FLORIDA HEALTH INSURANCE EXAM
CORRECT 100%
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
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 the insurer
, Aleatory - ANSWER A contract in which participating parties exchange unequal
amounts. Insurance 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
Alien Insurer - ANSWER An insurance company that is incorporated outside the USA
Carriers - ANSWER Organizations that process claims and pay benefits in an insurance
policy
Cease and Desist Order - ANSWER A demand of a person to stop committing an action
that is in violation of a provision
Certificate of Authority - ANSWER A document that authorizes a company to start
conducting business and specifies the kind(s) of insurance a company can transact. It is
illegal for an insurance company to transact insurance without this certificate
Certificate of Insurance - ANSWER A written document that indicates that an insurance
policy has been issued, and that states both the amounts and types of insurance
provided
Claim - ANSWER A request for payment of the benefits provided by an insurance
contract
Coercion - ANSWER An unfair trade practice in which an insurer uses physical or
mental force to persuade an applicant to buy insurance
Coinsurance - ANSWER An agreement between an insurer and insured in which both
parties are expected to pay a certain portion of the potential loss and other expenses
Coinsurance Clause - ANSWER A provision that states that the insurer and the insured
will share the losses covered by the policy in a proportion agreed upon in advance
Commissioner - ANSWER The chief executive and administrative officer of the
Insurance Department
Comprehensive Policy - ANSWER A plan that provides a package of health care
services, including preventative care, routine physicals, immunization, outpatient
services and hospitalization
Comprehensive Major Medical - ANSWER A combination of basic coverage and major
medical coverage that features low deductibles, high maximum benefits, and
coinsurance
Concealment - ANSWER The withholding of known facts which, if material, can void a
contract
CORRECT 100%
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
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 the insurer
, Aleatory - ANSWER A contract in which participating parties exchange unequal
amounts. Insurance 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
Alien Insurer - ANSWER An insurance company that is incorporated outside the USA
Carriers - ANSWER Organizations that process claims and pay benefits in an insurance
policy
Cease and Desist Order - ANSWER A demand of a person to stop committing an action
that is in violation of a provision
Certificate of Authority - ANSWER A document that authorizes a company to start
conducting business and specifies the kind(s) of insurance a company can transact. It is
illegal for an insurance company to transact insurance without this certificate
Certificate of Insurance - ANSWER A written document that indicates that an insurance
policy has been issued, and that states both the amounts and types of insurance
provided
Claim - ANSWER A request for payment of the benefits provided by an insurance
contract
Coercion - ANSWER An unfair trade practice in which an insurer uses physical or
mental force to persuade an applicant to buy insurance
Coinsurance - ANSWER An agreement between an insurer and insured in which both
parties are expected to pay a certain portion of the potential loss and other expenses
Coinsurance Clause - ANSWER A provision that states that the insurer and the insured
will share the losses covered by the policy in a proportion agreed upon in advance
Commissioner - ANSWER The chief executive and administrative officer of the
Insurance Department
Comprehensive Policy - ANSWER A plan that provides a package of health care
services, including preventative care, routine physicals, immunization, outpatient
services and hospitalization
Comprehensive Major Medical - ANSWER A combination of basic coverage and major
medical coverage that features low deductibles, high maximum benefits, and
coinsurance
Concealment - ANSWER The withholding of known facts which, if material, can void a
contract
