State RegulationsPA specificDifficulty 1/5
Which policy provision states the insurer's basic promise to pay the benefits the accident and health policy describes and identifies who is insured?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
The insuring clause is the provision that opens the contract with the insurer's core promise: it states that the insurer will pay the benefits the policy describes and identifies the insured person. Every other provision — consideration, renewability, cost-sharing — hangs off that central promise, and in policies governed by the Pennsylvania uniform provisions of 40 P.S. § 753 the insuring clause is where the coverage promise is located.
Why the other options are wrong
- B) The consideration clause records what each party exchanges — the premium for the promise — but it does not itself state the promise to pay.
- C) The renewability clause governs the insured's right to keep the policy in force over time, not the basic promise of payment.
- D) The coinsurance provision divides costs between insurer and insured after coverage attaches; it is a cost-sharing term, not the insuring promise.
Memory hook
The insuring clause makes the promise; everything else explains it.