Other Insurance Concepts Quiz

$5,000.

An insured has a primary group health plan and an excess plan, each covering losses up to $10,000. The insured suffered a loss of $15,000. Disregarding any copayments or deductibles how much will the excess plan pay? A. $15,000. B. $10,000. C. $7,500. D. $5,000.

Subrogation.

The legal process that gives the insurer, after payment of a loss, the right to seek recovery from a third party that was responsible for the loss is known as. A. Right of Rescission. B. Principle of Indemnity. C. Subrogation. D. Adverse Selection.

Legal benefits.

Under workers compensation, which of the following benefits are NOT included? A. Income benefits. B. Death benefits. C. Legal benefits. D. Medical and rehabilitation benefits.

Unlimited access to providers.

Which characteristic does NOT describe managed care? A. Unlimited access to providers. B. High-quality care. C. Shared risk. D. Preventive care.

The more liberal "own occupation".

Which of the following definitions would make it easier to qualify for total disability benefits? A. The more liberal "own occupation". B. The more strict "any occupation". C. The more liberal "any occupation". D. The more strict "own occupation".

"Own occupation" - less restrictive than other definitions.

A brain surgeon has an accident and develops tremors in her right arm. Which disability income policy definition of total disability will cover her for all losses? A. "Own occupation" - more restrictive than other definitions. B. "Any occupation" - less restrictive than other definitions. C. "Any occupation" - more restrictive than other definitions. D. "Own occupation" - less restrictive than other definitions.

The benefits will be coordinated.

A husband and wife are insured under group health insurance plans at their places of employment. Because their employers pay for their plans, each is covered as a dependent under their spouse's coverage. If the husband is hospitalized, how are the medical expenses likely to be paid? A. The husband will have to select a plan from which he wants to collect benefits. B. The benefits will be coordinated. C. Neither plan would pay. D. The husband can collect from each plan.

Residual disability.

Disability income policies can provide coverage for a loss of income when returning to work only part-time after recovering from total disability. What is the benefit that is based on the insured's loss of earnings after recovery from a disability? A. Recurrent disability. B. Partial disability. C. Income replacement. D. Residual disability.

30.

Group disability income insurance premiums paid by the employer are. A. Taxable to the employee. B. Tax deductible by the employee. C. Tax deferred to the employer. D. Deductible by the employer as an ordinary business expense.

Deductible by the employer as an ordinary business expense.

Group disability income insurance premiums paid by the employer are. A. Taxable to the employee. B. Tax deductible by the employee. C. Tax deferred to the employer. D. Deductible by the employer as an ordinary business expense.

Decreases.

If an insured changes his payment plan from monthly to annually, what happens to the total premium? A. Decreases. B. Stays the same. C. Doubles. D. Increases.

Is defined as the frequency and the amount of the premium payment.

The mode of premium payment. A. Does not affect the amount of premium paid. B. Is defined as the frequency and the amount of the premium payment. C. Is the factor which determines the amount of dividends in a policy. D. Is the method used to compute the cash surrender value of the policy.

A permanent resident lawfully present in the U.S.

Which of the following individuals will be eligible for coverage on the Health Insurance Marketplace? A. A permanent resident lawfully present in the U.S. B. Someone who has Medicare coverage. C. A U.S. citizen who is incarcerated D. A U.S. citizen living abroad.

A person's ability to work is significantly reduced or eliminated for the rest of his/her life.

Which of the following would best describe total disability? A. A person's inability to perform one of the regular duties of his/her occupation. B. A person's total loss of income. C. A person's inability to qualify for insurance coverage. D. A person's ability to work is significantly reduced or eliminated for the rest of his/her life.

State government.

Workers Compensation benefits are regulated by which entity? A. State government. B. Employer. C. Insurer. D. Federal government.