Chapter 13 Flashcards
What is an accident?
An accident is an unintended occurrence that results in a loss that’s caused by an external source. An accident is fixed in time and space.
What is accident insurance?
This form of insurance policy only covers losses that are caused directly by an accident as defined in the policy.
What is accidental bodily injury?
This is a common method of stating ‘accidental result.’ Many states require policies to define a covered accident no more restrictively than an ‘accidental bodily injury.’
What is Accidental Death and Dismemberment (AD&D) Insurance?
This is the purest form of accident insurance. AD&D provides the insured with a lump-sum benefit amount if accidental death or dismemberment occurs under accidental circumstances.
What does ‘accidental means’ refer to?
This is a restrictive way of defining an accident. It requires the cause of an accident to be unforeseen, unexpected, and unintended.
What is the definition of ‘accidental result’?
This is the definition of an accident that’s used by most policies, stipulating that if an action results in an injury, then that injury must be unexpected and accidental for any claim to be covered.
What is the Affordable Care Act (ACA)?
This act imposed new government standards on private major medical insurance and established government-run e-market exchanges to facilitate the sale of insurance to those in the individual and small group markets.
What is blanket insurance?
Insurance companies issue blanket insurance policies to cover situations in which a group’s individual members constantly change, but whose membership is consistently exposed to the same hazards.
What is the capital sum in an AD&D policy?
The capital sum is one of the benefits payable under an Accidental Death and Dismemberment policy, defined as a specified amount, typically expressed as a percentage of the maximum policy benefit.
What is the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)?
See TRI-CARE.
What is community rating?
Insurers in the small group market often underwrite risks based on the local community’s claims experience, without medical underwriting.
What are comprehensive policies?
This form of major medical insurance covers a broad range of losses and only excludes those that are specifically excluded in the policy.
What is credit disability insurance?
This type of insurance policy is designed to help the insured debtor pay off a loan if they become disabled.
What is critical illness insurance?
This type of contract pays a lump-sum amount to the insured if diagnosed with a critical illness, typically bundling several major diseases under one policy.
What is decreasing (term) disability insurance?
This type of insurance is described as disability credit insurance, with a fixed end date and payments decreasing as the total amount due to the creditor decreases.
What is dental insurance?
This is a specialized form of health expense coverage that focuses on diagnostic and preventive treatment.
What is disability (income) insurance?
This form of insurance insures the beneficiary’s earned income against the risk that a disability could prevent a worker from performing their occupation.
What is dread disease insurance?
This type of policy provides limited benefits for a specific disease, such as cancer or heart disease.
What is an effective date in insurance?
Once issued, every insurance policy has an ‘effective date,’ which is the health insurance coverage’s start date.
What is an elimination period?
This is the waiting period at the beginning of a covered disability or long-term care claim, after which benefits begin.
What is endodontics?
This is the dental specialty that performs root canals and treats diseases affecting the pulp of the tooth.
