the insuring clause of a disability policy usually statesthe insuring clause of a disability policy usually states

What organization can help ensure accomplish this, If a court order payment for a lost that was not covered in the policy even if it was clearly worded it would be example of which legal concept, Under affordable care act what Percentage of preventative care must be covered without cost sharing, On a participating insurance policy issued by mutual insurance company dividends paid to policyholder are, Not taxable since IRS treats them as return of portion of premium paid, In the event of loss after a notice of claim is submitted to the insurer who is responsible for providing claim forms into which party, The insuring clause of a disability policy usually states all the following except, What type of care is not covered by Medicare, Which of the following is incorrect concerning taxation of disability income benefits, If paid by individual premiums are tax deductible, Which of the following is considered a presumptive disability under income policy, Which of the following in 80s establish the do not call registry, In optionally renewable policy the insured has which of the following options, Which of the following producers will be required to complete continuing education hours to renew his license, A producer licensed four years ago who holds only one line of authority, Regarding Medicare select policies what are restricted network provisions, How many eligible employees must be included in a contributory plan, If an employee terminates her employment which of the following provisions would allow her to continue health coverage under an individual policy if registered within 30 days, A small business owner is insured under a disability policy that funds a buy sell agreement. -an individual who was previously covered by group health insurance for 6 months is eligible -an individual who has used up COBRA continuation coverage is eligible -an individual who doesn't qualify for Medicare may be eligible -the gap of coverage for eligibility is a period of 63 days or less, an individual who was previously covered by group health insurance for 6 months is eligible (HIPAA requires that the individual have a previous continuous creditable health coverage for at least 18 months) U5, A medical insurance plan in which the health care provider is paid a regular fixed amount for providing care to the insured and does not receive additional amounts of compensation dependent upon the procedure performed is called: -reimbursement plan -fee-for-service plan -prepaid plan -indemnity plan. Ch. If the insured could reasonably Perform another job utilizing similar skills after one month how long would she receive benefits under an own occupation disability plan, Which of the following cases would in any occupation disability income policy pay the benefits, The insured is unable to perform any jobs in the field related to the insureds education and experience, Which of the following hospice expenses would not be covered in a cost containing setting, Which of the following statements regarding conditional receipts is true, When in employee is still employed upon reaching age 65 in eligible for Medicare which of the following is the employees options, Remain on the group health insurance plan in different eligibility for medicare until retirement, What is the amount each position or supplier bills for a particular service or supply, A producer was originally license in April 1 of 2001. Yearly or monthly business of disability evaluation of the services By law and policy clause. This means that the policy includes: -benefit of payment clause -waiver of all payment -waiver of premium feature -return of premium rider, An applicant is considered to be high-risk, but not so much that the insurer wants to deny coverage. Nothing can happen until they get the results. Their answer is considered to be a: Accident and Health Insurance Basics DISABILITY PORTION, B) Making sure all material facts are included in the application. Last March she forgot to mail her premium to the company. A _______ of claim and Proof of loss are the insureds duties. Death due to sickness c. Loss of income due to injury d. The more frequent the mode, the higher the cost of insurance. Warranties are sworn statements of truth, but are not required on insurance applications. -guaranteed renewable -optionally renewable -conditionally renewable -cancellable, Under the uniform required provisions, proof of loss under a health insurance policy normally should be filed within: -60 days of a loss -90 days of a loss -20 days of a loss -30 days of a loss, Under a health insurance policy, benefits, other than death benefits, that have not otherwise been assigned, will be paid to: -beneficiary of the death benefit -the spouse of the insured -the insured -creditors, While a claim is pending, an insurance company may require: -the insured to be examined only once annually -an independent examination only once every 45 days -an independent examination as often as reasonably required -the insured to be examined only within the first 30 days, an independent examination as often as reasonably required U3, Under an individual disability policy, the MINIMUM schedule of time in which claim payments must be made to an insured is: -within 45 days -weekly -biweekly -monthly, In an optionally renewable policy, the insurer has which of the following options? Coverage is mandatory if an employer has one or more employees. These requirements include all of the following except, Mike Armstrong is a producer and wants to operate under the name of the insurance palace. Skip the main content File a claim The insurance company monitors the treatment and progress in order to make sure that everything proceeds according to the insurer's schedule. -attending physician's statement -physician's review -individual medical summary -comprehensive medical history, Which statement regarding insurable risks is NOT correct? -apply for social security benefits -apply for coverage under the same group policy that covers Kevin -convert to an individual insurance policy within 31 days so she won't have to provide evidence of insurability -COBRA, COBRA (dependents of employees are eligible to receive group health insurance under the employees plan. 20 10 15 Which statement is inaccurate regarding the Change of Occupation Provision? Nevertheless, until the adoption of the UN Convention on the Rights of Persons with Disabilities (CRPD), the world's largest minority group was largely excluded from global human rights protection (e.g., UN human rights treaty work), global initiatives (notably the Millennium Development Goals), and national level law and policy programming . The insurer issues the policy, not the producer. In response to a Misstatement of Age or Gender, benefits are adjusted to the correct premium. -5% -7% -10% -15%, 10% (most people who itemize their deductions can claim deductions for unreimbursed medical expenses, those that are not covered by health insurance, that exceed 10% of their adjusted gross income) U8, Premium payments for personally-owned disability income policies are: -not tax deductible -eligible for tax credits -tax deductible -tax deductible to the extent that they exceed 10% of the adjusted gross income of those itemizing deductions, Which of the following determines whether disability insurance benefits are taxed? In exchange for this limitation, the insured is offered a lower premium. -they allow several small employers purchase less expensive insurance together -they make deals with local hospital to provide low cost coverage to the needy -they provide insurance for larger corporations -they provide insurance companies with medical information on applicants, they allow several small employers purchase less expensive insurance together U6, In a noncontributory health insurance plan, what percentage of eligible employees must participate in the plan before the plan can become effective? -only post-hospitalization benefits -full benefits -partial benefits -no benefits, Under the Physical Exam & Autopsy provision, how many times can an insurer have the insured examined, at its own expense, while a claim is pending? They did, however, sign the application. -Part B will pay 80% of covered expenses, subject to Medicare's standards for reasonable charges -it is a voluntary program designed to provide supplementary medical insurance to cover physician services, medical services and supplies not covered under Part A -Part B coverage is provided free of charge when an individual turns age 65 -participants under Part B are responsible for an annual deductible, Part B coverage is provided free of charge when an individual turns age 65 U7, Which of the following programs is made up of 4 parts, where the first part is paid for by FICA, and the second part is financed by premiums and payroll taxes? The producers birthday is on October 17 the producer last renewed her license in 2012 by what date was the producer renew her license again, Insurance policy specifies that it will be $600 for the Specific loss. a) There are no participation requirements for employees. If an employer pays the premium, the employer may deduct the premium as a business expense. Pete Rathburn What Is the Free Look Period? -24-hour care -relief for a major care giver -daily medical care, given by medical personnel -institutional care, Which of the following long-term care benefits would provide coverage for care for functionally impaired adults on a less than 24-hour basis? -termination of employment due to downsizing -termination of employment for stealing -eligibility for coverage under another group plan -eligibility for Medicare, termination of employment due to downsizing U6, Which of the following is true regarding MET's? What type of agent authority does this describe? This means that the policy includes, If authorized to write life and property and casualty insurance how many hours of continuing education are producers required to complete every two years, An individual pies for life policy. -medical-surgical expense plan -basic medical expense plan -Health Maintenance Organization plan -group dental insurance plan, Health Maintenance Organization plan (HMOs provide a package of comprehensive health care services that include routine physicals, immunizations, well baby care, family planning, etc., as well as the treatment of sickness and injury) U5, When an insurer offers services like preadmission testing, second opinions regarding surgery, and preventative care, which term would best apply? Nothing in this chapter shall apply to or affect (1) any policy of workers' compensation insurance or any policy of liability insurance with or without supplementary expense coverage therein; or (2) any policy or contract of reinsurance; or (3) any blanket or group policy of insurance; or (4) life insurance, endowment or annuity contracts, or co. Under the Fair Credit Reporting Act, the producer or company is obligated to inform the client of the name and address of the reporting agency that furnished the report. -disability insurance for the owner -cash to the owner's business partner to accomplish a buyout -the rent money for the building -the business manager's salary, cash to the owner's business partner to accomplish a buyout U4, An insured is involved in an accident that renders him permanently deaf, although he does not sustain any other major injuries. The SIS writer should pay the difference between the rider amount in the actual benefit, The period of time immediately following a disability during which benefits are not payable is, And insurance company whats to obtain the insurance history of an applicant. when insurer may increase the policy premium (on class basis only) on the policy anniversary date; insured has the uni-lateral right to renew the policy for the life of the contract? -AD&D -Disability Buy Out -Medical Expense -Group Disability Income, group disability income (disability benefit payments that are attributed to employee contributions are not taxable, but benefits payments that are attributed to employer contributions are taxable to the employee) U4, Which of the following would best describe total disability? Which of the following options would be best for Nancy at this point? The amount of benefits that an insured receives is determined by the insured's earned income & is usually limited to a certain percentage of that amount) U2, What is the term used for an applicant's written request to an insurer for the company to issue a contract, based on the information provided? -loss of hearing in one ear -loss of one hand or one foot -loss of two limbs -loss of one eye, loss of two limbs (presumptive disability is a provision that is found in most disability income policies that specifies conditions that will automatically qualify the insured for full disability benefits, such as the loss of two limbs) U4, Which statement accurately describes group disability income insurance? Optional provision thats lets the insurer adjust benefits if the insured changes occupations? What type of license should the producer obtain? -to share liability among different insurance companies -to help the insurance company to prevent overutilization of the policy -to have the insured pay premiums to more than one company -to ensure payment to the doctors & hospitals, to help the insurance company to prevent overutilization of the policy U3, Which health insurance provision describes the insured's right to cancel coverage? -it allows the company to obtain an inspection & medical examination on the proposed insured prior to issuing the policy -it allows for the proposed insured to carefully look over the policy before applying for it -it allows the insured to return the policy within 10 days for a full refund of premium if dissatisfied for any reason -it allows the proposed insured to carefully look over the application prior to filling it out, it allows the insured to return the policy within 10 days for a full refund of premium if dissatisfied for any reason U3, An insured is involved in a car accident. However, the premiums can only be increased on a class basis, not on an individual policy), How soon following the occurrence of a covered loss must an insured submit written proof of such loss to the insurance company? whats it called when Insurer cannot cancel or raise premiums beyond amount stated in the policy? What is the insurance company obligated to do? 3. A) Payments of Claims B) Reinstatement At that point her ensure in the SIS benefit. -possible modifications to include expanded coverage -permanent coverage -premiums are not elevated -more medical evaluations are required, Hospital indemnity/hospital confinement indemnity policy will provide payment based on? The insured should have her husband name as what type of beneficiary, As it pertains to group health insurance COBR a stipulates that, Group coverage must be extended for terminated employees up to a certain period of time at the former employees expense, What is the illumination. -18 months -2 years -6 months -1 year, Which of the following is considered a presumptive disability under a disability income policy? Study with Quizlet and memorize flashcards containing terms like The insuring clause of a disability policy usually states all of the following EXCEPT (Choose from the following options) That insurance against loss is provided. What classification do you assume the applicant would receive from his insurer? Actual Policy and copy of the original Application. In addition to general, less serious injuries, he permanently loses the use of his leg and is rendered completely blind. Which type of insurance would help him pay for expenses of company during his time disabled, Which of the following cases would constitute a violation of Louisianas control business statute, Producer B writes group policy covering large hospital where his wife is the comptroller. -an auditor for auditing purposes -a researcher for marketing purposes -the Department of Insurance to assess legal compliance -law enforcement authorities for law-oriented purposes, All of the following are true regarding the Medical Information Bureau (MIB) EXCEPT: -MIB reports are based upon information supplied by doctors & hospitals -MIB information is reported to underwriters in coded form -MIB reports contain previous insurance information -insurers may not refuse to accept an application solely due to information in an MIB report, MIB reports are based upon information supplied by doctors & hospitals (information contained in MIB reports comes from the underwriting disclosures made by applicants to MIB member insurers on prior insurance applications) U2, Which benefits would a disability plan most likely pay? A Stock Life Insurance Company. -the cost the company is paying for monthly premiums -the policy benefits and exclusions -the procedures for filing a claim -the length of coverage, the cost the company is paying for monthly premiums U6, Which statement best defines a Multiple Employer Welfare Arrangement (MEWA)? Although replacement is not unlawful, it can lead to errors and omissions if the producer fails to explain that a new probationary period may apply and that the incontestability clause starts over. -decrease -increase -remain the same -either increase or decrease, Which of the following is NOT a cost-saving service in a medical plan? The Proof of Loss Provision (a Mandatory Uniform Provision) stipulates the insured is to prove their loss within 90 days of the loss, or in the shortest time possible, but not to exceed 1 year unless the insured suffers legal incapacity. What Ryder does the policy most likely have that would cause this, In insurance company ensures its new policy holders that their premium cost will not increase for a period of at least five years. -apparent -express -implied -fiduciary, apparent (the appearance or the assumption of authority based on the actions, words or deeds of the principal or because of circumstances the principal created). D) The contents of an inspection report cannot be disclosed to the applicant. GROUP LONG TERM DISABILITY INSURANCE Policyholder: Washington State Health Care Authority Policy Number: 377661 -B Effective Date: July 1, 1992 and as amended Drawing on a critical disability framework of policy sociology, the paper considers the policy problem of access to education for people with disabilities under recent reform by means of the National Disability Insurance Scheme (NDIS), which commenced full roll-out across the country from July 2016. This paper explores the changing terrain of disability support policy in Australia. A) that a loss must result directly from stated accidents or sicknesses b) the identities of the insurance company and the insured c) the method of premium payment d) that insurance against loss is provided A nonforfeiture option that provides continuing cash value buildup is. Usually the addition of a rider is reflected in an additional charge by the company and may require that the insured provide evidence of insurability. C) First premium has been paid and the application has been approved. -5 days -7 days -10 days -3 days, If an insurer wants to raise its premium rates, the new rates must be submitted to the Commissioner for the review and will take how many days to go into effect?

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