PSI practice health and accident exam
which oft he following is a characteristic of preferred provider org (PPO)
A: prearranged costs for services rendered
B: providers receive a flat montlyh amount for each user
C: ability to receive care at the same cost from any provider
D: emergency treatment is restricted to pre-select hospitals ...ANSWER...A:
prearranged costs for services rendered
how do most disability policies handle the case of a recurrent disability at least 90 days
after the first claim:
A: it is handled as a continuation of existing claim
B: it is excluded from coverage because the benefits have already been paid out
C: it must be handled as a new claim for a new period of disability, requiring a new
elimination period
D: it must be handles as a new claim for a new period of disability, without requiring a
new elimination period. ...ANSWER...D: it must be handles as a new claim for a new
period of disability, without requiring a new elimination period.
how are issues of amigity usually resolved because insurance contracts are contracts of
adhesion:
A: in favor of the insured because the insurance company drafts language in the
contract
B: in favor of the insured bec insurance companies often do not adhere to the more
specific contract principles
C: in favor of the insurer because most issues arise from misrepresentation on the part
of the insured
, D: in favor of the insurer bec the insured frequently does not adhere to the requirements
of the contract ...ANSWER...C: in favor of the insurer because most issues arise from
misrepresentation on the part of the insured
what is the difference between copayment and coinsurance:
A: a copayment is a set percentage, while coin insurance is a set dollar amount
B: a copayment is a set dollar amount, while coininsurance is a percentage
C: a copayment is an amount of money that must be paid up front anually before
benefits begin
D: coin insurance is an amount of money that must be paid up front anually before
benefits begin ...ANSWER...B: a copayment is a set dollar amount, while coininsurance
is a percentage
which policy provision permits the policyowner to take a specified number of days to
examine the contract, and all the cancellation and a full refund if the policyowner rejects
the terms or costs:
A: exclusions
B: free look
C: grace period
D: insuring clause ...ANSWER...B: free look
According to the time of payment of claims provision, the insurer must make the
payment immediately after receiving proof of loss EXCEPT:
A: for claims involving periodic payments
B: if the death is a suicide or due to pre existing conditions
C: when the policy is in the incontestability period
D: if the insured is able to eventually return to work ...ANSWER...C: when the policy is
in the incontestability period
A group conversion option may be used in all the following instances EXCEPT
1. the termination of the master policy
which oft he following is a characteristic of preferred provider org (PPO)
A: prearranged costs for services rendered
B: providers receive a flat montlyh amount for each user
C: ability to receive care at the same cost from any provider
D: emergency treatment is restricted to pre-select hospitals ...ANSWER...A:
prearranged costs for services rendered
how do most disability policies handle the case of a recurrent disability at least 90 days
after the first claim:
A: it is handled as a continuation of existing claim
B: it is excluded from coverage because the benefits have already been paid out
C: it must be handled as a new claim for a new period of disability, requiring a new
elimination period
D: it must be handles as a new claim for a new period of disability, without requiring a
new elimination period. ...ANSWER...D: it must be handles as a new claim for a new
period of disability, without requiring a new elimination period.
how are issues of amigity usually resolved because insurance contracts are contracts of
adhesion:
A: in favor of the insured because the insurance company drafts language in the
contract
B: in favor of the insured bec insurance companies often do not adhere to the more
specific contract principles
C: in favor of the insurer because most issues arise from misrepresentation on the part
of the insured
, D: in favor of the insurer bec the insured frequently does not adhere to the requirements
of the contract ...ANSWER...C: in favor of the insurer because most issues arise from
misrepresentation on the part of the insured
what is the difference between copayment and coinsurance:
A: a copayment is a set percentage, while coin insurance is a set dollar amount
B: a copayment is a set dollar amount, while coininsurance is a percentage
C: a copayment is an amount of money that must be paid up front anually before
benefits begin
D: coin insurance is an amount of money that must be paid up front anually before
benefits begin ...ANSWER...B: a copayment is a set dollar amount, while coininsurance
is a percentage
which policy provision permits the policyowner to take a specified number of days to
examine the contract, and all the cancellation and a full refund if the policyowner rejects
the terms or costs:
A: exclusions
B: free look
C: grace period
D: insuring clause ...ANSWER...B: free look
According to the time of payment of claims provision, the insurer must make the
payment immediately after receiving proof of loss EXCEPT:
A: for claims involving periodic payments
B: if the death is a suicide or due to pre existing conditions
C: when the policy is in the incontestability period
D: if the insured is able to eventually return to work ...ANSWER...C: when the policy is
in the incontestability period
A group conversion option may be used in all the following instances EXCEPT
1. the termination of the master policy
