Free Individual Accident and Health Provisions Study Guide
Wyoming Life, Accident & Health exam — Individual Accident and Health Provisions.
The national Individual Accident and Health Provisions guide covers the uniform provisions from NAIC Model 180 and what each one does. Wyoming puts them in Wyo. Stat. 26-18. Two Wyoming numbers differ from what many candidates expect:
- notice of claim is 60 days, not 20
- the time limit on certain defenses is three years
This guide covers the Wyoming wording and time periods.
Policy form (26-18-103)
- A family policy may cover the spouse, dependent children, children under a stated age of no more than 19, and other dependents.
- Text must be at least 10-point type.
Required provisions
| Provision | Wyoming rule |
|---|---|
| Entire contract; changes (26-18-105) | A change is valid only if an executive officer approves it and it is endorsed or attached. No agent may change the policy or waive a provision. |
| Time limit on certain defenses (26-18-106) | After three years from issue, only fraudulent misstatements may void the policy or deny a claim. |
| Grace period (26-18-107) | 7 days weekly, 10 days monthly, 31 days otherwise. |
| Reinstatement (26-18-108) | Without approval or written disapproval, the policy is reinstated on the 45th day after the conditional receipt. It covers accidents after reinstatement and sickness beginning more than 10 days after. |
| Notice of claim (26-18-109) | Written notice within 60 days after the loss, or as soon as reasonably possible. |
| Claim forms (26-18-110) | If forms aren't sent within 15 days, written proof of the loss is enough. |
| Proof of loss (26-18-111) | Within the policy's period. Late proof is accepted if given as soon as reasonably possible and within one year, unless the claimant lacked legal capacity. |
| Time of payment (26-18-112) | Paid promptly on proof. |
| Physical exam and autopsy (26-18-114) | At the insurer's expense during a claim. Autopsy only where the law allows. |
| Legal actions (26-18-115) | No suit until 60 days after proof of loss and none after three years from when proof was required. |
| Change of beneficiary (26-18-116) | A revocable beneficiary may be changed at will. An irrevocable beneficiary must consent. |
Optional provisions
- Change of occupation (26-18-118): a move to a more hazardous job reduces benefits to what the premium would buy at that class.
- Misstatement of age (26-18-119): benefits are adjusted to what the premium would have bought at the true age.
- Relation of earnings to insurance (26-18-122): disability benefits from all sources that exceed prior earnings may be reduced.
- Intoxicants and narcotics (26-18-126): Wyoming keeps this optional provision.
Renewal and age limits
- A conditionally renewable policy may be nonrenewed only for conditions stated in the contract. A refusal to renew takes effect only on a renewal date and doesn't affect claims that began while the policy was in force (26-18-127).
- If the insurer accepts premium for a period beyond the policy's age limit, coverage continues to the end of that period (26-18-133).
Claim payment (26-15-124)
Health claims are paid or denied within 45 days after proof of loss. An unreasonable refusal can bring attorney fees and 10% interest.
Common exam traps
- Notice of claim in Wyoming is 60 days.
- The time limit on certain defenses is three years.
- Grace periods are 7/10/31 days.
- Reinstatement covers sickness after 10 days and is automatic on the 45th day without disapproval.
- No suit before 60 days after proof, and none after 3 years.
- A family policy may cover children up to age 19.
Practice Individual Accident and Health Provisions questions All Life, Accident & Health topics
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.
