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Pa Life, Accident, and Health Insurance > Insurance Terms > Flashcards

Insurance Terms Flashcards

1
Q

Misrepresentation of material fact made knowingly with intent to be deceptive

A

Fraud

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2
Q

The reduction in value of an asset which is measured before and after

A

Loss

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3
Q

The state in which the insurer was formed and is headquartered

A

Domestic

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4
Q

Insurer writes business in states other than its home state

A

Foreign

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5
Q

Insurer outside of the United States

A

Alien

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6
Q

Insurer whose participation and dividends are owned by policyowners

A

Mutual

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7
Q

Insurer who is non-participating and no dividends are owned by stockholders

A

Stock

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8
Q

Insurer where company has certificate of authority and approved to transact insurance in that state

A

Admitted

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9
Q

Insurer where company has no certificate and not approved to transact in state

A

Non-Admitted

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10
Q

What is the process of evaluating risk determination if it is acceptable based on established guidelines

A

Underwriting

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11
Q

One sided contract where one party is legally bound to performed under contract

A

Unilateral

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12
Q

Feature of insurance contract in that there is an element of chance for both parties and that the dollar given by the policyholder (premiums) and the insurer (benefits) may not be equal

A

Aleatory

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13
Q

Intentional failure to disclose facts

A

Concealment

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14
Q

Intentionally or voluntarily giving up your known right

A

Wavier

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15
Q

Authority in writing

A

Express Authority

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16
Q

Authority not in writing

A

Implied Authority

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17
Q

Authority in action/statement

A

Apparent Authority

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18
Q

Transfer of risk

A

Insurance

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19
Q

Uncertainty

A

Risk

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20
Q

Type of risk with only possibility of loss

A

Pure Risk

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21
Q

Type of risk with possibility of loss or gain

A

Speculative Risk

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22
Q

Transfer of risk from one insurer to another. Company accepts the risk

A

Reinsurance

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23
Q

Reducing risk onto the reinsurer

A

Ceding Insurer

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24
Q

The dollar amount beyond which the insured is no longer participates in payment of medical expenses

A

Stop Loss limit

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25
Q

What is the frequency of payment

A

Mode

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26
Q

Type of annuity covers 2 or more annuitants and provides monthly incomes only until the first annuitant dies

A

Joint life annuity

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27
Q

Type of receipt makes the insurer liable for the risk from the application date regardless of applicant’s insurability

A

Binding receipt

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28
Q

Type of life policy that can be continued year after year without a medical examination, rates are dependent on age of insured at current time

A

Renewable term

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29
Q

What was specifically designed to address STOLI & IOLI

A

NCOLI Act (National Council of Insurance Legislators

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30
Q

What is considered double indemnity

A

Accidental death

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31
Q

What type of coverage pays a monthly cash benefit following the elimination period for total disability due to accident or sickness

A

Disability income insurance

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32
Q

What is a nonforfeiture option

A

cash dividend option

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33
Q

Current assumption whole life policies are sensitive to

A

Interest rates

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34
Q

Short term disability insurance generally only covers injuries due to

A

Non occupational injuries

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35
Q

What type of life insurance is also known as whole life and is in place until age 100

A

Permanent

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36
Q

Type of life insurance is temporary, only offered death benefit, and has no cash value

A

Term

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37
Q

What type of insurance has a distribution of dividends to its policyowners of 75%

A

Participating

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38
Q

What type of life insurance has no distribution of dividend of 100%

A

Non-Participating

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39
Q

What type of life insurance offers a guaranteed minimum or set benefits

A

Fixed

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40
Q

What type of life insurance has no guarantee of performance and has a separate account

A

Variable

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41
Q

Medical plan where is paid in return for service provided

A

Fee for service

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42
Q

Medical plan where individuals pay health pay maintenance organizations specified amount and HMO agrees to provide needed care

A

Pre-paid

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43
Q

What type of whole life insurance has the same premiums for the life of the policy and pays the cash value if the premiums are stopped

A

Continuous Premium Whole Life

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44
Q

What type of whole life insurance allows for a lifetime of premiums to be paid in a shorter period of time (10 or 20 level annual installments)

A

Limited Payment Whole life

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45
Q

What type of whole life insurance policy has only one payment made at the time of purchase and creates immediate cash value

A

Single premium whole life

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46
Q

What type of whole life insurance policy has lower premiums in the first 3-5 years but then increase and become more level? (End up being more expensive)

A

Modified Premium Whole Life

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47
Q

What type of whole life policy insurance has a lower initial premium than modified whole life and increases every 5-10 years as long as the policy remains in force

A

Graded Premium Whole Life

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48
Q

What type of whole life insurance policy is similar to a non-participating policy policy but allows foe adjustable premiums

A

Indeterminate Premium Whole Life

49
Q

What type of life insurance gives the policyowner power to adjust the face value and death benefit, premium, and length if coverage without have to change the policy

A

Adjustable Life Insurance

50
Q

What of life insurance insurance was designed for flexible premiums and flexible coverage for the life of the policy where death benefits can be altered. Premiums accumulate as interest within this policy’s cash value

A

Universal Life insurance

51
Q

What type of life insurance policy has a separate account instead of a guaranteed cash value with numerous death benefit options

A

Variable Life Insurance

52
Q

Agent who sells insurance products of several other companies and works for themselves or other agents

A

Independent Agent

53
Q

Agent who represents only one one company (insurance company) compensated by commission

A

Exclusive or Capitve Agent

54
Q

What of annuity provides an individual with an income within a month or up to 12 months

A

Immediate Annuity

55
Q

What type annuity doesn’t provide an immediate income and the owner choose the amount and the frequency of payments with funds to be withdrawn

A

Deferred Annuity

56
Q

What type of annuity has values guaranteed against loss and never be less than what is paid into the contract

A

Fixed Annuity

57
Q

What type of annuity has the potential to keep pace with inflation because they are supported by stocks and bonds and have an investment risk

A

Variable Annuity

58
Q

What type of annuity is also tax-deferred and its interest is linked to S&P 500 index

A

Equity Indexed Annuity

59
Q

What type of disability rider waives the premium if the interest is 100 percent disabled with a 6 month waiting period

A

Waiver of Premium

60
Q

What type of disability rider replaces lost income if one cannot work and premiums are waived

A

Disability Income

61
Q

What type of disability rider is used for for juvenile policies

A

Payor Benefit Life

62
Q

Type of disability insurance defined as the inability to perform any duties of own occupation

A

Total Disability

63
Q

Type of disability insurance defined as one can perform some but not all essential duties of their occupation

A

Partial Disability

64
Q

Type of disability insurance defined as the loss of 2 limbs, total and permanent blindness, total loss of speech, and loss of hearing

A

Presumptive Disability

65
Q

Type of disability insurance defined as one that is paid when insured cannot perform the same duties as before as based on income lost

A

Residual Disability

66
Q

Type of disability insurance as one for employees who return to work but becomes disabled again within 90 days

A

Recurrent Disability

67
Q

Type of disability insurance defined as requiring 40 quarters completed with a 5 month waiting period ceases when retirements starts

A

Social Security Disability

68
Q

Type of long term care that refers to skilled medical and therapy services performed by individuals home home by visiting home health aids

A

Home Health Care

69
Q

Type of long term care that provides company supervision along with social and recreational support for people whose grown children care for them at home but work during the day

A

Adult Day Care

70
Q

Type of long term care that is similar to hospice care where professionals care for someone who temporarily in order to give few days rest to family members who provide care

A

Respite Care

71
Q

Type of long term care for people who need assistance from time to time but can live independently compared to those who receive custodial care

A

Assisted Living

72
Q

Level of long term care that requires 24/7 nursing by a medical professional

A

Skilled Care

73
Q

Level of long term care that requires occasional nursing or rehab by medical professional

A

Intermediate Care

74
Q

Level of long term care that requires help with activities of daily living not performed by a medical professional

A

Custodial Care

75
Q

Type of limited health policy that pays a flat dollar amount as a daily benefit for each day the insured is hospitalized as an inpatient where payment is made directly to the insured not the hospital

A

Hospital Indemnity

76
Q

Type of limited health policy that only covers accidents as peril and excludes any type of sickness or disease

A

Accident Only

77
Q

Type of limited health policy that was developed to cover one or one type of catastrophic illness in the policy such as cancer or heart disease

A

Specified or Dread Disease

78
Q

Type of limited health policy that covers routine eye and vision correction

A

Vision Care

79
Q

Type of limited health policy that covers hearing exams and some or all hearing aids

A

Hearing Insurance

80
Q

Type of limited health policy where group policy has retailer as master policyowner and the debtors are group members. If debtor becomes disabled then policy benefits are paid to the creditor

A

Creditor Disability Insurance

81
Q

Type of of limited health where group members engage in similar activity and members are automatically covered when part of the (no application or certificate)

A

Blanket Coverage

82
Q

Type of limited health policy which which is sold as a means of temporary health coverage which are not renewable and must be qualified for

A

Short-Term Medical Expenses

83
Q

What is the use of annuity uses settlement to make big deposit into annuity

A

Lump Sum

84
Q

What use of annuity allows IRS to accept annuity as a retirement option

A

Retirement Plan

85
Q

What use of annuity allows one to have income during retirement as a supplemental income

A

Retirement Income

86
Q

What use of annuity allows for money to be put away for educational purposes

A

Education

87
Q

Types of of specialized life policy that has more than one person but the benefit is paid after the first death

A

Joint Life

88
Q

Type of of specialized policy that has more than one person but the death benefit extends to the last death

A

Survivorship

89
Q

Type of business disability insurance where important member of business loss could cause financial incapability to cover the expenses for business

A

Key Person Disability

90
Q

Type of business disability insurance to cover overhead expenses while owner is disabled but doesn’t cover the owner/partner salary

A

Business Overhead Expense

91
Q

Type of disability insurance used to fund agreement to buy out interest of business owner/partners

A

Disability Buy-Sell

92
Q

Type of life insurance policy rider where policyholder becomes disabled premiums are paid so coverage continues

A

Waiver of Premium

93
Q

Type of life insurance policy rider that provides insured with monthly benefit

A

Disability Income

94
Q

Pays a large portion of healthcare bills for people for 65 and older, have end-stage renal failure, or have been receiving social security disability for at least 24 months. Individual must be fully insured with 40 credits and funded by the branch of the Department of Human Health Services

A

Medicare

95
Q

Medical plan that includes HMO allows subscribers to use providers outside of HMO, no gatekeeper for out of network services, subscribers pay more of the cost, called an open-ended HMO

A

Position of Service (POS)

96
Q

Medical plan that includes managed care, fee for service, pre-negotiated rates, insured pay less when using in network providers

A

Preferred Provider Organization (PPO)

97
Q

Medical plan that includes managed care, prepaid services, co-pays, gatekeeper, limited choice of providers, limited service area, emergency care, preventive care, hospital care, office based care, and outpatient services

A

Health Maintenance Organization (HMO)

98
Q

Includes a size of group, composition of group, contributory/non-contributory, persistency, administrative capability

A

Enrollment Card in Group Health

99
Q

What are the 2 annuity phases

A

Accumulation: Pay in
Annuitization: Pay out

100
Q

Illness or disease or that existed before individual’s health insurance went into effect

A

Pre-existing Condition

101
Q

What are the 2 types of perils covered by health insurance

A

Accident and Sickness

102
Q

Assignment that transfers all rights of ownership to another person or entity

A

Absolute/Permanent Assignment

103
Q

Assignment does not change ownership of a policy and is common within loans

A

Collateral Assignments

104
Q

Health insurance coverage that offers benefits for only particular type of loss and are number of special insurance policies

A

Limited Coverage

105
Q

Health insurance coverage that offers broad services

A

Comprehensive Coverage

106
Q

Cause of loss that insurer agrees to cover caused by a specific one

A

Peril

107
Q

Include evidence of coverage, who is covered by plan and summary of benefits

A

Certificated of Coverage in Group Health

108
Q

Risk assumed by insurer amount is responsible for paying out

A

Exposure

109
Q

Designed to provide steady cashflow during retirement years and protect against someone living too long

A

Annuity

110
Q

Death within 24 months

A

Terminally Ill

111
Q

Inability to perform 2 activities of daily living (ADLs)

A

Chronically Ill

112
Q

What are 5 types of beneficiaries

A

Individuals, Classes, Estates, Trusts, Minors

113
Q

Hazard that involves one’s state of mind or careless attitude

A

Morale Hazard

114
Q

Hazard that arises from individual’s character

A

Moral Hazard

115
Q

Hazard that is physical identifiable using equipment that produces tangible evidence of existence

A

Physical Hazard

116
Q

Type of life insurance policy rider which changes insured to a different person

A

Exchange Privilege

117
Q

Type of life insurance policy rider with convertible term insurance spouse or immediate family member of primary insured

A

Other Insured Term

118
Q

Type of life insurance policy rider where if person responsible for the premiums becomes disabled/deceased premiums are waived until child is 18-21 years of age

A

Payor Benefit Life

119
Q

Medical supplement insurance that is sold by private companies to help cover some health care cost that original medicare does not cover and is designed to to fill the gaps in Parts A and B, but cannot be purchased by someone in Part C

A

Medigap

Pa Life, Accident, and Health Insurance (4 decks)

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