Mandatory provisions I: entire contract, incontestability, grace period, reinstatement

Correct answer: The policy, including its endorsements and any attached papers

The entire contract provision says the policy, including the endorsements and the attached papers, if any, constitutes the entire contract of insurance.

Correct answer: Approval by an executive officer of the insurer, endorsed on or attached to the policy

No change is valid until approved by an executive officer of the insurer, and that approval must be endorsed on or attached to the policy.

Correct answer: Two years from the date of issue

After two years from the date of issue, no misstatement, except a fraudulent one, may be used to void the policy or deny a claim for a loss beginning after that period.

Correct answer: Pay the claim, because the time limit bars using a non-fraudulent misstatement after two years

The misstatement was not fraudulent, the policy is past two years from issue, and the disability began after that period, so the insurer cannot void the policy or deny the claim.

Correct answer: It may still contest, because the standard provision excepts fraudulent misstatements

The standard time limit provision bars misstatements after two years except fraudulent misstatements, so a proven deliberate lie can still be used.

Correct answer: 10 days

The grace period minimums are 7 days for weekly, 10 days for monthly and 31 days for all other premium modes.

Correct answer: 31 days

Policies with premiums other than weekly or monthly, including annual premiums, have a minimum 31-day grace period.

Correct answer: 7 days

Weekly-premium policies must allow a grace period of at least 7 days.

Correct answer: It is covered, because the policy stays in force during the grace period

The loss occurred on day 5 of a 10-day grace period, and the policy continues in force during the grace period, so the claim is covered.

Correct answer: On the 45th day after the conditional receipt, unless the insurer has given written notice of disapproval

When a conditional receipt is issued, the policy is reinstated on approval or, absent prior written disapproval, on the 45th day after the receipt.

Correct answer: No, because sickness is covered only if it begins more than 10 days after reinstatement

A reinstated policy covers sickness only if it begins more than 10 days after the reinstatement date; June 6 is only 5 days after.

Correct answer: Yes, because accidental injuries sustained after reinstatement are covered

A reinstated policy covers loss from accidental injury sustained after the date of reinstatement, with no waiting period.

Correct answer: It is reinstated by the acceptance of the premium

Acceptance of a late premium by the insurer or an authorized agent, without requiring an application, reinstates the policy.

Correct answer: They may not be applied to any period more than 60 days before the reinstatement date

Premiums accepted for reinstatement may be applied to an unpaid period, but not to any period more than 60 days before the reinstatement date.

Correct answer: The right to keep it in force by paying premiums on time until at least age 50

The Incontestable clause may be used in a policy the insured can continue in force by timely payment of premium until at least age 50 (or for at least five years if issued after age 44).

Correct answer: No, because periods of disability do not count toward the two years in force

This policy's Incontestable clause keeps the optional wording that excludes periods of disability, so the four months of disability do not count toward the two years in force and about four more months must run.

Correct answer: When the regulator approves the wording and it is not less favorable in any respect to the insured or beneficiary

The mandatory provisions must appear in the statutory words, except that the insurer may substitute regulator-approved wording that is not less favorable in any respect to the insured or beneficiary.

Correct answer: The brochure is not part of the contract; only the policy, endorsements and attached papers are

Under the entire contract provision, only the policy, its endorsements and attached papers make up the contract; outside materials such as brochures are not part of it.

Correct answer: Yes, because the notice was given fewer than 30 days before the renewal date

A policy in which the insurer reserves the right to refuse renewal must begin its grace period provision with a clause under which the grace period does not apply only if written notice of nonrenewal was delivered or sent by first class mail at least 30 days before the renewal date. Here the notice was sent 12 days before, so the grace period applies to the premium due on the renewal date.

Correct answer: The policy lapses, and the insured can seek reinstatement under the reinstatement provision

Coverage continues only during the grace period; if the premium is still unpaid at its end, the policy lapses, and reinstatement is the path back.

Correct answer: The claim is covered, because the loss occurred within the 31-day grace period

Quarterly premiums fall under the 31-day grace period for all other policies, and the policy stays in force during it, so a loss on March 28 is covered.

Correct answer: June 15

Absent prior written disapproval, the policy is reinstated on the 45th day after the conditional receipt; 45 days after May 1 is June 15.

Correct answer: To keep someone who is already ill from reinstating just to have that illness covered

The standard reinstatement provision's 10-day sickness waiting period guards against adverse selection: a person who lets a policy lapse and then feels ill could otherwise reinstate just to cover that illness. Accidents cannot be anticipated the same way.

Correct answer: No; the time limit does not limit the separate rules for misstatement of age, so benefits can be adjusted

The time limit on certain defenses is not to be construed to limit the provisions dealing with misstatement of age, occupation or other insurance; a misstated age leads to an adjustment of benefits.

Correct answer: It places no limit of its own on the insurer's defenses during the first two years after issue

The provision expressly does not affect any legal requirement for avoiding a policy or denying a claim during the initial two-year period, so whatever other law permits then is left unchanged; its own bar applies only afterward and excepts fraud.

Correct answer: No; after two years, a claim cannot be denied for a pre-existing condition not excluded by name or specific description

The second part of the time limit on certain defenses bars reducing or denying a claim for a loss beginning after two years from issue on the ground that a condition existed before the effective date, unless the condition was excluded by name or specific description.

Correct answer: No, because the approval must be endorsed on or attached to the policy

The entire contract provision requires both executive officer approval and that the approval be endorsed on or attached to the policy.

Correct answer: It is not covered, because the 10-day grace period had ended and the policy had lapsed

This monthly-premium policy grants only the 10-day minimum grace period; by the 20th that period had ended with the premium unpaid, so the policy had lapsed.

Correct answer: The policy is not reinstated, because the insurer gave written disapproval before the 45th day

With a conditional receipt, the policy is reinstated on approval or on the 45th day unless the insurer has previously notified the insured in writing of its disapproval; written disapproval on day 30 prevents reinstatement.

Correct answer: As part of the contract, because attached papers are included in the entire contract

The policy, including the endorsements and the attached papers, constitutes the entire contract, so an attached application is part of it.

Correct answer: No, because a reinstated policy covers only accidental injuries sustained after the reinstatement date

A reinstated policy covers loss from accidental injury sustained after the date of reinstatement; an injury during the lapse is not covered.

Correct answer: Time limit on certain defenses

The time limit on certain defenses bars use of non-fraudulent misstatements after two years from issue to void the policy or deny a claim for a loss or disability beginning after that period.

Correct answer: Reinstatement: sickness is covered only if it begins more than 10 days after reinstatement

A reinstated policy covers sickness beginning more than 10 days after reinstatement; the other pairings mix up the 10, 31, 45 and two-year figures.

Correct answer: At least five years from the date of issue

The Incontestable clause may be used where the insured can continue the policy until at least age 50 or, for a policy issued after age 44, for at least five years from issue.