field Underwriting Procedures Flashcards

1
Q

elements of a contract

A

agreement (offer and acceptance)
consideration (something of value that each party gives each other)
competent parties
legal purpose ( Must have insurable interest and consent)

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2
Q

insurable interest

A

Required at the time of policy insurance for health and life

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3
Q

conditional

A

certain conditions must be met by the policy owner and company for the contract to be executed

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4
Q

unilateral

A

the only one of the parties is legally bound to do anything

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5
Q

adhesion

A

prepared by the insurer accepted or denied by insured, insured has little to say about provisions

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6
Q

aleatory

A

exchange of unequal amounts of value

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7
Q

completeness and accuracy of application

A

the agents responsibility to ensure the application is complete and accurate to the best knowledge of the applicant

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8
Q

whos signatures are required on contract?

A

Proposed insured
policy owner ( if different than insured)
agent

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9
Q

correct way to make changes to an applications

A
  1. start over with fresh application (best option)
  2. draw a line through the wrong answer insert correct one, applicant initials correct answer
    (any changes on the application must be initialed by applicant or insured)
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10
Q

premiums with the application

A

an initial premium and sent with the application
-conditional receipt is given from the agent

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11
Q

when does coverage start?

A

when application is approved and policy issued

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12
Q

what is required if premium isn’t collected during application?

A

premium and statement of continued good health before releasing the policy

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13
Q

Medical information Bureau (MIB)

A

nonprofit trade organization that collect maintain and available to insurance companies

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14
Q

who is responsible for the costs of medical exam report?

A

insurer

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15
Q

consumer reports

A

written or oral info regarding consumers collected by the reporting agency through employment records, credit reports, and other public sources

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16
Q

what info is collected in a consumer report?

A

credit
character
reputation
habits

17
Q

what are the four characteristics of a contract?

A

adhesion
aleatory
conditional
unilateral

18
Q

whats the best way for accurate information on an applicants medical history?

A

Attending physician report

19
Q

MIB report

A

helps insurance companies share adverse medical information of insureds

20
Q

credit reports

A

contain factors related to a risk’s potential for loss. include consumer reports and investigative consumer reports

21
Q

investigative consumer reports (ICR)

A

provides info on character, reputation, and habits

22
Q

how is information gathered in an investigative consumer reports?

A

through investigation and interview with associates, friends, and neighbors

23
Q

when must a consumer be notified of an investigative consumer report?

A

must have written notice within 3 days of the date the report was requested
(insurance applicants must be notified in writing whenever insurers request investigative consumer reports)

24
Q

when must an applicant receive information found in an investigative consumer report?

A

5 days upon request

25
who conducts medical exam reports?
physicians, paramedics, certified nurse
26
what are an agent's responsibilities?
- compare benefits, limitations, and exclusions found in the current and proposed replacement policy - Ensure that the current policy is not canceled before the new policy is issued
27
types of cost sharing
Deductible, coinsurance
28
Deductible
paid first, set dollar amount, larger the deductible the lower the premium
29
coinsurance
paid after the deductible and after the insurer paid their share, percentage, the higher the coinsurance percentage the lower the premium