WEST VIRGINIA HEALTH INSURANCE EXAM
Absolute - ANSWER An assignment that occurs when the policy owner assigns all
rights including cash values to another person or entity. Synonymous with voluntary
assignment.
Absolute Value - ANSWER A medical expense plan that pays a fixed maximum
dollar amount for a procedure.
Accelerated Benefit Rider - ANSWER Life insurance rider which allows the insured
to receive a portion of the death benefit prior to death if the insured has a terminal
illness.
Accidental Bodily Injury - ANSWER Definition of accident in which the injury is
unintentional and unexpected. Policies using this definition cover all injuries except
self-inflicted injuries.
Accidental Death and Dismemberment (AD&D) - ANSWER Standalone accident-
only policy which only pays benefits if an insured dies or has a dismembered body
part as a result of an accident.
Accidental Death and Dismemberment (AD&D) Rider - ANSWER Pays a lump-sum
benefit for death, loss of limbs, or blindness. Identical to the standalone AD&D
policy.
Accidental Death and Dismemberment Rider - ANSWER Life insurance rider which
pays an additional amount for dismemberment or death caused by an accident.
Accidental Death Benefit - ANSWER Life insurance rider which pays an additional
sum, termed the principal sum, to the beneficiary if the insured dies due to an
accident. Also applies to accidental death and dismemberment policies in which the
policy will pay double or triple the benefit based on dismemberment or death.
Synonymous with multiple indemnity rider.
Accidental Injury - ANSWER An unforeseen and unintentional bodily injury resulting
from an accident.
Accidental Means - ANSWER Restrictive definition of accident in which the cause of
the accident must be unintentional and unexpected.
Accumulation at Interest - ANSWER Dividend option in which the insurer retains the
dividend to be invested.
Accumulation Period - ANSWER The pay-in period of an annuity during which the
contract owner pays premiums. Synonymous with accumulation phase.
Accumulation Phase - ANSWER The pay-in period of an annuity during which the
contract owner pays premiums. Synonymous with accumulation period.
, Accumulation Units - ANSWER A variable annuity contract owner's interest in the
separate account prior to annuitization.
Activities of Daily Living (ADLs) - ANSWER Functions of everyday life allowing an
individual to maintain independence. ADLs include bathing, dressing, eating,
mobility, transferring, personal hygiene, toileting, and continence.
Actual Charge - ANSWER A physician's or medical provider's actual bill for services
rendered (Medicare).
Actuaries - ANSWER Mathematicians employed by insurers to collect and analyze
risk data.
Additional Monthly Benefit (AMB) - ANSWER Disability income policy rider that pays
disability income benefits during the Social Security waiting period.
Adjustable Life - ANSWER Mix of whole and term insurance. The policyowner can
modify the premium, face amount, coverage period, and premium-paying period.
Adjusters - ANSWER investigate losses and determine payment of claims
Administrative Services Only - ANSWER In group health insurance, a group policy
is self-funded and the insurer is subcontracted only to process claims.
Admitted Insurers - ANSWER Insurers authorized to transact insurance by holding a
certificate of authority in a particular state, district or commonwealth
Adult Day Care - ANSWER Care provided to an individual who does not need 24-
hour care. Adult day care may be provided in the home or at an adult day care
facility.
Advance Beneficiary Notice - ANSWER Provided to individuals by their medical
providers stating which medical services Medicare will not or probably will not cover.
Adverse Selection - ANSWER Tendency for poorer than average risks to seek
insurance
Age Discrimination in Employment Act (ADEA) - ANSWER Legislation enacted to
prevent discrimination of employees age 40 or older.
Agency - ANSWER Insurance distribution system that uses producers to transact
insurance.
Agent Report - ANSWER Part III of the application, also referred to as the
producer's report. The agent report is used to underwrite coverage, but does not
become part of the policy.
Agents - ANSWER Insurance producers who represent the insurer, not the insured.
Absolute - ANSWER An assignment that occurs when the policy owner assigns all
rights including cash values to another person or entity. Synonymous with voluntary
assignment.
Absolute Value - ANSWER A medical expense plan that pays a fixed maximum
dollar amount for a procedure.
Accelerated Benefit Rider - ANSWER Life insurance rider which allows the insured
to receive a portion of the death benefit prior to death if the insured has a terminal
illness.
Accidental Bodily Injury - ANSWER Definition of accident in which the injury is
unintentional and unexpected. Policies using this definition cover all injuries except
self-inflicted injuries.
Accidental Death and Dismemberment (AD&D) - ANSWER Standalone accident-
only policy which only pays benefits if an insured dies or has a dismembered body
part as a result of an accident.
Accidental Death and Dismemberment (AD&D) Rider - ANSWER Pays a lump-sum
benefit for death, loss of limbs, or blindness. Identical to the standalone AD&D
policy.
Accidental Death and Dismemberment Rider - ANSWER Life insurance rider which
pays an additional amount for dismemberment or death caused by an accident.
Accidental Death Benefit - ANSWER Life insurance rider which pays an additional
sum, termed the principal sum, to the beneficiary if the insured dies due to an
accident. Also applies to accidental death and dismemberment policies in which the
policy will pay double or triple the benefit based on dismemberment or death.
Synonymous with multiple indemnity rider.
Accidental Injury - ANSWER An unforeseen and unintentional bodily injury resulting
from an accident.
Accidental Means - ANSWER Restrictive definition of accident in which the cause of
the accident must be unintentional and unexpected.
Accumulation at Interest - ANSWER Dividend option in which the insurer retains the
dividend to be invested.
Accumulation Period - ANSWER The pay-in period of an annuity during which the
contract owner pays premiums. Synonymous with accumulation phase.
Accumulation Phase - ANSWER The pay-in period of an annuity during which the
contract owner pays premiums. Synonymous with accumulation period.
, Accumulation Units - ANSWER A variable annuity contract owner's interest in the
separate account prior to annuitization.
Activities of Daily Living (ADLs) - ANSWER Functions of everyday life allowing an
individual to maintain independence. ADLs include bathing, dressing, eating,
mobility, transferring, personal hygiene, toileting, and continence.
Actual Charge - ANSWER A physician's or medical provider's actual bill for services
rendered (Medicare).
Actuaries - ANSWER Mathematicians employed by insurers to collect and analyze
risk data.
Additional Monthly Benefit (AMB) - ANSWER Disability income policy rider that pays
disability income benefits during the Social Security waiting period.
Adjustable Life - ANSWER Mix of whole and term insurance. The policyowner can
modify the premium, face amount, coverage period, and premium-paying period.
Adjusters - ANSWER investigate losses and determine payment of claims
Administrative Services Only - ANSWER In group health insurance, a group policy
is self-funded and the insurer is subcontracted only to process claims.
Admitted Insurers - ANSWER Insurers authorized to transact insurance by holding a
certificate of authority in a particular state, district or commonwealth
Adult Day Care - ANSWER Care provided to an individual who does not need 24-
hour care. Adult day care may be provided in the home or at an adult day care
facility.
Advance Beneficiary Notice - ANSWER Provided to individuals by their medical
providers stating which medical services Medicare will not or probably will not cover.
Adverse Selection - ANSWER Tendency for poorer than average risks to seek
insurance
Age Discrimination in Employment Act (ADEA) - ANSWER Legislation enacted to
prevent discrimination of employees age 40 or older.
Agency - ANSWER Insurance distribution system that uses producers to transact
insurance.
Agent Report - ANSWER Part III of the application, also referred to as the
producer's report. The agent report is used to underwrite coverage, but does not
become part of the policy.
Agents - ANSWER Insurance producers who represent the insurer, not the insured.
