insurance, it assumes the financial risk of damages, according to its terms, that a third party may claim against a treating medical professional. Stated otherwise, it will pay on behalf of the insured those amounts which the insured is found legally responsible for. Other aspects of medical malpractice insurance also track liability insurance as a general genre. These include: 1. The insurer requires that the insured report the claim to it within a reasonable time. This allows the insurer to investigate the claim. If the investigation concludes that the insured is likely responsible for legally cognizable damages, the insurer may be able to settle the claim without the need for a lawsuit and the expenses that attend one. 2. If the claim cannot be settled, generally the insurer provides a defense to the insured in a lawsuit. This means that the insurer will hire a lawyer to represent the insured, and pay all or most of the costs incurred in that representation. In return for that, the insured has to abide by the directives of the insurer and the attorney, attend depositions, answer interrogatories, and otherwise participate in the proceeding. 3. Usually, the insurer has the right to make the decision as to whether or not to settle the claim. Sometimes, though, the policy will have a "consent to settle" provision which essentially gives the insured a veto over a proposed settlement. 4. In order to recover, the person who claims to be injured has to prove that his/her injuries proximately resulted from the act or omission of the health care provider. This is an integral part of any negligence claim. While negligence, in general, equates with carelessness, there must also be proximate causation. This means that BUT FOR the negligence, the injuries or damages would not have occurred.
Distinguish between co-insurance and reinsurance?
Coinsurance in medical health (casualty) is sharing of costs between insurer and insured, and in property insurance it is were the risk( one risk) is shared between different insurance companies. Reinsurance is insurance for an insurance company, where by an insurance companies seeks for indemnification in case that a stated loss takes place.
