Exam Terms
Accident - ANSWER ✔✔An unplanned, unforeseen event which
occurs suddenly and at an unspecified place.
Accident Insurance - ANSWER ✔✔A type of insurance that protects
the insured against loss due to accidental bodily injury.
Accidental Bodily Injury - ANSWER ✔✔Unplanned, unforeseen
traumatic injury to the body.
Accidental Death and Dismemberment - ANSWER ✔✔An insurance
policy which pays a specified amount or a specified multiple of the
insured's benefit if the insured dies, loses his or her sight, or loses two
limbs due to an accident.
,Accidental Death Benefits - ANSWER ✔✔A policy rider that states
that the cause of death will be analyzed to determine if it complies
with the policy description of accidental death.
Acquired Immunodeficiency Syndrome (AIDS) - ANSWER ✔✔An
infectious and incurable disease caused by the human
immunodeficiency virus (HIV).
Activities of Daily Living - ANSWER ✔✔Activities individuals must do
every day such as moving about, getting dressed, eating, bathing, etc.
Actual Charge - ANSWER ✔✔The amount a physician or supplier
actually bills for a particular service or supply.
Adhesion - ANSWER ✔✔A contract offered on a "take-it-or-leave-it"
basis by an insurer, in which the insured's only option is to
accept or reject the contract. Any ambiguities in the contract will be
settled in favor of the insured.
Admitted (Authorized) Insurer - ANSWER ✔✔An insurance company
authorized and licensed to transact insurance in a particular state.
Adult Day Care - ANSWER ✔✔A program for impaired adults that
attempts to meet their health, social, and functional needs in a
,setting away from their homes.
Adverse Selection - ANSWER ✔✔The tendency of risks with higher
probability of loss to purchase and maintain insurance more
often than the risks who present lower probability.
Agent - ANSWER ✔✔An individual who is licensed to sell, negotiate,
or effect insurance contracts on behalf of an insurer.
Aleatory - ANSWER ✔✔A contract in which participating parties
exchange unequal amounts. Insurance contracts are aleatory in that the
amount the insured will pay in premiums is unequal to the amount the
insurer will pay in the event of a loss.
Alien Insurer - ANSWER ✔✔An insurance company that is
incorporated outside the United States.
Alzheimer's Disease - ANSWER ✔✔A disease that causes the victim
to become dysfunctional due to degeneration of brain cells and severe
memory loss.
Ancillary - ANSWER ✔✔Additional, miscellaneous services provided
by a hospital, such as x-rays, anesthesia, and lab work, but not hospital
room and board.
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, Apparent Authority - ANSWER ✔✔The appearance or the
assumption of authority based on the actions, words, or deeds of the
principal or because of circumstances the principal created.
Approved Amount - ANSWER ✔✔The amount Medicare determines
to be reasonable for a service that is covered under Part B of
Medicare.
Assignment - ANSWER ✔✔A claim to a provider or medical supplier
to receive payments directly from Medicare.
Attained Age - ANSWER ✔✔The age of the insured at a determined
date.
Attending Physician's Statement (APS) - ANSWER ✔✔A statement
usually obtained from the applicant's doctor.
Avoidance - ANSWER ✔✔A method of dealing with risk (e.g. if a
person wanted to avoid the risk of being killed in an airplane crash,
he/she might choose never to fly in a plane).
Basic Hospital Expense Insurance - ANSWER ✔✔Coverage that
provides benefits for room, board and miscellaneous hospital expenses
for a certain number of days during a hospital stay.