field Underwriting Procedures Flashcards
elements of a contract
agreement (offer and acceptance)
consideration (something of value that each party gives each other)
competent parties
legal purpose ( Must have insurable interest and consent)
insurable interest
Required at the time of policy insurance for health and life
conditional
certain conditions must be met by the policy owner and company for the contract to be executed
unilateral
the only one of the parties is legally bound to do anything
adhesion
prepared by the insurer accepted or denied by insured, insured has little to say about provisions
aleatory
exchange of unequal amounts of value
completeness and accuracy of application
the agents responsibility to ensure the application is complete and accurate to the best knowledge of the applicant
whos signatures are required on contract?
Proposed insured
policy owner ( if different than insured)
agent
correct way to make changes to an applications
- start over with fresh application (best option)
- draw a line through the wrong answer insert correct one, applicant initials correct answer
(any changes on the application must be initialed by applicant or insured)
premiums with the application
an initial premium and sent with the application
-conditional receipt is given from the agent
when does coverage start?
when application is approved and policy issued
what is required if premium isn’t collected during application?
premium and statement of continued good health before releasing the policy
Medical information Bureau (MIB)
nonprofit trade organization that collect maintain and available to insurance companies
who is responsible for the costs of medical exam report?
insurer
consumer reports
written or oral info regarding consumers collected by the reporting agency through employment records, credit reports, and other public sources
what info is collected in a consumer report?
credit
character
reputation
habits
what are the four characteristics of a contract?
adhesion
aleatory
conditional
unilateral
whats the best way for accurate information on an applicants medical history?
Attending physician report
MIB report
helps insurance companies share adverse medical information of insureds
credit reports
contain factors related to a risk’s potential for loss. include consumer reports and investigative consumer reports
investigative consumer reports (ICR)
provides info on character, reputation, and habits
how is information gathered in an investigative consumer reports?
through investigation and interview with associates, friends, and neighbors
when must a consumer be notified of an investigative consumer report?
must have written notice within 3 days of the date the report was requested
(insurance applicants must be notified in writing whenever insurers request investigative consumer reports)
when must an applicant receive information found in an investigative consumer report?
5 days upon request
who conducts medical exam reports?
physicians, paramedics, certified nurse
what are an agent’s responsibilities?
- compare benefits, limitations, and exclusions found in the current and proposed replacement policy
- Ensure that the current policy is not canceled before the new policy is issued
types of cost sharing
Deductible, coinsurance
Deductible
paid first, set dollar amount, larger the deductible the lower the premium
coinsurance
paid after the deductible and after the insurer paid their share, percentage, the higher the coinsurance percentage the lower the premium
