Louisiana Accident Health Insurance Exam Questions and Complete Solutions
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/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.
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.
Basic Medical Expense Insurance - Answer: Coverage for doctor visits, x-rays, lab tests, and emergency room visits; benefits, however, are limited to specified dollar amounts.
Beneficiary - Answer: The person who receives the proceeds from the policy when the insured dies.
Benefit Period - Answer: The length of time over which the insurance benefits will be paid for each illness, disability, or hospital stay.
Birthday Rule - Answer: The method of determining primary coverage for a dependent child, under which the plan of the parent whose birthday occurs first in the calendar year, is designated as primary.
Blanket Medical Insurance - Answer: A policy that provides benefits for all medical costs, including doctor visits, hospitalization, and drugs.
Boycott - Answer: An unfair trade practice in which one person refuses to do business with another until he or she agrees to certain conditions.
Buyer's Guide - Answer: A booklet that describes insurance policies and concepts, and provides general information to help an applicant make an informed decision.
Cafeteria Plan - Answer: A selection of health care benefits from which an employee may choose the one that he/she needs.
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/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.
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.
Basic Medical Expense Insurance - Answer: Coverage for doctor visits, x-rays, lab tests, and emergency room visits; benefits, however, are limited to specified dollar amounts.
Beneficiary - Answer: The person who receives the proceeds from the policy when the insured dies.
Benefit Period - Answer: The length of time over which the insurance benefits will be paid for each illness, disability, or hospital stay.
Birthday Rule - Answer: The method of determining primary coverage for a dependent child, under which the plan of the parent whose birthday occurs first in the calendar year, is designated as primary.
Blanket Medical Insurance - Answer: A policy that provides benefits for all medical costs, including doctor visits, hospitalization, and drugs.
Boycott - Answer: An unfair trade practice in which one person refuses to do business with another until he or she agrees to certain conditions.
Buyer's Guide - Answer: A booklet that describes insurance policies and concepts, and provides general information to help an applicant make an informed decision.
Cafeteria Plan - Answer: A selection of health care benefits from which an employee may choose the one that he/she needs.
