PRINCIPAL TYPES OF LOSSES AND BENEFITS & DEFINITIONS OF PERILS
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
