Life License Qualification Program (LLQP) Practice Exam

What should an insured do if the insurer fails to send claims forms within the stipulated time period in a health policy?

1. File a lawsuit

2. Submit the claim in any form

3. Wait for the claim form to arrive

4. Resubmit the request for a claim form

The correct answer is: Submit the claim in any form

In the context of health insurance claims, if an insurer fails to provide the required claims forms within the specified time frame, the insured has the option to submit the claim in any form. This is because the purpose of the claim form is to allow the insured to provide information regarding the claim, but it is not the only acceptable means of communication. The insured can compile the necessary details about the injury, treatment, and expenses incurred, and submit this information to the insurer to ensure the claim is processed. Submitting the claim in any form ensures that the insured does not delay receiving benefits due to administrative issues on the insurer's part. This approach can be particularly useful when time is of the essence in accessing coverage or benefits related to medical expenses. The insured has the right to receive their benefits without being penalized for the insurer's failure to send the proper forms in a timely manner. Therefore, submitting a claim using an alternative method fortifies the insured's position and ensures they still have recourse to the benefits of their health insurance policy.