Ny Independent General Adjuster Question with correct
answers
2 types of insures offer insurance plans - 1. commercial
insurance companies
2. health and managed care service providers
claims- health insurance - vary from one type of product
to the next
reimbursement vs valued - reimbursement: contracts
base the amount of benefit on the loss that is actually incurred
Valued contracts pay a stipulated sum as set forth in the
contract, w/o regard for actual expenses
Normal reinstatement period - 3 years from the date of
lapse
insurer does not notify the insured of its decisions within how
many days of the date of application for reinstatement, the
policy is automatically reinstated - 45 days
,free-look period (lets policyowners return the policy to the
insurer within a limited time and receive a full refund of all
premiums and fee paid) begins when? - 10 days- when
the policy is delivered to the policyowner
probationary period in health insurance - exclude
coverage if illness-related losses only, accident-related losses
are covered
probationary period in health insurance exist for how long -
its a limited time after a policy is first issued, while the
elimination period is imposed from the moment the policy is
issued
guaranteed renewable policy - medical expense/long-term care
- the insurer guarantees that, during the guaranteed
renewable period, it will cancel the policy, through it does have
the right to increase premiums
dwelling 1 - Fire, lighting and internal explosion and
v&mm
Optional extended windstorm, explosion, riot, aircraft vehicle
smoke volcanic eruption
,principal sum - the benefit payable for accidental death
capital sum - the benefit payable in the event of
accidental dismemberment
hospitalization - not required to be eligible for critical
illness benefit payments
blanket insurance - covers participants only when they
are actively participating in the covered activity
dental indemnity plan - freedom to choose any dentist or
dental care provider
prepaid dental plan - functions much like a health
maintenance organization (HMO), which also operate on a
prepayment-for-service model
Skeletal system - comprised of bones as well as the
tendons, ligaments and cartilage that connect them
, soft tissue injuries - occur when muscles, ligaments or
tendons are damaged, typically from a sprain, strain or overuse
of part of the body
nervous system - includes the brain, spinal cord sensory
organs, and all of the nerves that connect these organs with the
rest of the body
traumatic brain injury - the function of the brain is
disrupted by a blow to the head, while an acquired brain injury
is caused by conditions such as strokes, aneurysms, meningitis,
brain tumors or anoxia
Tachycardia, atherosclerosis and coronary - thrombosis
are medical conditions that affect the heart
Magnetic resonance imaging (MRI) - a test procedure
that uses a strong magnetic field and radio waves to take
detailed pictures of organs, soft tissues, bones, and other
structures inside the body
answers
2 types of insures offer insurance plans - 1. commercial
insurance companies
2. health and managed care service providers
claims- health insurance - vary from one type of product
to the next
reimbursement vs valued - reimbursement: contracts
base the amount of benefit on the loss that is actually incurred
Valued contracts pay a stipulated sum as set forth in the
contract, w/o regard for actual expenses
Normal reinstatement period - 3 years from the date of
lapse
insurer does not notify the insured of its decisions within how
many days of the date of application for reinstatement, the
policy is automatically reinstated - 45 days
,free-look period (lets policyowners return the policy to the
insurer within a limited time and receive a full refund of all
premiums and fee paid) begins when? - 10 days- when
the policy is delivered to the policyowner
probationary period in health insurance - exclude
coverage if illness-related losses only, accident-related losses
are covered
probationary period in health insurance exist for how long -
its a limited time after a policy is first issued, while the
elimination period is imposed from the moment the policy is
issued
guaranteed renewable policy - medical expense/long-term care
- the insurer guarantees that, during the guaranteed
renewable period, it will cancel the policy, through it does have
the right to increase premiums
dwelling 1 - Fire, lighting and internal explosion and
v&mm
Optional extended windstorm, explosion, riot, aircraft vehicle
smoke volcanic eruption
,principal sum - the benefit payable for accidental death
capital sum - the benefit payable in the event of
accidental dismemberment
hospitalization - not required to be eligible for critical
illness benefit payments
blanket insurance - covers participants only when they
are actively participating in the covered activity
dental indemnity plan - freedom to choose any dentist or
dental care provider
prepaid dental plan - functions much like a health
maintenance organization (HMO), which also operate on a
prepayment-for-service model
Skeletal system - comprised of bones as well as the
tendons, ligaments and cartilage that connect them
, soft tissue injuries - occur when muscles, ligaments or
tendons are damaged, typically from a sprain, strain or overuse
of part of the body
nervous system - includes the brain, spinal cord sensory
organs, and all of the nerves that connect these organs with the
rest of the body
traumatic brain injury - the function of the brain is
disrupted by a blow to the head, while an acquired brain injury
is caused by conditions such as strokes, aneurysms, meningitis,
brain tumors or anoxia
Tachycardia, atherosclerosis and coronary - thrombosis
are medical conditions that affect the heart
Magnetic resonance imaging (MRI) - a test procedure
that uses a strong magnetic field and radio waves to take
detailed pictures of organs, soft tissues, bones, and other
structures inside the body
