KEY FACTS **** STUDY IF ALL ELSE FALLS Flashcards
The earliest that coverage would start would be the day of the application, Assuming the applicant paid the premium, no conditions to fulfill, and had not lied.
Field Underwriting Procedures
Applications, Premiums, Underwriting:
An incomplete application is usually returned. This being said, should the underwriter approve it as it is, coverage begins. If this occurs, the company gives up some of its ability to contest a claim.
Field Underwriting Procedures
Applications, Premiums, Underwriting:
The Medical Information Bureau (MIB) collects claims information.
Field Underwriting Procedures
Applications, Premiums, Underwriting:
Coverage can never begin unless the premium has been paid. Even though the premium has been paid, coverage will NOT start until the applicant has satisfied all of the conditions of the conditional receipt, if any.
Field Underwriting Procedures
Applications, Premiums, Underwriting:
The underwriter determines the final rating classification, not the producer.
Field Underwriting Procedures
Applications, Premiums, Underwriting:
A buyer’s guide and policy summary must be left with the applicant prior to accepting the initial premium.
Field Underwriting Procedures
Applications, Premiums, Underwriting:
Although the producer must sign the application, he or she is not a party to the contract.
Field Underwriting Procedures
Applications, Premiums, Underwriting:
It is the responsibility of the producer to explain the policy provisions, riders, and exclusions to the policyowner and/or insured
Field Underwriting Procedures
Applications, Premiums, Underwriting:
The applicant’s consideration is both the answers on the application and the premium. In return, the insurance company promises coverage. Consideration does not have to be equal
Field Underwriting Procedures
Contract Law:
Insurable interest may be based on economics or family relationships
Field Underwriting Procedures
Contract Law:
An absolute guarantee of truth is called a warranty.
Field Underwriting Procedures
Contract Law:
Permanent disability does not go away (such as loss of a limb)
Types of Health Policies
Disability Income
Short-term disability policies have shorter elimination periods than long-term disability policies
Types of Health Policies
Disability Income
Premiums paid by the insured on an individual disability income policy are not tax deductible, but any benefits received would be received tax free.
Types of Health Policies
Disability Income
A blanket disability policy may be written to cover passengers on a common carrier, an employee group, a student group, a debtor group, or a sports team. Blanket policies do not require individual applications, nor are certificates of insurance insured to those covered.
Types of Health Policies
Disability Income
Business overhead insurance will cover the ongoing business expenses of a self-employed person, such as rent or salaries, while the self-employed person is disabled.
Types of Health Policies
Business Disability Insurance
Key person disability insurance indemnifies the business for the loss of services of a key employee due to disability.
Types of Health Policies
Business Disability Insurance
On an AD&D policy, loss of eyesight due to an accident is covered. Loss of hearing is not covered, nor is loss of use of a limb.
Types of Health Policies
Accidental Death and Dismemberment
Limited health insurance policies (like AD&D) only cover limited perils and amounts.
Types of Health Policies
Accidental Death and Dismemberment
Base plans cover in-hospital only. There is no deductible or coinsurance on a base plan.
Types of Health Policies
Medical Expense Insurance
When calculating how much the company will pay on a claim, always subtract the deductible first, and then apply the coinsurance percentage
Types of Health Policies
Medical Expense Insurance
Medical expense policies cover both accident and sickness
Types of Health Policies
Medical Expense Insurance
Basic medical expense policies provide first dollar coverage without a deductible
Types of Health Policies
Medical Expense Insurance
Health insurance exludes war, self-inflicted injury and cosmetic surgery.
Types of Health Policies
Medical Expense Insurance
Health insurance underwriters may discriminate based on and applicant’s health history
Types of Health Policies
Medical Expense Insurance
A surgical expense policy will pay a claim up to the policy limit. They are only health insurance policies that may use a relative value schedule
Types of Health Policies
Medical Expense Insurance
Major medical and Medicare Part B policies have both deductibles and coinsurance requirements
Types of Health Policies
Medical Expense Insurance
