Illinois Health Insurance Practice Exam

In which scenario is coverage excluded while insured is engaged in an illegal occupation?

1. Under the Guaranteed Insurability Rider

2. When under the influence of intoxicants

3. With the Assignment clause

4. With the Illegal occupation provision

The correct answer is: With the Illegal occupation provision

The correct choice is indeed the option related to the Illegal occupation provision. This provision specifically states that coverage is generally excluded if the insured is engaged in activities that are illegal. Insurers include this clause to manage risk, as individuals involved in illegal behaviors may pose a higher risk for claims or have a higher likelihood of engaging in risky behavior that could lead to harm or loss. The other scenarios do not focus specifically on illegal activities. For example, the Guaranteed Insurability Rider allows for certain health conditions to be covered regardless of changes in health status, which wouldn’t be relevant here. Being under the influence of intoxicants creates different implications for coverage and usually falls under rules concerning intoxication rather than a specific illegal activity. Lastly, the Assignment clause relates to the transfer of benefits and does not address exclusions based on occupation legality.