CARD Q081
A health policy requires claim forms within 15 days after notice. The insurer does not supply them. How can the claimant satisfy proof-of-loss requirements?
- Restart the notice period by filing a new notice
- Submit timely written proof describing the loss
- Wait for the insurer’s forms even if the proof deadline passes
- Treat the original notice as sufficient proof without further details
Submit timely written proof describing the loss
Under the standard claim-forms provision, failure to supply forms allows the claimant to submit written proof covering the occurrence, character, and extent of the loss within the proof deadline.
Why each choice is right or wrong
A. Restart the notice period by filing a new notice
Incorrect. Restarting notice does not satisfy the existing proof obligation.
B. Submit timely written proof describing the loss
Correct. Under the standard claim-forms provision, failure to supply forms allows the claimant to submit written proof covering the occurrence, character, and extent of the loss within the proof deadline.
C. Wait for the insurer’s forms even if the proof deadline passes
Incorrect. The claimant need not let the proof deadline pass while waiting for forms.
D. Treat the original notice as sufficient proof without further details
Incorrect. The original notice alone need not contain the details required for proof.
Review the related terms
Use these lessons to revisit the concepts and try additional practice questions.