Illinois Health Insurance Practice Exam

When can coverage be excluded while insured is under the influence of intoxicants and narcotics?

1. With the Renewability provisions; conditionally renewable

2. Under the Guaranteed Insurability Rider

3. Under the Assignment clause

4. With the Intoxicants and Narcotics provision

The correct answer is: With the Intoxicants and Narcotics provision

The correct answer focuses on the Intoxicants and Narcotics provision, which is specifically designed to address situations where coverage may be excluded if the insured is using intoxicants or narcotics at the time of an injury or illness. This provision outlines the circumstances under which benefits may not be available, emphasizing the insurer's right to limit or deny coverage based on the insured’s substance use. This exclusion is commonly included in health insurance policies to mitigate risks associated with behaviors that could lead to higher claims and liabilities, thereby protecting the insurer. The presence of such a provision is aligned with the principle that insurance is meant to cover unforeseen events, not those that are anticipated due to behavior influenced by substances. In contrast, the other options relate to different aspects of insurance policies such as renewability terms, riders for guaranteed insurability, or clause specifics like assignment, which do not inherently provide grounds for excluding coverage based on the insured’s substance use. Thus, the context of the question clearly aligns with the specifics of the Intoxicants and Narcotics provision as the pertinent clause for exclusion.