Chapter2: Health Insurance Basics

Statements made on the application are considered true to the best of the applicant's knowledge and belief are considered to be:

Representations

The prior medical conditions for which the applicant has received, or should have received, medical advice or treatment within a specified period before the effective date of a policy are called:

Pre-Existing Conditions

Accident and Health Insurance provides coverage for two major categories of perils. They are:

Accidental injury and sickness

During the underwriting process, an underwriter was alerted that the applicant previously failed a medical exam by testing positive for marijuana while applying for a disability income policy 2 years ago. Which of the following sources provides this type

Medical Information Bureau

A medical or physical exam requested by the underwriter to determine insurability:

Is performed by a licensed professional and includes checking vital statistics and routine lab work

Before a policy will be issued, an insurable interest must exist between the owner (applicant) and the

Insured

An applicant for accident and health insurance works two jobs. Which of the jobs will be used to underwrite the policy?

The most hazardous of the two

Policy replacement is the process of:

Cancelling an existing policy and issuing a new policy

Which of the following must be given to consumers under the provisions of the Fair Credit Reporting Act:

Notice of Information Practices

Which of the following would be considered a pre-existing condition?

Diabetes

A producer gathers information about the applicant for the insurer in order to avoid adverse selection. This is considered to be:

Field underwriting

When it comes to health insurance underwriting and HIV/AIDS, which statement is TRUE?

Insurers can refuse to issue a policy based on HIV test results

In the event a policy is delivered by an agent to the insured, and the premium payment is to be collected at the time of this delivery, normally what else must the agent obtain to make the delivery complete?

A statement of good health

An application for health insurance was submitted on November 1 with the initial premium and a conditional receipt was provided. Due to an existing medical condition, the underwriter requesting an Attending Physician Statement, medical exam, and MIB repor

Agent explained the policy coverage, surcharge, and collected the additional premium

The ___________ was created in order to alert insurer home office underwriters of errors, omissions, or misrepresentations made on insurance applications.

MIB