Louisiana Accident/Health Insurance Exam Questions AND
Correct Answers
Accident - ✔✔An unplanned, unforeseen event which occurs suddenly
and at an unspecified place.
Accident Insurance - ✔✔A type of insurance that protects the insured
against loss due to accidental bodily injury.
Accidental Bodily Injury - ✔✔Unplanned, unforeseen traumatic injury
to the body.
Accidental Death and Dismemberment - ✔✔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 - ✔✔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) - ✔✔An infectious and
incurable disease caused by the human immunodeficiency virus (HIV).
,Activities of Daily Living - ✔✔Activities individuals must do every day
such as moving about, getting dressed, eating, bathing, etc.
Actual Charge - ✔✔The amount a physician or supplier actually bills
for a particular service or supply
Adhesion - ✔✔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 - ✔✔An insurance company authorized
and licensed to transact insurance in a particular state.
Adult Day Care - ✔✔A program for impaired adults that attempts to
meet their health, social, and functional needs in a setting away from
their homes.
Adverse Selection - ✔✔The tendency of risks with higher probability
of loss to purchase and maintain insurance more often than the risks
who present lower probability.
Agent - ✔✔An individual who is licensed to sell, negotiate, or effect
insurance contracts on behalf of an insurer.
,Aleatory - ✔✔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 - ✔✔An insurance company that is incorporated outside
the United States.
Alzheimer's Disease - ✔✔A disease that causes the victim to become
dysfunctional due to degeneration of brain cells and severe memory
loss.
Apparent Authority - ✔✔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 - ✔✔The amount Medicare determines to be
reasonable for a service that is covered under Part B of Medicare.
Assignment - ✔✔A claim to a provider or medical supplier to receive
payments directly from Medicare.
Attained Age - ✔✔The age of the insured at a determined date.
, Attending Physician's Statement (APS) - ✔✔A statement usually
obtained from the applicant's doctor.
Avoidance - ✔✔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 - ✔✔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 - ✔✔Coverage for doctor visits, x-
rays, lab tests, and emergency room visits; benefits, however, are
limited to specified dollar amounts.
Beneficiary - ✔✔The person who receives the proceeds from the
policy when the insured dies.
Benefit Period - ✔✔The length of time over which the insurance
benefits will be paid for each illness, disability, or hospital stay.
Birthday Rule - ✔✔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.
Correct Answers
Accident - ✔✔An unplanned, unforeseen event which occurs suddenly
and at an unspecified place.
Accident Insurance - ✔✔A type of insurance that protects the insured
against loss due to accidental bodily injury.
Accidental Bodily Injury - ✔✔Unplanned, unforeseen traumatic injury
to the body.
Accidental Death and Dismemberment - ✔✔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 - ✔✔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) - ✔✔An infectious and
incurable disease caused by the human immunodeficiency virus (HIV).
,Activities of Daily Living - ✔✔Activities individuals must do every day
such as moving about, getting dressed, eating, bathing, etc.
Actual Charge - ✔✔The amount a physician or supplier actually bills
for a particular service or supply
Adhesion - ✔✔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 - ✔✔An insurance company authorized
and licensed to transact insurance in a particular state.
Adult Day Care - ✔✔A program for impaired adults that attempts to
meet their health, social, and functional needs in a setting away from
their homes.
Adverse Selection - ✔✔The tendency of risks with higher probability
of loss to purchase and maintain insurance more often than the risks
who present lower probability.
Agent - ✔✔An individual who is licensed to sell, negotiate, or effect
insurance contracts on behalf of an insurer.
,Aleatory - ✔✔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 - ✔✔An insurance company that is incorporated outside
the United States.
Alzheimer's Disease - ✔✔A disease that causes the victim to become
dysfunctional due to degeneration of brain cells and severe memory
loss.
Apparent Authority - ✔✔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 - ✔✔The amount Medicare determines to be
reasonable for a service that is covered under Part B of Medicare.
Assignment - ✔✔A claim to a provider or medical supplier to receive
payments directly from Medicare.
Attained Age - ✔✔The age of the insured at a determined date.
, Attending Physician's Statement (APS) - ✔✔A statement usually
obtained from the applicant's doctor.
Avoidance - ✔✔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 - ✔✔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 - ✔✔Coverage for doctor visits, x-
rays, lab tests, and emergency room visits; benefits, however, are
limited to specified dollar amounts.
Beneficiary - ✔✔The person who receives the proceeds from the
policy when the insured dies.
Benefit Period - ✔✔The length of time over which the insurance
benefits will be paid for each illness, disability, or hospital stay.
Birthday Rule - ✔✔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.
