Merritt Personal Lines Manual: Health Insurance -- Analyzing Standard Policy Language
Please select a topic below to learn more:
- Health Insurance -- Analyzing Standard Policy Language Introduction
- Part I: Standard Health Insurance Provisions
- Basic Terms and Definitions
- A Difficult Case of Dependent Child Coverage
- More Health Insurance Definitions
- A Key Issue: Preexisting Conditions
- Another Flashpoint: How the Policy Defines Regular and Customary
- How the Policy Defines Sickness
- The Most Common Exclusions
- No Coverage for Teeth, Babies or Face Lifts
- Chapter 3 The Mechanics of Health Coverage
- A Case of Problematic Health Insurance Mechanics
- Definitions that Apply to the Mechanics of Coverage
- A Key Issue: Reinstatement of Coverage That Lapses
- Notifying the Insurance Company of a Claim
- Limiting Your Right to Sue the Insurance Company
- Requiring Physical Exams
- How State Regulations Affect Health Insurance Policies
- Part II: Basic Hospital Expense Policy
- A Key Issue: Replacement
- No Coverage for a Pregnant Woman
- Actual Authority vs. Apparent Authority
- Other Terms and Definitions that Affect Coverage
- Who's Covered and Why
- How the Policy Handles Premiums and Payments
- How Individuals Are Terminated from the Policy
- Other Rights That Continue Beyond the Policy Terms
- Converting Existing Coverage to Some New Form
- Specific Limits on Preexisting Conditions
- A Key Issue: Adding New Family Members
- A Major Family Member Dispute
- How the Policy Handles Out-Patient Care
- How the Policy Handles In-Patient Care
- Optional Coverage: Childbirth
- Optional Coverage: Extended Care
- Optional Coverage: Extra Miscellaneous Expense
- Optional Coverage: Intensive Care Expense
- Optional Coverage: Doctor's Visits
- Optional Coverage: Private Nurse Expense
- Optional Coverage: Added Surgical Costs
- A Sample of Operation Coverages
- Conditions of Surgical Coverage
- Part III: Major Medical Expense Policy
- Doctors Themselves Disagree Over What's Medically Necessary
- The Mechanics of Major Medical Coverage
- How the Policy Defines Various Kinds of Service
- Extended Care Coverage
- Coverage for Mental Illness and Drug Dependency
- Deductibles, Copayments and Other Matters
- How One Catastrophic Medical Policy Compared to Major Med
- Other Major Medical Coverage Matters
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