Before paying a health insurance claim, what must the insurer do according to the Unpaid Premiums provision?

The Unpaid Premiums provision in an insurance policy requires that before an insurer pays a health insurance claim, it must deduct any past due premiums from the claim amount. This means that if the insured has missed any premium payments, the amount owed will be taken into consideration when settling the claim.

This provision is designed to protect the insurer from incurring losses due to unpaid premiums. By deducting these amounts from the claim payment, the insurer ensures that they are compensated for the coverage provided up to the point of the claim. It underscores the responsibility of the insured to maintain timely premium payments, as failure to do so can impact their ability to fully benefit from their policy.

In contrast, paying the claim amount fully would not take into account the financial obligations the insured has towards the insurer, which would be impractical and against the principles of risk management. Not considering unpaid premiums at all would be contrary to enforcing the contractual agreement between the insurer and the insured. Lastly, while requesting payment of premiums could be a part of the overall claims process, it is not a requirement before settling a claim under this specific provision.