PRINCIPAL TYPES OF LOSSES AND BENEFITS & DEFINITIONS OF PERILS

¡Supera tus tareas y exámenes ahora con Quizwiz!

What type of policy provides daily care for and insured confined to a nursing home

Long Term Care

Dental Expense

Medical Health Insurance policy that covers the preventative treatment, care of dental disease and injury effecting insured's teeth

tri-care was designed to provide healthcare for

Military Personel

What are insured with pre-existing conditions subject to after issue date of their policy?

Probationary Period

Who must sign an application in additions to the applicant

Agent

Explain when an Accidental Death and Dismemberment policy pays the principle sum?

An Insured dies or losses multiple limbs or body parts as a result of an accident

What type of insurance contract covers loss of income

Disability

What is the Primary risk associated with a disability

Loss of income

all the following may be medical expense exclusions except

an injury caused by an accident

Medical Expense

A health insurance category that covers medical care, but does not cover loss of income.

Long-Term Care Expence

Health Insurance Policy that provides for the daily care of an insured, when confined to a Nursing Home, or in some cases, to their own home (Home Health Care).

SPECIFIED DISEASE (DREAD DISEASE POLICY)

A Specified Disease Policy is a policy specifically issued to provide coverage for certain conditions or limited sicknesses. For example, a Dread Disease Policy also known as a Critical Illness Policy, would cover Heart Disease or Cancer.

What kind of injury is considered an unforeseen act

Accidental

an unintentional or unforeseen act that causes bodily harm

Accidental Injury

Health insurance contain two major causes of loss (Parils) within a police

Accidents and sickness

ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D)

An Accidental Death and Dismemberment (AD&D) in a Disability Income Policy pays a benefit when an insured dies or loses multiple limbs or body parts as a result of an accident. This is the Principal Sum or Face Amount. A lesser amount is paid if an insured loses a single limb or body part known as the Capital Sum. The Capital Sum is always a percentage of the principal sum. The loss of one hand, arm, leg, or eye is often (1/2) or 50% of the face amount. The principal and capital sums are paid in a lump sum. In general, as long as an insured (client) dies as a result of an accident and the death occurs within 90 days of an accident, the policy will pay the Accidental Death Benefit

Reimbursement Benefit Payment Plans

Benefits payed to an insured, but the insured is responsible for the medical expenses

underwriters use religious and political preferences to determine A&H rates

False

HEARING

Hearing coverage provides examination and supplemental devices for insureds.

What was the title a health condition a person had in existence before their policy was issued called

Pre-existing

An illness or disease that occurs during an insurance policy (most health insurance claims are do to sickness rather than accidents)

Sickness

When is dental treatment covered under a hospital or Medical Expence Policy

To repair an injury

Vision

Vision coverage is designed to provide eye examinations and eyeglasses on a limited basis, and is generally provided in Group Health Insurance coverage by employers for their employees. A Vision policy would not contain coverage for sunglasses

PRESCRIPTION

it is usually provided in a Group Health Plan. An insured pays a co-payment amount, and an insurance company (insurer) pays the balance. There are often limitations on quantities (30 to 90 day supply) that can be purchased. Generic or off the label drugs may also be covered

Loss of Income from a disability

loss of income from an accident or sickness is covered under a Disability Income Policy. From an insurance company's perspective loss of income is the primary risk associated with a disability

what is another name for disease or illness

sickness

What are the two most important considerations in replacing a health policy

the exclusions and limitations in the policy


Conjuntos de estudio relacionados

Nursing Process and Drug Therapy

View Set

Valvebody and pressures - automatic transmission/transaxle

View Set

Chapter 41 PrepU Management of Patients with Intestinal and Rectal Disorders

View Set