Health Insurance Underwriting

Question 1

Most common sources of underwriting an applicants information is?

Answer 1

The application, the medical report, physician statement, medical information bureau, special questionnaires, inspections reports. And credit reports

Question 2

What are the three basic parts to an application?

Answer 2

Part1-general
Part2-medical
Part3-agents report

Question 3

Part 1 of the application asks general questions about the proposed insured, including name, age, address, birthdate, sex, income, marital status, and occupation.. details that pertain to the application require?

Answer 3

Type of policy, amount of insurance, name and relations with beneficiary

Question 4

Part 2 focuses on the propellers insureds health and asks a number of questions about health history

Answer 4

May have to take a piss test or even blood test nigga

Question 5

Part three of the report, called agents report is where the agent what?

Answer 5

Reports personal observations about the proposed insured

Question 6

In part 3, the agent provides additional information about the applicants financial condition and character, the background and purpose of the sale, and how long the agent has known the applicant.

Answer 6

Yup yup yup nigga

Question 7

Medical report, if the application raises medical issues then the underwriter may also request a attending physicians statement (APS) from the physician who treated the patient, it will also request A copy of the signed authorization

Answer 7

Yup

Question 8

The medical informations on bureau report, will also identify the life insurance in force with other carriers as well as lifestyle habits such as drug use. The bureau is formed of over 700 members

Answer 8

Yup

Question 9

Informations received from the medical information bureau about a proposed insured may be released to the proposed insureds physician

Answer 9

Yup

Question 10

The USA patriot act was enacted in 2001 and requires insurance companies to establish formal anti-money laundering programs… the purpose of the USA patriot acts is to?

Answer 10

Detect and deter terrorism

Question 11

Special questionnaires are like what?

Answer 11

Questions for personnel who do crazy shit for a living or hobby, like pilots fly so they need additional aviation questions

Question 12

Inspection reports do what?

Answer 12

Give general information to the agencies about the applicant, when an investigate consumer report is used in connection with an insurance application, the applicant has the right to receive a copy of the report….

Question 13

If an insurance company obtains an inspection report on a prospective insurer, it must inform the prospect that it is permitted to do so under the Fair Credit Reporting Act.

Answer 13

Yup

Question 14

Application rating does what?

Answer 14

You classify the risk of the applicant, this is called risk classification.

Question 15

Preferred risk?

Answer 15

Characters that contribute to a preferred risk include, not smoking, weight within an ideal range, and not drinking

Question 16

Standard risk?

Answer 16

Individuals who fit the insurers guidelines for policy issue without speacial restrictions.

Question 17

Substandard risk

Answer 17

Is below the standard risk. It means you have a shitty job your fat and unhealthy, or even dangerous occupation, and they pay the highest premiums

Question 18

Proper solicitation?

Answer 18

One of the main things is that the agent is to deliver to the applicant a Buyers Guid and a policy summary. These documents are usually delivered before the agent accepts the applicants initial premium.
(Buyers guide explains life and health insurance Ina way that consumers understand)
(Policy summary sums up that specific deal for the consumer… who the agent was, who’s the insurer and what plan they got)

Question 19

Completing the application, some things to remember are that the insurance company will return the application tot he insurer of its not filed correctly. Also representations are statements an applicant makes as being true tot he best of their ability on the application.

Answer 19

Each application requires the signature of the proposed adult insured, the policy owner (if different from the insured) and the agent who solicits the application.

Question 20

Also required by state law the agent must sign a form attesting that a disclosure statement has been given to the applicant.

Answer 20

Yup and all the other people’s signatures

Question 21

Changes in application

Answer 21

When the applicant makes a mistake In the information given to the agentX the person can have the agent correct it but the applicant has to initial the correction.

Question 22

Initial premium and receipts

Answer 22

If a premium is not paid with the application, the agent should submit the application to the insurance company without the premium. The policy will not become valid until the initial premium is collected

Question 23

Applicants who pay premium deposits with the application are entitled to a premium receipt. What that is is pretty much the exact transaction that took place. There are two types of receipts, conditional and binding.

Answer 23

Yup

Question 24

Premium mode

Answer 24

Refers to the policy feature that permits the policy owner to select the timing of premium payments.

Question 25

Mode of premium provision is

Answer 25

Additional charges the insurance company will charge an insurer for having their premium payment anything but

Question 26

Conditional receipts

Answer 26

They are the most common type of premium receipt. It pretty much indicates that certain terms have to be met before coverage goes into effect.

Question 27

Also on conditional receipts

Answer 27

They provide when the applicant pays the initial premium, coverage is effective on the condition that the applicant proves to be insurable either on the date the application was signed or the date of the medical exams.

Question 28

Binding receipts

Answer 28

Under a binding receipt, coverage is is guaranteed until the insurer formally rejects the application. Even if the applicant is ultimately uninsurable coverage is still guaranteed until its rejected

Question 29

Constructive delivery

Answer 29

Is accomplished if the insurance company intentionally relinquished all control over the policy and turns it over to someone acting for the policy-owner, including the company’s own agent. Mailing the policy to the agent for unconditional delivery to the policy-owner also constitutes constructive delivery, even if the agent never personally delivers the policy….

Question 30

Explaining the policy and ratings to clients

Answer 30

Agents should deliver policies in person. Only by personally delivering a policy does the agent have a timely opportunity to review the contract and its provisions, exclusions and riders.

Question 31

Obtaining a statement on insureds good health

Answer 31

The agents must collect the premium and obtain from the insured a signed statement attesting to the insureds continued good health

Question 32

Risk factors in health insurance areeeeeee?

Answer 32

Physical condition, moral hazard (lifestyle or habits of the person), occupation

Question 33

Other risk factors

Answer 33

Age, sex. History, avocations

Question 34

Four ways to classify the applicant

Answer 34

Standard, preferred risks (better then standard risks), uninsurable, substandard

Question 35

Interest

Answer 35

The interest earnings reduce the premium amount

Question 36

Morbidity rates

Answer 36

Show the expected incidence of sickness or disability within a given group during a given period of time

Question 37

Taxation of disability income insurance

Answer 37

Premiums paid for personal disability income insurance are not deductible by the individual insured, but the disability benefits are tax-free to the recipient

Question 38

Alsoooooo

Answer 38

When a group disability income insurance plan is paid for entirely by the employer and benefits are paid directly to the individual employees who qualify, the premiums are deductible by the employer. The benefits in turn, are taxable to the recipient

Question 39

If an employee contributes to any portion of the premium, the benefit will be received tax-free in proportion to the premium contributed

Answer 39

Ok ok

Question 40

Taxation on med expense insurance

Answer 40

For self employed individuals, 100% of their health insurance premium is tax deductible

Question 41

Medical cost management

Answer 41

Process of controlling how policyowners utilize their policies

Question 42

4 approaches to use for cost management..

Answer 42

Mandatory second opinions, pre certification review, ambulatory surgery, and case management

Question 43

Mandatory second opinions

Answer 43

Many health policies contain a provisions requiring the insured to acquire a second opinion before surgery.. under mandatory second surgical opinion provision, an insured typically will pay more out of pocket expenses for surgeries for which only the one opinion was obtained l

Question 44

Pre certification review

Answer 44

It’s pretty much a pre-hospitalization program, it determines whether the requested treatment is medically necessary..