FLORIDA HEALTH INSURANCE EXAM
Questions and Answers
1.An unplanned, unforeseen event which occurs suddenly and at an
unspec- ified place
Answer Accident
2.A type of insurance that protects the insured against loss due to
accidental bodily injury
Answer Accident Insurance
3.Unplanned, unforeseen traumatic injury to the body
Answer Accidental Bodily Injury
4.An insurance policy which pays a specified amount or a specified
multiple of the insured's benefit if the insured dies, loses his/her sight, or
loses two limbs due to an accident
Answer Accidental Death and Dismemberment
5.A policy rider that states that the cause of death will be analyzed to deter-
mine if it complies with the policy description of accidental death
Answer Accidental Death Benefits
6.Activities individuals must do every day such as moving about,
1/
19
,getting dressed, eating, bathing, etc.
Answer Activities of Daily Living
7.The amount a physician or supplier actually bills for a particular service
or supply
Answer Actual Charge
8.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
Answer Adhesion
9.An insurance company authorized and licensed to transact insurance in a
particular state
Answer Admitted (Authorized) Insurer
10.A program for impaired adults that attempts to meet their health,
social, and functional needs in a setting away from their homes
Answer Adult Day Care
11.The tendency of risks with higher probability of loss to purchase and
maintain insurance more often than the risks who present lower probability
Answer - Adverse Selection
12.An individual who is licensed to sell, negotiate, or effect insurance
2/
19
, con- tracts on behalf of the insurer
Answer Agent
13.A contract in which participating parties exchange unequal amounts. In-
surance contracts are this 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
Answer Aleatory
14.An insurance company that is incorporated outside the USA
Answer Alien Insurer
15.The appearance or the assumption of authority based on the actions,
words, or deeds of the principal or because of circumstances the
principal created
Answer Apparent Authority
16.The amount Medicare determines to be reasonable for a service that
is covered under Part B of Medicare
Answer Approved Amount
17.A claim to a provider or medical supplier to receive payments directly
from Medicare
Answer Assignment
18.The age of the insured at a determined date
3/
19
Questions and Answers
1.An unplanned, unforeseen event which occurs suddenly and at an
unspec- ified place
Answer Accident
2.A type of insurance that protects the insured against loss due to
accidental bodily injury
Answer Accident Insurance
3.Unplanned, unforeseen traumatic injury to the body
Answer Accidental Bodily Injury
4.An insurance policy which pays a specified amount or a specified
multiple of the insured's benefit if the insured dies, loses his/her sight, or
loses two limbs due to an accident
Answer Accidental Death and Dismemberment
5.A policy rider that states that the cause of death will be analyzed to deter-
mine if it complies with the policy description of accidental death
Answer Accidental Death Benefits
6.Activities individuals must do every day such as moving about,
1/
19
,getting dressed, eating, bathing, etc.
Answer Activities of Daily Living
7.The amount a physician or supplier actually bills for a particular service
or supply
Answer Actual Charge
8.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
Answer Adhesion
9.An insurance company authorized and licensed to transact insurance in a
particular state
Answer Admitted (Authorized) Insurer
10.A program for impaired adults that attempts to meet their health,
social, and functional needs in a setting away from their homes
Answer Adult Day Care
11.The tendency of risks with higher probability of loss to purchase and
maintain insurance more often than the risks who present lower probability
Answer - Adverse Selection
12.An individual who is licensed to sell, negotiate, or effect insurance
2/
19
, con- tracts on behalf of the insurer
Answer Agent
13.A contract in which participating parties exchange unequal amounts. In-
surance contracts are this 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
Answer Aleatory
14.An insurance company that is incorporated outside the USA
Answer Alien Insurer
15.The appearance or the assumption of authority based on the actions,
words, or deeds of the principal or because of circumstances the
principal created
Answer Apparent Authority
16.The amount Medicare determines to be reasonable for a service that
is covered under Part B of Medicare
Answer Approved Amount
17.A claim to a provider or medical supplier to receive payments directly
from Medicare
Answer Assignment
18.The age of the insured at a determined date
3/
19
