Basics
An unforeseen and unintended injury that resulted from an accident rather than a sickness.
What is an Accidental Injury?
What is an application?
An insurance that is a valued contract or stated amount that pays weekly or monthly benefits due to injury or sickness.
What is a disability income policy?
Name some of the general exclusions found in accident & health insurance.
What is any of the following:
An act of war; intentionally self-inflicted injuries;elective cosmetic surgery; experimental or investigation procedures; conditions covered by workers comp; government plans; participation in criminal activity and injuries resulting from drug or alcohol intoxications
Name the individual responsible for conducting field underwriting.
Who is the Agent?
What is reimbursement and scheduled?
When the application is approved and a policy is issued, the producer must collect the premium along with this document.
What is a statement of continued good health?
A limited policy that provides coverage for death, dismemberment, disability or medical care resulting only from an accident.
What is an Accident Only Policy?
The fact that those most likely to have claims are those who are most likely to seek insurance.
What is Adverse Selection.
Name all of the required signatures on an insurance application
What is the agent, policyowner and insured (if different from the policyowner)?
What is diagnostic and preventive care?
This is often ordered by underwriters in order to determine an applicant's current medical condition.
What is an attending physician's report?
A policy that provides coverage for death and injury resulting from accidents occurring while a fare-paying passenger on a common carrier.
What is a Travel Accident policy?
Whose function is it to select risks, which are acceptable to the insurance company.
True or False
It is the agent's responsibility to make certain the application is filled out completely, correctly, and to the best of the applicant's knowledge.
True
Benefits provided for medically necessary services which one received in a nursing home or their own home but not in an acute care unit of a hospital
What is Long-term Care Expense?
This document starts coverage right away if all conditions have been satisfied.
What is a conditional receipt?
A policy that provides a specific amount on a daily, weekly, or monthly basis wile the insured is confined to a hospital.
What is a hospital indemnity policy?
What must be issued to all applicants for health insurance and informs the applicant that a credit report will be ordered.
What is a Fair Credit Notice?
What is start over with a fresh application or draw a line through the incorrect answer and insert the correct one and initial the change?
What is accidental injury and sickness?
This is a significant factor in health insurance underwriting because of the possibility of malingering.
What is moral hazard?
Dental policies usually distinguish among several classes of expense and provide for different treatments. Name three of them.
Name one of the sources used in underwriting.
What is an Application; Producer Report; Attending Physician Statement; Investigative Consumer (inspection) Report; Medical Information Bureau; Medical Examination and lab tests (including HIV consent);
Name the document given to the applicant, upon signing of the application and payment of the initial premium which sets out the effective date of the policy.
What is the Insurability Conditional Receipt?