Card Set Information

2010-07-15 12:07:00
Health exam

Review for ch.3
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  1. Roger writes his company and notifies them that he has become disabled. What provision states that claims must be paid immediately upon written proof of loss?
    Time of Payment claims
  2. Under the mandatory uniform provision Notice of Claim, the first notice of injury or sickness covered under an accident and health policy must contain
    A statement that is sufficiently clear to identify the insured and the nature of the claim.
  3. Which of the following is NOT true regarding uniform mandatory provisions concerning claims?
    An insured must notify the insurer of a claim on forms prescribed by the insurer.
  4. Which renewability provisions are you most likely to see on a travel accident policy?
    Period of time
  5. Ray has an individual major medical policy that requires a coinsurance payment. Ray very rarely visits his physician and would prefer to pay the lowest premiun possible. Which coinsurance arrangement would be best for Ray?
  6. The provision that provides for the sharing of expenses between the insured and the insurance company is
  7. The premium charged for exercising the Guaranteed Insurability Rider is based upon
    Attained age.
  8. What is NOT a feature fo a noncanelable policy?
    The insurer may increase the policy premium annually.
  9. The provisions which prevents the insured from bringing any legal action against the company for at least 60 days after proof of loss in known as
    Legal actions
  10. In a group health policy, a probationary period is intened for people
    who have joined the group after the effective date
  11. A medical expense policy that established the amount of benefit paid based upon the prevailing charges which fall within the standard range of fees normally charged for a specific procedure by a doctor of similar training and experience in that geongraphic area is known as
    usually, customary and reasonable
  12. Jack was treated for hypertension prior to applying for a major medical policy. If Jack incures expenses related to hyertension, the insurer will likely exclude coverate because the hypertension represents a/an
    Pre-Existing condition
  13. What is NOT an exclusion in medical expense insurance policies?
    Chiropractic care
  14. You have a Major Medical policy that calls for a $1,000 deductible and 80/20 participation. If you incur covered medical expenses of $5,000, you would have to pay
    $1,800 (deductible + 20% of the remaining bill of $4,000).
  15. A guaranteed renewable health insurance policy allows the
    Policyholder to renew the policy to a stated age, with the company having the right to increase premiums on the entire class
  16. Which of the following entities has the authority to make changes to an insurance policy?
    Insurer's executive officer.