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Health & Life > Chapter 4 - Disability Income and Related Insurance > Flashcards

Chapter 4 - Disability Income and Related Insurance Flashcards

1
Q

A period of time during which benefits are paid under the policy

A

Benefit period

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2
Q

A portion of the principal sum of a health insurance policy; paid for accidental dismemberment of loss of sight in one eye

A

Capital Sum

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3
Q

Salary, wages, or commissions; but not income from investments, unemployment benefits and similar sources of income

A

Earned Income

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4
Q

Insurance that exceeds in amount the actual value of the person or property insured or insurance in a greater amount than the insured can afford

A

Overinsurance

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5
Q

The amount of coverage paid for an accidental death under a health insurance policy

A

Principal Sum

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6
Q

Fully insured or currently insured, depending on the number of coverage credits earned.

A

Social Security Disability Insured Status

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7
Q

A qualified expense that may reduce the amount of income subject to taxation

A

Tax Deductible

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8
Q

Subject to taxation

A

Taxable

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9
Q

Inability of the insured to perform any occupation for which he or she is reasonable suited by reason of education, training, or experience

A

Total disability

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10
Q

Relinquishment of a right or Interest

A

Waiver

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11
Q

Replaces lost income in the event of disability and no longer being able to work

A

Disability Income

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12
Q

Disability Income benefits are based on a _____ of past income. Typically an average wage of 24 months from time of incident.

A

Percentage

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13
Q

Disability income benefits pay at a percentage (never in full) of current income to incentivize you to _____

A

return to work

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14
Q

Total disability will have varying descriptions from one ______ to a next

A

company

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15
Q

Inability to perform either any gainful occupation or the major duties of the insured’s regular occupation or an occupation for which the insured is qualified by education or experience

A

Total Disability

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16
Q

a disability policy that is more favorable to the insured

A

any occupation

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17
Q

A disability policy that reduces the insurers liability

A

own occupation

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18
Q

Inability to perform on or more of the regular duties of ones occupation or inability to work on a full-time basis

A

Partial disability

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19
Q

Partial disability benefits are typicall ___ % of total disability benefit

A

50

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20
Q

Partial disability is limited to a certain _______ of _____

A

Period of time

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21
Q

Partial disability benefits are paid in a ____ of _____ amount

A

flat or residual

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22
Q

specifies conditions that will automatically qualify the insured for full disability benefits

  • provides benefits for dismemberment
  • Total and permanent blindness
  • loss of speech
  • loss of hearing
A

Presumptive disability

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23
Q

loss of use of any two limbs

A

dismemberment

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24
Q

It is presumed that this disability will not be reversed and waives the need to go see a doc every 6 months to determine continued disability

A

presumptive disability

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25
Q

specifies conditions that will automatically qualify the insured for full disability benefits

A

Presumptive disability

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26
Q

specifies the period of time during which the recurrence of an injury or illness will be considered a continuation of a prior period of disability.

  • requiring no new elimination period
  • Usually 3-6 months
A

Recurrent disability

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27
Q

Provides benefits for loss of income when a person returns to work after a total disability but is unable to work as long or at the same level as he or she could before becoming disabled

A

Residual Disability

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28
Q

When does disability begin?

A

on the date of the event the caused the disability

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29
Q

The period of time you must wait before you begin to get paid on your disability

A

elimination (waiting) period

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30
Q

Longer elimination period = _____ premium

A

lower

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31
Q

Longer benefit period = ______ premium

A

higher

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32
Q

Are there benefits for short term disability within disability income policy?

A

No

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33
Q

Disability income policy will pay to a ____ years or the the age of _____

A

limited or maximim / 65

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34
Q

in the event of a permanent or total disability, premiums will be _____ for the duration of the disability

A

Waived

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35
Q

How long must you typically be disabled to receive waiver of premium

A

usually 3-6 months

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36
Q

Waiver of premium is ______ if necessary. The premium paid during the waiting period must be paid but then is reimbursed.

A

retroactive

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37
Q

a feature Included with guaranteed renewable and noncancellable disability income policies

A

Waiver of premium

38
Q

If you qualify for ssi your waiting period is

A

5 months

39
Q

social security benefit is base on your _____

A

PIA - principal insurance amount

40
Q

Social security disability benefits _____ when you either retire, benefits start or when your disability ends.

A

stop paying

41
Q

Business disability that covers expenses for hiring and training replacement - Business is owner and beneficiary.

A

Key Person

42
Q

Business disabiliity specifies how the business will pass between owners in the event of disability of one owner / lump-sum benefit for a buyout

A

disability buy-sell

43
Q

business disability that pays for rent, utlities, employee, salaries, etc. - meant for small business

A

business overhead expense

44
Q

What portion, if any, of the individual disability income policy benefits are taxed to the insured?

A

disability benefits are not income taxable

45
Q

Provision found in most disability income policies that specifies the conditions that will automatically qualify for full disability benefits

A

presumptive disability provision

46
Q

After the elimination period, a totally disabled insured qualified for benefits from a disability income policy that has a waiver of premium rider. What will happen to the premium that was paid into the policy during the elimination period?

A

Premium will be refunded

47
Q

What does the amount of disability benefit that an insured can receive depend on?

A

The insured’s income at the time of policy application

48
Q

With key person disability insurance, who pays the policy premiums?

A

The business / employer

49
Q

What type of health insurance would pay for hiring a replacement for an important employee who becomes disabled?

A

key-person disability insurance

50
Q

What type of health insurance is sold to small business owners to reimburse them for the overhead expenses?

A

BOE - Business overhead expense insurance

51
Q

Insured’s inability to perform duties of his or her current job or an occupation for which the insured is educated and trained.

A

Own Occupation Disability

52
Q

What type of disabilities will be covered by occupation coverage

A

Disabilities that result from accidents or sickness that occur on or off the job

53
Q

What type of insurance covers an employee who is hurt on the job?

A

Workers compensation

54
Q

What is the term for a period of time immediately following a disability during which benefits are not payable?

A

Elimination period

55
Q

What entity regulates workers compensation benefits?

A

State government

56
Q

Specifies how the business will pass between owners when one of them dies or becomes disabled.

A

Buy-Sell agreement

57
Q

What benefit is based on a primary insurance amount (PIA)

A

Social Security disability benefit

58
Q

What is another name for Old Age, survivors, and disability insurance benefits?

A

Social Security

59
Q

A waiver of premium provision may be included with what type of health insurance policies?

A

Disability Income

60
Q

How can an AD&D Policy be written?

A

As a rider to a health insurance policy, or as a separate policy

61
Q

How can an AD&D Policy be written?

A

As a rider to a health insurance policy, or as a separate policy

62
Q

What are the four types of workers compensation benefits?

A

Medical
income
rehabilitation
death benefits

63
Q

How does someone qualify for social security disability income benefits?

A

The insured must have the proper insured status (such as fully insured), meet the definition of disability, and satisfy the waiting period

64
Q

What is the primary purpose of disability income insurance?

A

To replace income lost due to disability

65
Q

specifies period of time during with the recurrence of an injury or illness will be considered a continuation of a prior disability

A

recurrent disability

66
Q

Period after the policy starts during which benefits wont be paid for illness related disabilities

A

probationary period

67
Q

Length of time monthly disability benefit payments last

A

benefit period

68
Q

Maximum benefits an insurer is willing to accept for an individual risk; based on a percentage of insured’s past earnings

A

benefit limitations

69
Q

What are the two types of group dissability

A

Short term disability and long term disability

70
Q

benefit period no longer than 2 years

A

short term disability

71
Q

elimination period may last as long as the benefit period for short term.

  • benefit period may last until age 65
  • usually reserved for management employees
A

Long term disability

72
Q

to qualify for social security benefits must have ___ credits in the ___ quarter period

A

6 / 13

73
Q

To qualify for social security benefits there is a ___ month waiting period

A

5

74
Q

to be covered by workers comp you must work in an occupation that is ______

A

covered by workers comp

75
Q

benefits paid in response to work related injuries

A

workers comp

76
Q

fault or negligence may not be a factor in being eligible for ____

A

workers comp

77
Q

what 4 kind of benefits are paid out by workers comp

A

medical, income, death, and rehab

78
Q

In disability income insurece, the own occupation definition of disability applies for the first ______ of a disability

A

2 years

79
Q

coverage will apply only if the insured cannot find any means of income whatsoever. This is more or less strict than the other option.

A

Any Occupation - More strict

80
Q

When a person merely has to prove that they cannot perform the job for which they were previously trained

A

Own occupation - less strict

81
Q

In a plan funded entirely by the employer, income benefits are included in the employee’s _______ and taxed as ordinary _____

A

gross income; income

82
Q

coverae provided by a disability income policy that does not pay benefits for losses occuring as the result of the insureds employment

A

nonoccupational coverage

83
Q

if a policy is rated-up the _____ increases

A

premium

84
Q

What is the maximum period that an insurer would pay benefits in accordance with an additional monthly benefit rider?

A

1 year

85
Q

Stipulates that the insurer will pay benefits comparable to what social security would pay. After a years’ time the insurer ends the benefit and assumes that social security will then begin benefit payment.

A

additional monthly benefit rider

86
Q

True or False: Group disability income coverage applies both on and off the job

A

False; employees on the job are covered by workers comp.

87
Q

A worker is _____ insured under social security if the worker has accumulated the required number of credits based on his/her age

A

fully

88
Q

A provision that is found in most disability income policies that specifies conditions that will automatically qualify the insured for full disability benefits, such as the loss of two limbs

A

presumptive disability

89
Q

Under own occupation, if the insured cannot perform his or her current job for a period of up to ______, disability benefits will be issued, even if the insured would be capable of performing similar job during that two year period. After that, if the insured is capable of performing another job utilitzing similar skills, benefits will not be paid.

A

own occupation

90
Q

True or False: General disability policies covers losses caused by war, military service, intentional self inflicted injuries, overseas residence, or injuries suffered while committing or attempting to commit suicide

A

False

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