Technical Questions

Within how many days of requesting an Investigative Consumer Report must an insurer notify the consumer in writing that the report will take place?

3 days

How does a hospital income plan pay an insured?

A hospital indemnity policy pays an amount directly to an insured while being hospitalized

What is another term for a waiting period?

A waiting period is also called an elimination period.

What contains personal information an agent gathered from an applicant?

Agent report

When they an application to be the primary and only source of medical underwriting information?

An application can be a primary source for underwriting if an applicant's medical background is flawless

Under whose authority can a policy provision be changed?

An executive officer of the company

Under the health insurance misstatement of age provision, what happens to benefits when an insuredwhat happens to benefits when an insured's age is misstated on their application?

An insurer would pay benefits according to an insured's correct age at the time of their application.

When was the outline of coverage be presented

At the time of application or upon delivery of the policy to an insured.

What must an insurance company obtain before conducting insurance transactions?

Certificate of Authority

Risk vs Peril

Chance vs cause

What must an agent always followed to protect the interests of an insured?

Code of Ethics

In insurance contract law, what describes consideration?

Consideration is something of value.

Insurance intended to make loan payments until a person is able to return to work from their disability

Credit disability insurance

Apparent Authority is best expressed by which of the following examples? A. An agent accepts a premium payment from an applicant B. An agent advertises without expressed permission C. The agent gives advice about insurance claims D. The agent has business cards and stationery printed with their insurance company's name

D. The agent has business cards and stationery printed with their insurance company's name

What type of insurance contract will cover loss of income?

Disability income

If an insurer cancels a policy how are prepaid premiums to be returned to the insured?

If an insurer cancels a policy the premium is refunded on a pro rata basis.

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

Long Term Care

What association is composed of all U.S. Commissioners

NAIC

What organization seeks to educate legislators so they can make decisions to improve the insurance matters?

National conference of insurance legislators (NCOIL)

When will a healthcare policy cover and injury from participation in an illegal act

Never

What notice must be issued to applicants to inform them that credit information will be gathered concerning their past history?

Notice to the applicant

An _______ is an application submitted to an insurer that contains an applicant's initial premium.

Offer is an application submitted to an insurer that contains an applicant's initial premium.

Self-insurance is an example of what kind of risk management?

Retention

What is another name for a disease or illness?

Sickness

What provision in an accident and health policy addresses pre-existing conditions?

The Time Limit on Certain Defenses addresses pre-existing conditions.

Within how many days must Bob notify his insurer of a claim under the notice of claim provision?

The notice of claim provision states that an insured must notify their insurer of a claim within 20 days after their loss occurred.

What provision in Maria's health policy states to what party must an insurer pay benefits?

The payment of claims provision states to who benefits will be paid.

Cosmetic surgery maybe covered under a health plan when

The surgery is due to an accident of birth defect

The principal of insurance is an example of what kind of risk management?

Transfer

True or false: An insurer may not change any provision in a guaranteed renewable policy except its premium rate.

True

Who is responsible for deciding if a group should be insured or rejected coverage?

Underwriter

When does an application process for insurance begin?

When an approved application form is provided by an insurer and is completed by the producer

What is the primary risks associated with a disability?

Loss of income

Tri-care was designed to provide healthcare for

Military personnel

In Franchise groups, how many Master Policies will be issued?

None

When a producer is notified about an insured's death, what is their immediate duty?

A producer represents an insurer. It is the producer's duty to notify their insurer about the death of an insured.

Credit Disability

Also known as credit accident and health insurance is intended to pay off a loan balance of a disabled person. It expires 15 days after the loan is satisfied.

When an insured owes a premium payment at the same time their claim is filed...

Any premium due to an insurer will be deducted from a claim.

What three things must an agent compare in a replacement situation?

Benefits and limitations and exclusions

Who manages a mutual company?

Board of Trustees

What report contains information on a customers habits and lifestyle?

Consumer report

A contract offered on an accept it basis

Contract of adhesion

The act that ensures all employees receive benefits and pensions promised by employers

ERISA

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

Exclusions and limitations

What part of an application that contains the name and address of an applicant?

Part 1

What is the primary concern when replacing health insurance?

Pre-existing conditions

What are four classifications of risk?

Preferred risks Standard risks Substandard risks Declined risks

Accidental death and dismemberment benefits cover________ and __________ amounts.

Principal and Capital

The insured with pre-existing conditions are subject to what?

Probationary period

Roger wrote his company and notified them that he had become disabled. What provision states that his claim must be paid immediately upon written proof of his loss?

The Time Payment of Claims Provision States that claims must be paid immediately after proof of a loss.

Jenny has an individual major medical insurance policy that she reinstated February 15. What describes her coverage?

With the reinstatement of health coverage accidents are covered immediately and sickness is covered in 10 days.