Accident Health Or Sickness Ins Basics Flashcards
Under a credit disability policy, payments to the creditor will be made for the insurer until what point in time?
Until the period of disability ends or until the debt is repaid
Who is a field underwriter?
Agent/producer
Most health policies will pay the accidental death benefits if the death is caused by an accident and occurs within how many days?
90 days
What is the term used for a written request for an insurer to issue an insurance contract based on the provided information?
Application
What is adverse selection?
People who are more likely to submit insurance claims are seeking insurance more often than preferred risks
What is the capital sum in accidental death and dismemberment coverage?
A percentage of the principal sum
What is the entire contract in health insurance underwriting?
The application and the policy issued
In health insurance, what is considered a sickness?
An illness that first arises while the policy is in force
Who is responsible for paying the cost of a medical examination required in the process of underwriting?
Insurer
Who must sign a health insurance application?
The policyowner, the insured (if different), and the agent
What are the two types of expenses covered by health ins?
Expenses related to health care, and expenses that compensate for loss of income
What type of hospital policy pays a fixed amount each day that the insured is in the hospital?
Hospital indemnity
In health insurance, the policy itself and the insurance application form what?
The entire contract
During which stage in the insurance process do insurers evaluate information that identifies adverse selection risks?
Underwriting
What do limited health policies cover?
A specified accident or disease
When should an agent obtain a statement of good health from the insured?
When the premium was paid upon policy delivery and not at the time of application
If an agent makes a correction on the application for health insurance, who must the initial the correct answer?
The applicant
Under an individual disability income policy, the benefits must be paid on at least what schedule?
Monthly
What health policy provision defines the insureds duty to provide the insurer with reasonable notice in the event of loss?
Notice of claim
What will determine the length of the grace period in a health insurance policy?
The mode of the premium payment
What health policy renewability provision allows the insurer to terminate coverage for any reason, and to increase the premiums for any class of insureds?
Optionally renewable
What health policy provision prevents the insured from bringing a lawsuit against the insurance company for at least 60 days after proof of loss is provided?
Legal actions
What health policy provision states to whom the claim benefits must be paid?
Payment of claims
Who pays the expense for an autopsy under the physical examination and autopsy provision?
The insurer
Who decides which optional provisions would be included in a health policy?
The insurance company
Health policy provision that allows the insured a period of time to examine the policy and determine whether or not to keep it?
Free-look period
What renewability provision will most likely appear on a travel accident policy?
Period of time
Monthly premium payment grace period length?
10 days
What will happen if there is no payment during the grace period?
The policy will be cancelled
If a health ins policy has a 31 day grace period, what does that mean?
The policy remains in effect for 31 days after the premium is due and not paid
How will changing one’s occupation to be more hazardous affect the health insurance policy in force?
Claim benefits will be reduced to what the premium would have bought for a more hazardous occupation
When can an irrevocable beneficiary be changed?
With the written consent of the beneficiary
According to the reinstatement provision, once a lapsed policy is reinstated, how soon will coverage be available for accidents?
Immediately
According to the time limit on certain defenses provision in health insurance policies, when can an insurer contest fraudulent misstatements on a health insurance application?
Any time while the policy is in force
What is the name of the act by the insured to voluntarily give up insurance?
Cancellation
What health policy provision allows the insurer to non renew health coverage if certain events occur?
Conditionally renewable
What health insurance policy provision describes the insureds right to cancel coverage?
Renewability provision
What does the free look period allow the insured to do?
Return the policy for a full refund of premium within a specific time period, usually 10 days
Insurance is defined as the transfer
of pure risk to the insurance company in return for a premium
Pure risk is
the chance of loss without any gain
Risk is
the chance of loss
A condition that could result in loss
Exposure
Hazard
something that increases the chance of loss
A peril
cause of loss such as a fire
To be insurable losses must be
Calcuable
This allows insurers to predict claims more accurately
Law of large numbers
Most insurers buy what to protect themselves in the event of catastrophic loss
Reinsurance
Are insurance laws required to be the same from state to state?
No
An offer is
A specific and definite proposal to enter into a contract
Does consideration on a policy need to be equal?
No
Under the consideration clause what must be exchanged?
Something of value
Are stock insurer dividends guaranteed?
No
Who manages a reciprocal ins co?
An attorney in fact
Reciprocal insurer
Unincorporated association of individuals who insure each other
A foreign company has their home office where
Another state
Company incorporated outside the US
Alien
