Florida 2-40 health license chapter 1 questions and answers rated A+

Florida 2-40 health license chapter 1 questions and answers rated A+ Health insurance contracts are unilateral. What does that mean? Only one party makes a legally enforceable promise What are the two types of expenses that are covered by health insurance? Expenses related to health care, and expenses that compensate for loss of income Who is responsible for paying the cost of a medical examination required in the process of underwriting? Insurer When must The Outline of Coverage be provided to the insured? No later than policy delivery In health insurance, what is considered a sickness? An illness that first arises while the policy is in force If an agent makes a correction on the application for health insurance, who must initial the correct answer? The applicant What is the purpose of the Outline of Coverage in health insurance? To provide the insured full and fair disclosure about the policy issued What is the term used for a condition for which the insured has received diagnosis, care or treatment during a specified period of time prior to the health policy issue? Pre-existing condition What are the three types of risk rating classifications in health insurance? Standard, substandard and preferred Who must sign a health insurance application? The policyowner, the insured (if different), and the agent In health insurance, the policy itself and the insurance application form what? The entire contract What is the entire contract in health insurance underwriting? The application and the policy issued What report is used to assess risk associated with a health insurance applicant's lifestyle and character? Investigative Consumer Report What is the term used for a written request for an insurer to issue an insurance contract based on the provided information? Application What risk classification would require the highest premium for health insurance policy? Substandard Whose responsibility is it to determine that all the questions on an insurance application are answered? The agent What risk classification would typically qualify for lower premiums? Preferred risk Most health policies will pay the accidental death benefits if the death is caused by an accident and occurs within how many days? 90 days In forming an insurance contract, when does an acceptance usually occur? When the insurer approves a prepaid application How is the information obtained for an investigative consumer report? Through interviews with the applicant's associates, friends and neighbors What type of health insurance would be most appropriate for a group of children in a summer camp? Blanket What do limited health policies cover? A specified accident or disease What characteristics would qualify an applicant for health insurance as a substandard risk? Poor health history or a dangerous occupation or avocation What type of group health insurance is used to provide accident coverage on a group of persons that are participating in a particular activity, when the individual insureds are unknown, and are covered automatically? Blanket If an insurer decides to obtain medical information from different sources in order to determine the insurability of an applicant, who must be notified of the investigation? The applicant In health insurance contracts, the insured is not legally bound to any particular action; however, the insurer is obligated to pay for losses covered by the policy. What contract element does this describe? Unilateral When should an agent obtain a Statement of Good Health from the insured? When the premium was paid upon policy delivery and not at the time of application Health contracts are prepared by insurers and must be accepted by the insured on an 'as is'/"take it or leave it" basis. This describes what aspect of a health insurance contract? Contract of adhesion In medical expense contracts, what is the term that describes the payment method when the insured is responsible for paying the medical expenses, and then the insurer pays directly to the insured? Reimbursement What is adverse selection? People who are more likely to submit insurance claims are seeking insurance more often than preferred risk. If an applicant does not receive his or her insurance policy, who would be held responsible? The agent What type of hospital policy pays a fixed amount each day that the insured is in the hospital? Indemnity How can health insurance policies be delivered to the insured? Personally delivered by the agent or mailed What type of health insurance plans cover all accidents and sicknesses that are not specifically excluded in the policy? Comprehensive plans Who is a field underwriter? Agent/Producer What entity provides underwriters with information concerning an applicant's health history? MIB - Medical Information Bureau If an underwriter requires extensive information about the applicant's medical history, what report will best serve this purpose? Attending Physician's Statement What are the four elements of an insurance contract? Agreement (offer and acceptance), consideration, competent parties, and legal purpose What information are the members of the Medical Information Bureau required to report? Adverse medical information about the applicants of the insured During which stage in the insurance process do insurers evaluate information that identifies adverse selection risk? Underwriting Under a credit disability policy, payments to the creditor will be made for the insurer until what point in time? Until the period of disability ends or until the debt is repaid What is the capital sum in Accidental Death Dismemberment (AD and D) coverage? A percentage of the principal sum What is a warranty in an insurance contract? An absolute true statement upon which the validity of the insurance contract is based During the application process for health insurance, a producer is trying to obtain credible information about the applicant that would help underwriters determine if the risk is insurable. In what role is the producer acting Field underwriter In insurance, when is the offer usually made on a contract? When the insurance application is submitted What are the common exclusions in most health insurance policies? War, self-inflicted injuries, pre-existing conditions, elective cosmetic surgeries, injuries caused by participating in illegal activities, and workers compensation benefits. What entities make up the Medical Information Bureau? Insurers ACCEPTANCE TAKES PLACE WHEN AN INSURER'S UNDERWRITER APPROVES THE APPLICATION AND ISSUES A POLICY CONSIDERATION IS THE BINDING FORCE IN ANY CONTRACT. SOMETHING OF VALUE THAT EACH PARTY GIVES EACH OTHER. COMPETENT PARTIES THE PARTIES TO A CONTRACT MUST BE CAPABLE OF ENTERING INTO A CONTRACT IN THE EYES OF THE LAW. LEGAL PURPOSE THE PURPOSE OF THE CONTRACT MUST BE LEGAL AND NOT AGAINST PUBLIC POLICY. INSURABLE INTEREST IS PROVEN BY LOVE AND AFFECTION, ECONOMIC OR FINANCIAL LOSS WARRANTY IS AN ABSOLUTELY TRUE STATEMENT UPON WHICH THE VALIDITY OF THE INSURANCE POLICY DEPENDS. REPRESENTATIONS ARE STATEMENTS BELIEVED TO BE TRUE TO THE BEST OF ONE'S KNOWLEDGE, BUT ARE NOT GUARANTEED TO BE TRUE. MISREPRESENTATIONS UNTRUE STATEMENTS ON THE APPLICATION. COULD VOID THE CONTRACT. CONDITIONAL CONTRACT REQUIRES THAT CERTAIN CONDITIONS MUST BE MET BY THE POLICY OWNER AND THE COMPANY IN ORDER FOR THE CONTRACT TO BE EXECUTED AND BEFORE EACH PARTY FULFILLS ITS OBLIGATIONS.