What right does the Physical exam and autopsy provision grant the insurer?

Study for the Ohio Health Insurance Exam. Study with flashcards and multiple choice questions, each question has hints and explanations. Get ready for your exam!

The Physical exam and autopsy provision allows the insurer to examine the insured at its expense while a claim is pending. This provision is critical because it ensures that the insurer can verify the legitimacy of a claim through direct examination. It serves as a means for the insurer to gather necessary information regarding the insured's health status or the circumstances surrounding a claim, particularly in situations of illness, injury, or death.

When a claim is filed, the insurer has a vested interest in confirming that the details provided align with the actual situation. By exercising this right, the insurer can prevent fraudulent claims and ensure that they are paying out benefits only in valid cases. This provision also helps in determining the appropriate amount of benefits, based on the true circumstances of the claim.

The rights mentioned in the other options do not align with the intent of the Physical exam and autopsy provision. Denying claims without examination does not facilitate verification of claims. Similarly, withdrawing coverage or requesting additional premiums are not related to the determination of a pending claim's validity through examination. Thus, the focus of the appropriate provision is clearly on allowing insurers to conduct examinations while claims are under consideration.

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy