Free Individual Accident and Health Provisions Study Guide
Arkansas Life, Accident & Health exam — Individual Accident and Health Provisions.
The uniform individual health policy provisions are explained in the national guide. Arkansas codifies them in Ark. Code 23-85, which follows the NAIC model closely. The Arkansas Health exam asks for the specific periods below.
Required provisions
| Provision | Arkansas rule |
|---|---|
| Policy form | Printed in at least 10-point type (23-85-104) |
| Time limit on certain defenses | After three years from issue, non-fraudulent misstatements can't void the policy or deny a claim. A condition not excluded by name or specific description can't be used to deny a loss beginning after three years (23-85-107) |
| Grace period | 7 days for weekly premiums, 10 days for monthly, 31 days for other modes. If the insurer may refuse renewal, the grace period doesn't apply when written nonrenewal notice was given at least 30 days before the due date (23-85-108) |
| Reinstatement | With a conditional receipt and no written disapproval, the policy is reinstated on the 45th day. Accidents are covered from reinstatement; sickness only if it begins more than 10 days later. Reinstatement premium can't be applied to a period more than 60 days before reinstatement (23-85-109) |
| Notice of claim | Within 20 days after the loss, or as soon as reasonably possible. For loss-of-time benefits payable two years or more, notice of continuing disability may be required every six months (23-85-110) |
| Claim forms | Furnished within 15 days. Otherwise the claimant may file written proof in any form (23-85-111) |
| Proof of loss | Within 90 days. Late proof is accepted as soon as reasonably possible, but no later than one year after it was due, absent legal incapacity (23-85-112) |
| Time of payment | Non-periodic benefits immediately on proof; periodic benefits at least monthly (23-85-113) |
| Legal actions | No suit until 60 days after proof of loss, and none after three years from when proof was required (23-85-116) |
| Change of beneficiary | Unless the designation is irrevocable, the beneficiary's consent isn't needed to change the beneficiary or to surrender or assign the policy (23-85-117) |
Common exam traps
- Arkansas uses a three-year time limit on certain defenses.
- Monthly-premium grace is 10 days.
- Claim forms are due in 15 days. Proof of loss is due in 90 days, with a one-year outside limit.
- After reinstatement, sickness is covered only if it begins more than 10 days later.
- Suit can't be filed until 60 days after proof of loss, and not after three years.
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Practice questions are study aids generated for exam preparation and are not actual exam questions. Content is provided for educational purposes and is not legal advice. Verify current statutes, rules, and exam specifications with the Insurance Department and the exam administrator before relying on it.
