Chapter 11- Health and Accident Insurance

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An insurance company would MOST likely pay benefits under an Accidental Death and Dismemberment policy for which of the following losses?

Loss of eyesight due to an accidental injury.

P is insured under a basic cancer plan. Which of the following conditions would be covered under this plan?

Operation for a malignant tumor

Group/voluntary long-term care policy premiums are typically deducted from the employee's income and

are LESS costly as compared to individual long-term care coverage

Which of the following medical expenses does Caner insurance NOT cover?

arthritis

T is covered by two health insurance plans: a group plan through his employer and his spouse's plan as a dependent. under the model group coordination of benefits, when T files a claim, his employer's plan is considered the:

primary carrier. The primary company must pay as much of the calim as the policy limits permit

Which mode of payment is NOT used by health insurance policies?

single premium

G is an accountant who has ten employees and is concerned about how the business would survive financially if G became disabled. The type of policy which BEST addresses this concern is

Business Overhead expense

Which of these circumstances is a Business Disability buy-sell designed to help in the sale of a business?

Business owner becoming disabled

Which side of these circumstances is a Business Disability buy-sell policy designed to help in the sale of a business?

Business owner becoming disabled

When an employee is required to pay a portion of the premium for an employer/employee group health plan, the employee is covered under which of the following plans?

Contributory

A policyowner's rights are limited under which beneficiary designation?

Irrevocable

Which of the following BEST describes how a policy that uses the "accidental bodily injury" definition of an accident differs from one that uses the "accidental means" definition?

Less restrictive

The benefits under a disability buy-out policy are:

payable to the company or another shareholder.

On an Accidental Death and Dismemberment (AD&D) insurance policy, who is qualified to change the beneficiary designation?

policyowner

How does group insurance differ from individual insurance

premiums are lower

Which of these types of coverages is best describes as a short-term medical policy?

Interim coverage

All students attending a large university could be covered by

A blanket insurance policy

J has Accidental Death and Dismemberment policy with a principal sum of $50,000. While trimming the hedges, J cuts off one of his fingers. What is the maximum J will receive from his policy?

$25,000

B has a $100,000 Accidental Death and Dismemberment policy that pays triple indemnity for a common carrier death. If B is killed from an accident on a commercial flight what will the policy pay B's beneficiary?

300,000

B has a $100,000 Accidental Death and Dismemberment policy that pays triple indemnity for common carrier death. If B is killed from an accident on a commercial flight, what will the policy pay B's beneficiary?

300,000

All of the following statements regarding group health insurance is true, EXCEPT:

An individual policy is given to each member All of the following is true about GROUP HEALTH INSURANCE -premiums are usually determined by the claims experience of the group -A master contract is issued for the group -Group health insurance premiums are typically lower than individual health insurance premiums

Accidental Death coverages is provided to commercial airline passengers in which of the following types of policies?

Blanket accident policy

G is an accountant who has 10 employees and is concerned about how the business would survive financially if G became disabled. The type of policy which BEST addresses this concern is:

Business Overhead Expense

Which of the following statements does NOT accurately describe the tax treatment of premiums and benefits of individual Accident and Health insurance?

Disability income policy premiums are tax-deductible. Premiums paid by the individuals for disability income policies are NOT tax-deductible. However, the BENEFITS would be considered tax-free to the individual

Which of the following statements is CORRECT regarding an employer/employee group health plan?

Employer receives master policy and empolyees receive certificates

If the insured and primary beneficiary are both killed in the same accident and it cannot be determined who died first, where are the death proceeds to be directed under the uniform simultaneous Death act?

Insured's contingent beneficiary

P and Q are married and have three children. P is the primary beneficiary on Q's Accidental Death and Dismemberment (AD&D) policy and Q's sister R is the contingent beneficiary. P, Q, and R are involved in a car accident and Q and R are killed instantly. The Accidental Death benefits will be paid to

P only

K is the insured and P is the sole beneficiary on an Accidental Death and Dismembermemt (AD&D) insurance policy. Both are involved in a fatal accident where K dies before P. Under the common Disaster provision, which of these statements is true?

Proceeds will be paid to P's estate

Which type of policy pays benefits to a policyholder under a Hospital Expense policy?

Reimbursement

T is covered by an Accidental Death and Dismemberment (AD&D) policy that has an irrevocable beneficiary. What action will the insurance company take if T requests a change of beneficiary?

Request of the change will be refused

Which of the following statements is TRUE regarding a group accident and health policy issued to an employer?

The employer receives the policy and each employee is issued a certificate

A business overhead expense policy

covers business expenses such as rent and utilities

Which of these types of coverage is best described as short term medical policy?

interim coverage

Dental care coverage is designed to cover the costs of all of the following EXCEPT:

loss of income

An accident policy will most likely pay a benefit for a(n)

off the job accident


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