Health And Accident Flashcards
(205 cards)
1
Q
A general way of describing insurance against loss through sickness or accidental bodily injury
A
Health insurance
2
Q
A form of insurance that ensures, the beneficiaries earned income against the risk that a disability creates a barrier for a worker to complete the core functions of their work
A
Disability (income) insurance
3
Q
Insurance which pays benefits for non-surgical doctors fees commonly rendered in a hospital; sometimes pays for home and office calls
A
Medical expense insurance
4
Q
A short term policy is purchased on an interim basis, typically in between jobs or waiting for a new policy to start
A
Interim coverage
5
Q
The purest form of accident insurance. It provides the insured with a lump sum benefit amount in the event of accidental death, or dismemberment under accidental circumstances.
A
Accidental death and dismemberment insurance
6
Q
Insurance, under which the insured is not entitled to share the divisible surplus of the company
A
Non-participating plan
7
Q
A plan under which the policy owner receives shares (commonly called the dividends) of the divisible surplus of the company
A
Participating plan of insurance
8
Q
Healthy act designed to increase health insurance, quality and affordability, lower the uninsured rate by expanding insurance, coverages and reduce the cost of healthcare.
A
The Patient Protection and Affordable Care Act
9
Q
Insurance that provides coverage for a group of persons, usually employees of a company, under one master contract
A
Group health insurance
10
Q
Are provisions that define the rights of the insurer to cancel the policy a different points during the life of the policy
A
Renewability provisions
11
Q
Allows the insurer to cancel, or terminate the policy at any time. This type of renewability is prohibited in most states.
A
Cancelable policies
12
Q
Policies which gives the insurer in the option to terminate the policy on a date specified in the contract
A
Optional renewable policies
13
Q
A policy that gives the insurer the option to terminate the policy only in the event of one or more conditions stated in the contract
A
Conditional renewability
14
Q
Policies which specify that the policy must be renewed, (usually until the insured reaches a specified age)
A
Guaranteed renewable policies
15
Q
State the policy cannot be cancelled nor can its premium rates be increased under any circumstances. Disability policies are the most common noncancellable (noncan) policies
A
Noncancellable Policies
16
Q
Policies that are for a predetermined terms of a year or less (typically short term health insurance) and are considered temporary
A
Non-renewable policies
17
Q
Benefit arrangements in which employees can pick and choose from a menu of benefits, thus tailoring the benefits package to their specific needs
A
Cafeteria plans
18
Q
Cafeteria plans are also referred to as what?
A
A Section 125 plan
19
Q
Plans which provide a way to health Athens nurse continue in the event and owner or key employee, dies or in the event of a disabling sickness or injury
A
Business continuation plans
20
Q
A form of disability income insurance designed to pay necessary business, overhead expenses, such as rent, should the insured business owner become disabled
A
Business overhead expense insurance
21
Q
Agreements between business co-owners that provides that share, owned by anyone of them who becomes disabled, and shall be sold two and purchased by the other co-owners, or by the business using funds from disability income insurance
A
Disability buy/sell plans
22
Q
The protection of a business against financial loss caused by the death or disablement of a vital member of the company, usually individuals possessing special managerial, or technical skill or expertise
A
Key person disability insurance
23
Q
An employee benefit plan under which the employer bares the forecast of the employees benefits; in most states, the plan must ensure 100% of eligible employees
A
Non-contributory
24
Q
Benefits designed to prevent duplication of group insurance benefits. Limits benefits from multiple group health insurance policies in a particular case to a percentage of the expenses, covered and designates the order in which the multiple carriers are to pay benefits
A
Coordination of benefits
25
The limited period of time during which all members may sign up for a group plan. This period typically happens once a year for a set number of days.
Enrollment period
26
Must be completed and signed by a new employee during the open enrollment period to enroll in group insurance.
Enrollment card
27
A period of time (often 12 months) beginning with your effective date during which your health insurance plan does not provide benefits of pre-existing conditions. This period may be reduced or waived based on any prior healthcare coverage you had before applying for your new health insurance plan.
Waiting period
28
A specified number of days after insurance policies, issue dates during which coverage is afforded for sickness
Probationary period
29
The act which provides the ability to transfer and continue health insurance coverage for millions of American workers and their families when they change or lose their jobs
Health Insurance Portability and Accountability Act (HIPAA)
30
Allows the policy owner, before an original insurance policy expires, to elect to have a new policy issued that will continue with the insurance coverage
Conversion privilege
31
An illness or medical condition that existed before a policy is effective date
Pre-existing conditions
32
Previous coverage under another insurance plan when there has not been a break in coverage of 63 days
Creditable coverage
33
Federal legislation, which extends group health coverage to terminated employees, and or their families at the individuals, expense, for up to 18 months
COBRA - Consolidated Omnibus Budget, Reconciliation Act of 1985
34
Policies issued to cover a group who may be exposed to the same risks, but the composition of the group are constantly changing
Blanket health policies
35
Plans that provide health insurance coverage to members of an association or professional society
Franchise health plans (wholesale plans)
36
Policies designed to help the insured pay off a loan in the event they are disabled due to an accident or sickness, or in the event they die
Credit policies
37
Coverage provided by a disability income policy that does not provide benefits for losses occurring as the result of the injured’s employment
Non-occupational coverage
38
A tax advantage to medical savings account available to taxpayers in the United States, who are enrolled in a high deductible health plan
Health savings accounts
39
The unforeseen, unexpected, unintended cause of an accident. The cause of the mishap must be accidental for any accident face policy claim to be payable.
Accidental means
40
Policies that use the accidental bodily insurance provision required that the result of the injury has to be unexpected and accidental. This is far less restrictive than the accidental means provision.
Accidental results
41
The amount payable as a death benefit. It is the amount of insurance purchased. It is the max amount the policy will pay.
The principal, some under and AD&D policy
42
A form of payment available under AD&D. It is a specified amount, usually expressed as a percentage of the principal sum, which fairies, according to the severity of the injury.
Capital sum
43
Provides coverage for specific kinds of accidents or illnesses, such as injuries received as a result of travel, accidents, or medical expenses stemming from a specified disease
Limited risk policies
44
A policy which covers unusual hazards, not normally covered under ordinary accident and health insurance
Special risk policy
45
The person or entity designated in the policy to receive the death proceeds
The beneficiary of an accidental death and dismemberment policy
46
The first in line to receive death benefit proceeds
Primary beneficiary
47
The second in line to receive death benefit proceeds
Secondary (contingent) beneficiary
48
The third in line to see if death benefit proceeds. If no one is named death benefit will go to the Insurance Estate
Tertiary beneficiary
49
A beneficiary that the policy owner may change at any time without notifying or getting permission from the beneficiary
Revocable beneficiary
50
A beneficiary that may not be changed without the written consent of the beneficiary
An irrevocable beneficiary
51
In the event that a beneficiary dies before the insured, benefits from the policy will be paid to the beneficiaries heirs
Per stirpes (by the bloodline)
52
Evenly distribute its benefits among all named living beneficiaries
Per capita (by the head)
53
The act which states that if the insured and the primary beneficiary die at approximately the same time for a common accident, with no clear evidence as to who died first, the law will assume that the primary died first, this allows the death benefit proceeds to be paid to the contingent beneficiaries
Simultaneous death act
54
A provision which ensures a policy owner, if both of the insured and the primary beneficiary die within a short period of time, the death benefits will be paid to the contingent beneficiary
Common disaster provision
55
A Clause which prevents a beneficiary from recklessly spending benefits by requiring the benefits to be paid and fixed amounts or installments over a certain period of time
A spendthrift clause
56
Entities which offer benefits to subscribers in return for the payment of premium. Benefits are in the form of services provided by hospitals and physicians in the plan.
Service providers
57
With the dominant health insurers of the United States
Blue Cross and blue shield
58
Another type of organization offering comprehensive, prepaid healthcare services to it, subscribing members
A health and maintenance organization (HMO)
59
A collection of healthcare providers, such as physicians, hospitals, and clinics, who offer their services to certain groups at prearranged discount prices
A preferred provider organization (PPO)
60
A program created to provide hospital and medical expense insurance protection to those aged 65 and older
The federal administered Medicare program
61
In addition to Medicare, the federal government also provides disability related benefits, through what program?
Social Security OASDI program
62
Title XIX of the social Security act, added to the Social Security program in 1965
Medicaid
63
The program with the purpose to provide matching federal funds to states for their medical public assistance, plans to help needy persons, regardless of age
Medicaid
64
Laws in programs and acted to provide mandatory benefits to employees for work, related injuries, illness, or death
Worker’s Compensation
65
A method of marketing group benefits, to employers who have a small number of employees
Multiple employer trusts
66
A type of MET (Multiple employer trust) which consists of small employers, who have joined to provide health benefits to their employees, often on a self insured basis
Multiple employer welfare arrangement (MEWA)
67
A federal government, accident, and health plan, which provides accident and health coverage to military service members and their families
Tricare
68
Helps pay for inpatient hospital, care, and patient care and a skilled nursing facility, home healthcare, and hospice care
Medicare part A
69
Pays for Dr. services and a variety of other medical services and supplies that are not covered by hospital insurance
Medicare part B
70
Medicare provided by an approved health, maintenance organization, or preferred provider organization. Known as Medicare choice or Medicare advantage.
Medicare part C
71
Optional coverage that provides access to private prescription drug plans, that contract with Medicare
Medicare part D
72
Total disability that requires that for disability income benefits, to be payable, the insured must be unable to perform any job for which the insured is “reasonably suited by reason of education, training, or experience”
Any occupation
73
Total disability that requires that in order to receive disability income benefits, the insured must be unable to work at the insured’s own occupation
Own occupation
74
Coverage provided by a disability income policy that does not provide benefits for a loss is occurring as the result of the insured’s employment
Non-occupational
75
A disability income policy benefit that provides that if an insured experiences, a specified disability, such as blindness, the insured is presumed to be totally disabled, and entitled to the full amount, payable under the policy, whether or not the insured is able to work
Presumptive disability
76
An illness or injury preventing the insured from performing at least one or more, but not all of the insurance, occupational duties, or the inability to work at that job on a full-time basis, either of which result in a decrease in income
Partial disability
77
A disability income payment based on the proportion of income the insured has actually lost, taking into account, the fact that the insured is able to earn some income
Residual amount benefit
78
The unforeseen, unexpected, unintended cause of an accident. The cause of the mishap must be accidental for any accident best policy claim to be payable.
Accidental means
79
Policies that use the accidental, bodily injury provision (sometimes called the results of provision) required that the result of the entry has to be unexpected, an accidental. This is far less restrictive than the accidental means provision.
Accidental results
80
A specified number of days after an insurance policy is issued date, during which coverage is not afforded for sickness.
Probationary Period
81
A duration of time between the beginning of an insured’s disability, and the commencement of the period for which benefits are payable
Elimination period
82
The maximum length of time, during which a benefit is paid. The longer the benefit period the higher the cost of the policy.
Benefit period
83
A disability income policy provision that allows a certain amount of time after an accident for disability to result, and the insured remains eligible for benefits
Delayed disability provision
84
A disability income policy provision that specifies the period of time during which the reoccurrence of a disability is considered a continuation of a prior disability
Recurrent disability provision
85
Provides for the payment of additional income when the insured is eligible for social insurance benefits, but those benefits have not yet begun, have been denied, or has begun in an amount less than the benefit amount of the rider
The Social Security rider
86
A rider available with some policies that provides for an automatic increase in benefits (typically tied to the consumer price index) offsetting the effects of inflation
Cost of living adjustment rider
87
And arrangements usually provided by a Rider whereby additional insurance may be purchased at various times, without evidence of insurability
Guaranteed insurability rider
88
Facilitates vocational training to prepare insured for a new occupation.
Rehabilitation benefit
89
Determines the benefit of using a percentage of the insured’s pre-disability earnings, and take some to account other sources of disability income
The percent of earnings approach
90
Specifies a flat income benefit amount that will be paid if the insured becomes totally disabled
Flat amount approach
91
Allows the insurer to reduce the maximum benefit, payable under the policy. If the insured switches to a more hazardous occupation, or to reduce the premium rate, changed, if the insured changes to a less hazardous occupation
Change of occupation, provision
92
Injuries that may have resulted from an accident, but are not necessarily a disability
Non-disabling injuries
93
May be selected by the insured when applying for a disability policy. These are typically for short term, disability income policies, and provide for an optional lump sum payment for certain named injuries.
Elective, indemnity options
94
Allows the policy owner to waive premium payments during a disability and keeps the policy in force. It does not provide cash payments to the policy owner. The disability must be total and permanent.
The waiver of premium rider
95
A health insurance policy that provides “first dollars” benefits for specified and limited healthcare, such as hospitalization, surgery, or physician services. Characterized by limited benefit periods and relatively low coverage limits.
Basic medical expense insurance
96
A health insurance policy that provides broad coverage and high benefits for hospitalization, surgery, and physician services. Characterized by deductibles and coinsurance cost sharing.
A major medical expense policy
97
An amount of expense or a loss to be paid by the insured before a health insurance policy starts paying benefits
Deductible
98
A deductible that is a State a dollar amount that applies to a covered loss. This deductible is applied per occurrence, per insured individual. Sometimes referred to as an “initial deductible”
Flat deductible
99
A deductible which comes into play when a major medical policy is supplementing basic coverage that contains no deductible.
A corridor deductible
100
A deductible used when a major medical plan is supplementing basic coverages
An integrated deductible
101
With this kind of deductible, the insured must satisfy a deductible for each accident or illness
Per cause deductible
102
With this kind of deductible, if the insured only has to meet the deductible amount once during the benefit period
All cause deductible
103
The provision which allows an insured to defer current health charges to the following year’s deductible instead of the current years deductible. Usually applies to expenses incurred during the last three months of the plan year.
Carryover provision
104
The principal, under which the company insures only part of the potential loss, the policy owners of paying the other part
Coinsurance
105
Designed to stop the companies loss at a given points, as an aggregate, payable, under a policy, a maximum payable, for anyone, disability, or the like
A stop loss
106
An illness or medical condition that existed before policies, effective date; usually excluded from coverage through the policies, standard provisions, or by waiver
Pre-existing conditions
107
Tax advantaged medical savings accounts available to taxpayers in the United States, who are enrolled in a high deductible health plan. Funds contributed are not subject to federal income tax at the time of deposit.
Health savings accounts (HSA)
108
Employer funded an employer established, tax-advantaged health benefit plans that reimburse employees for out-of-pocket medical expenses and individual health insurance premiums.
Health reimbursement arrangements
109
Accounts created to help employees of small employers, as well as self-employed individuals, pay their medical care expenses
Medical savings accounts (MSAs)
110
Text advantaged accounts that can be set up through a cafeteria plan of an employer. It allows an employee to set aside a portion of earnings to pay for qualified medical expenses as established in the cafeteria plan.
Flexible savings accounts or flexible spending accounts
111
Forms of health insurance, providing a stipulated daily, weekly, or monthly indemnity during hospital confinement
Hospital indemnity policy is
112
Restricted benefits to specified accidents or diseases, such as travel policies, dreaded disease policies, ticket policies, and so forth
Limited benefit policies
113
A policy which provides a variety of benefits for a specific disease, such as cancer or heart disease. Benefits are usually paid as a scheduled fixed dollar amount for specified perils or medical procedures, such as hospital, confinement or chemotherapy.
Limited risk (dread disease) policy
114
And insurance product in which the insurer is contracted to typically make a lump sum cash payment if the policyholder is diagnosed with one of the specific illnesses on a predetermined list as part of an insurance policy
Critical illness policies
115
Policies which cover, hospital room and board, miscellaneous hospital, expenses, such as lab and x-ray charges, medicines, use of operating room, and supplies.
Hospital expense policies
116
A policy where expenses are covered while the insured is confined in a hospital. There is no deductible, and the limits on room and board are set at a specified a dollar amount per day up to a maximum number of days.
Hospital expense policies
117
Benefits which cover expenses for occupancy of the room in bed, general, nursing care, food, and beverages, and personal hygiene items. These limits may not provide for the full amount of hospital room and board of charges incurred by the insured.
Hospital room and board benefits
118
Policies commonly written in conjunction with Hospital expense policies. These policies pay for the cost of surgeons services whether the surgery is performed in or out of the hospital.
Surgical expense policies
119
Under this approach, every surgical procedure is assigned a dollar amount by the insurer
Surgical schedule approach
120
An approach similar to the surgical schedule method. The difference is that instead of a flat dollar amount being assigned to every surgical procedure, a specified set of units is assigned.
The relative value approach
121
An approach where the surgical expense is compared to what is deemed a reasonable and customary for the geographical part of the country where the surgery was performed.
The usual, customary, and reasonable approach (UCR)
122
This combines the features of basic expense coverage and major medical coverage, sold as one policy. Cover practically all medical expenses, hospital, physicians, surgical, nursing, drugs, laboratory, test, etc..
Comprehensive major medical
123
Health insurance that provides coverage to fill the gaps in Medicare coverage
Medicare, supplements
124
A type of Medicare supplement plan sold in some states that can be any of the standardized Medigap plans (A-N) but which requires policyholder to receive services from within a defined network of hospitals, and in some cases doctors in order to be eligible for full benefits
Medicare select
125
A program that offers a prescription drug benefit to health, Medicare beneficiaries pay for the drugs they need. This benefit is optional
Medicare part D
126
Insurance which refers to the broad range of medical and professional services for individuals, often the elderly, who need assistance with daily activities for an extended period of time
Long-term care insurance
127
Daily nursing care ordered by a doctor; often medically necessary. It can only be performed by or under the supervision of skilled medical professionals, and is available hours a day.
Skilled nursing care
128
The level of health or medical care, given to meet daily personal needs, such as dressing, bathing and getting out of bed. Though it does not require medical training, it must be administered under a physicians order.
Custodial care
129
Skilled or unskilled care, provided in an individuals home, usually on a part-time basis
Home health care
130
A type of care (usually custodial) designed for individuals who require assistance with various activities of daily living, while their primary caregivers are absent. Offered in care centers.
Adult daycare
131
A type of health or medical care designed to provide a short rest. For a caregiver. Characterized by its temporary status.
Respite care
132
All Medicare supplement plans, cover coinsurance on hospital cost, up to an additional 365 days after Medicare part A hospital benefits run out
Core benefits
133
Programs which are federally, supported, state operated initiative that allows individuals who purchase a qualifying, long term, care, insurance, policy, or coverage to protect a portion of their assets that they were typically need to spend down prior to qualifying for Medicaid coverage
Long-term care partnership programs
134
Designed to provide a benefit for elderly individuals who live in a continuing care retirement community
Continuing care
135
States the insurance policy itself, any riders and endorsements/amendments, and the application comprise the entire contract between all parties. Insurance producers cannot make changes to a policy.
The entire contract
136
States the policy is incontestable after it has been in force a certain period of time, usually two years. This is similar to the incontestable clause.
The time limit on certain defenses
137
A period after the due date of a premium, during which the policy it remains in force without penalty
Grace Period
138
Putting elapsed policy back-and-forth by producing satisfactory evidence of insurability and paying any past due premiums required
Reinstatement
139
A policy provision that describes the policy owners obligation to provide notification of a claim to the insurer within a reasonable period of time
Notice of claim
140
Specifies the formal request to an insurance company asking for a payment based on the terms of the insurance policy
The claim forms provision
141
A mandatory health insurance provision, stating that the insured must provide a completed claim form to the insurer within days of the date of loss
Proof of loss
142
A provision that requires claims be paid immediately or within a stated number of days.
Time of payment of claims
143
In an insurance contract, specifies, how and to whom claim payments are made
The payment of claims provision
144
A standard health insurance policy provision, allowing the insurer to examine the insured. When I claim is pending, and in the event of death perform an autopsy, where not prohibited by law.
The physical exam and autopsy provisions
145
A provision which states the insured cannot take legal action against the company and a claim dispute, until after 60 days from the time the insured submits proof of loss.
The legal actions provisions
146
A provision that permits, the insured to change the beneficiary as often as he, or she wishes, except in policies where the beneficiary is irrevocable
Change of beneficiary
147
The provision which allows the insurer to reduce the maximum benefit, payable under the policy if the insured switches to a more hazardous occupation, order to reduce the premium rate, charged if the insured changes to a less hazardous occupation
Change of occupation provision
148
The provision which allows the insurer to adjust the policy benefit if the insured’s age or sex is misstated on the policy application
The misstatement of age or sex provision
149
The provision which states that the total amount of coverage to be under written by a company for one person, is restricted to a specified maximum amount, regardless of the number of policies issued
The other insurance in this insurer provision
150
The provision which states that benefits payable for expenses incurred, will be prorated in cases where the company excepted the risk without being notified of other existing coverage for the same risk
The insurance with other insurers provision
151
The provision which outlines that if disability income benefits from all disability income policy is for the same law succeed, the insured’s monthly earnings at the time of disability. This provision states that the insurer is liable only for that proportionate amount of benefits as the insured’s earnings bear to the total benefits under all such coverage
The relation of earnings provision
152
The provision which states if there is an unpaid premium at the time of claim, becomes payable, the amount of the premium is to be deducted from the sum, payable to the insured or beneficiary. It’s a provision that permits unpaid premiums to be taken from claim payments.
The unpaid premiums provision
153
The provision which simply states that any provision of this policy that is in conflict with state statutes in the state, where the insured lives at the time the policy is issued is automatically amended to conform with the minimum statutory requirements
Conformity with state statutes provision
154
A clause that states the insured is not covered for losses that arise if he or she tries to commit a felony. Coverage is also voided if the insured is working at an illegal occupation.
The illegal occupation clause
155
A provision that states the policy is not liable for losses that occur as a result of the policyholder, being intoxicated, or taking a narcotic without a physician, supervision and recommendation
The intoxicants and narcotics provision
156
Insurance contracts that may be terminated by the company or that is renewable at its option
Cancelable policies
157
Provisions found in whole life policies and some long-term care policies. These policies must begin to build cash value after certain number of years. In most states this is three years.
Policy loan or cash value provisions
158
The provision which allows the insurer to automatically use the cash policy value to pay an overdue premium. There is no cost for this provision.
Automatic premium loans
159
Features of an insurance policy, stating that the policy will not cover certain risks.
Exclusions
160
The clause that states the policy will be voided and no benefit will be paid if the insured commits suicide within two years from policy issuance
Suicide clause
161
The options you have for your cash value if you terminate a policy that has cash value.
Nonforfeiture options
162
The option which permits the policy owner to use the policies, cash value to buy level, extended term insurance for a specified period.
Extended term option
163
The option where the policy owner pays no more premiums, but the face amount is decreased
Reduced paid up option
164
The options a policy owner has when receiving dividend payments from an insurance policy
Dividend options
165
A rider which allows the policy owner to waive premium payments during a disability, and keeps the policy in force. It does not provide cash payments to the policy owner. The disability must be total and permanent, and have sustained through the waiting period
The waiver of premium rider
166
The writer which ensures that premiums will be waived, if the individual paying the premiums on a juvenile life policy, becomes disabled or dies
The payor rider (or Payor Clause)
167
The rider which allows the insured to receive a portion of the death benefit prior to death if the insured has a terminal illness, and is expected to die within one to two years
Accelerated benefit rider
168
The rider which permits the policy owner to buy additional permanent license Sherance coverage at specific points of time in the future, without submitting proof of insurability. Usually the benefit is allowed every three years.
The guaranteed insurability rider
169
The rider which pays the total amount of premiums paid into the policy, in addition to the face value as long as the insured dies within a certain time period specified in the policy
The return of premium rider
170
The rider which provides for the payments of additional income, when the insured is eligible for social insurance benefits, but those benefits have not yet begun, have been denied, or have begun in an amount less than the benefit amount of the rider
The Social Security rider
171
This is built into the most commercial health policies, and let’s owners assigned benefit payments from the insurer directly to the healthcare provider, thus relieving the policy owner of first, having to pay the medical care provider
The right of assignment
172
The clause which prohibits the insurer from questioning the validity of the contract after a certain period of time has elapsed
Incontestable clause
173
The right to transfer a policy rights to another person or entity
The assignment clause
174
When they assign, he receives full control of the policy and rights to the policy benefits from the current policy owner
Absolute assignment
175
The partial and temporary transfer of rights to another person or entity. These assignments are usually intended for securing a loan with a creditor.
Collateral assignment
176
States the policy owner is permitted a certain number of days once the policy is delivered to look over the policy and return it for a refund of all premiums paid
The free look
177
The clause, which is the insurer’s basic promise to pay specified benefits to a designated person, in the event of a covered loss. States the scope and limits of coverage “we insure you for…”
The insuring clause / insuring agreement
178
The clause which states a policy owner, must pay a premium in exchange for the insurers promise to pay benefits. A policy owners consideration consists of completing the application and paying the initial premium.
The consideration clause
179
The 12 mandatory provisions that are required to be part of all health insurance contracts
- Entire contract
- Time limit on certain defenses (incontestable)
- Grace period
- Reinstatement
- Notice of claim
- Claim forms
- Proof of loss
- Time payment of claims
- payment of claims
- Physical examination and autopsy
- legal actions
- Change of beneficiary
180
The 11 optional health provisions that may be part of a health insurance contract
- change of occupation
- Misstatement of age
- Conformity with state statutes
- Other insurance in this insurer
- Insurance with other insurer
- Insurance with the other insurers
- Relation of earnings to insurance
- Unpaid premiums
- Cancellation
- Illegal occupation
- Intoxicants and narcotics
181
The tendency of a disproportionate number of poor risks to seek or buy insurance or maintain existing insurance in force.
Adverse selection
182
Hobbies or non-occupational activities
Avocation
183
One of the types of receipts, given by an insurance company upon the completion of an insurance application, when the applicant pays the initial premium with the application
Binding receipt / unconditional receipt
184
A pamphlet that describes an compares various forms of life or health insurance
Buyers guide
185
An insured‘s history of claims or rate of loss.
Claims experience
186
Insurance carriers generally base this on their overall claim experience and healthcare costs in a geographical area
Community rating
187
Insurers issue this kind of receipts when agents collect the initial premium with an application
Conditional receipt
188
This occurs when an insurance carrier gives up all control of a policy and releases at four unconditional delivery to someone acting for the policyholder, including the company’s own agent
Constructive delivery
189
A detailed background investigation them include an interview with coworkers, friends, commas, and neighbors about an applicant character, reputation, lifestyle, etc.
Consumer report
190
The legal description of what happens when an insurer declines a paid application for insurance with a standard rate classification, but is willing to offer a “rated” or substandard policy that will require a higher premium
Counter offer
191
A summary of an insurance applicant credit history made by an independent organization that has investigated an applicants credit standing
Credit report
192
Usually can designate the start of the policies free look period
Delivery receipt
193
A prorated amount of paid in advance premiums allocated to the proportion of the policy term that has already elapsed
Earned premium
194
A receipt which documents the temporary release of a new policy to the perspective policy owner without payment. It allows the prospective insured to review the contract before actually buying it.
Inspection receipt
195
A report that contains general information regarding the health habits, finances and reputation of an applicant. This report is developed by affirm that specializes in rendering this type of service.
Inspection report
196
Describes the financial or emotional relationship between two or more parties. Exist in health insurance. If the applicant is in a position to suffer a loss show to the insured and Curt medical expenses, or be unable to work due to a disability.
Insurable interest
197
The dates, the insurance company finishes underwriting, a risk exposure and generates the insurance contract
Issue date
198
Hey service organization that collects medical data on life and health insurance applicants for member insurance companies
Medical information bureau
199
Describes the basic benefits, conditions, and other terms of an insurance policy, without using industry jargon
Outline of coverage
200
The person responsible for paying the policy
Payor
201
Funds set aside to pay future claims. Some state statutes require them.
Reserves
202
Describes the underwriting category into which a risk exposure is placed, depending upon the applicants susceptibility to injury, illness, or death
Risk classification
203
Describes an applicant who cannot qualify for a standard policy. They secure one with a rider waiving the payment for a loss involving certain existing health impairments.
Special class
204
An application submitted without the initial premium
Trial application
205
A prorated amount of paid in advance premiums that have not been “and” by the insurer
Unearned premium
