Accident and Health Basics - Disability

The Health Insurance Portability and Accountability Act, HIPAA __________a-All of these are correct statements.b-Is a Federal regulation.c-Deals with the topic of portability which means moving health coverage from one insurer to another without being required to show evidence of insurability.d-requires that the individual had group coverage in force within the past 63 days of applying for the new coverage.

a-All of these are correct statements.HIPAA applies to groups of two or more employees. If the individual signs up for the new group plan or individual plan within 63 days of losing group coverage, and was covered under the old group plan for at least 18 months, the new plan may not reject the application for coverage and cannot exclude coverage for any preexisting conditions.

Individual disability insurance policies must provide that the covered spouse and dependents may continue the coverage under a new policy, __________ , should they cease to be eligible for coverage under the old policy.a-following a physicalb-following a waiting periodc-until the child reaches age 31d-without evidence of insurability

d-without evidence of insurability

Joe has an AD and D policy for $100,000. After being involved in a serious car accident, Joe suffers a heart attack from the trauma and dies. How much will the insurer pay?a-$100,000b-$200,000c-$50,000d-$0

a-$100,000

If a policy is issued with a substandard risk, all of the following are true EXCEPTa-The effective date of coverage is the date the counter offer is signed and the premium is paid.b-The client must accept the counteroffer by signing an acceptance form.c-If it costs more, the client must pay the difference.d-The effective date will still be the application date.

d-The effective date will still be the application date.In order for the contract to be legal, there must be consideration by both parties. The client must have paid a full months premium and signed all the paperwork in exchange for the policy.

Max wants to buy a car but he is worried because of his high-risk occupation. He is concerned that if he becomes disabled he will not be able to cover the car payments to his creditor. What should he purchase?a-A Critical Illness Planb-A Credit Disability Planc-A Hospital Indemnity Pland-A Life Insurance Policy

b-A Credit Disability PlanCredit Disability is a type of group coverage. A master policy is issued to a creditor (the bank) to insure persons who are debtors of the creditor. The creditor is the beneficiary to cover the repayment of a loan in the event the borrower (insured) becomes disabled before the loan has been repaid.

Mr. Smith has a $300,000 AD and D policy. While in the hospital, he loses one of his legs due to diabetes. How much will this policy pay to Mr. Smith?a-$300,000b-$150,000c-$0d-$100,000

c-$0

If the policy issues as requested, the effective date of coverage isa-The issue dateb-The insured's birthdayc-The application dated-The delivery date

c-The application dateThe effective date of coverage (a.k.a. consideration) is the date that the client has paid 1 full month of premium and signed all required documents. If the policy is issued as requested, that is the application date. If the requested policy is met with a counteroffer, that is the delivery date.

Maryann filled out an application for Disability income on January 15. The policy issued with counteroffer on February 8. The policy was delivered, accepted, and any additional premium paid March 9. March 9 isa-Issue dateb-Underwriting datec-Date the agent gets paidd-Effective date

d-Effective dateThe effective date of coverage (a.k.a. consideration) is the date that the client has paid 1 full month of premium and signed all required documents. If the policy is issued as requested, that is the application date. If the requested policy is met with a counteroffer, that is the delivery date.

Under an AD and D policy, the amount paid for the loss of one arm following an accident is known as the __________ sum of the policy.a-capitalb-secondaryc-primaryd-dismemberment

a-capitalThe benefit paid under an AD and D policy for accidental, partial dismemberment, is the capital sum.

The beneficiary of an accidental death and dismemberment policy, AD and D policy, receives $25,000 after the insured is killed in an auto accident. The $25,000 death benefit otherwise could be identified as the __________ of the policy.a-maximum figureb-principal sumc-capital sumd-primary benefit

b-principal sumThe death benefit under an AD and D policy is known as the principal sum.

If an error occurs on the applicationa-A single line should be drawn through the error, and the insured should initial the errorb-A single line should be drawn through the error and the agent should initial the errorc-A single line should be drawn through the error and the insurer should initial the errord-A single line should be drawn through the error and the producer should initial the error

a-A single line should be drawn through the error, and the insured should initial the errorThe application is part of the contract, which is a legal document. All changes MUST be initialed by the client.

Disability income insurance coverage can be written for a maximum of exactlya-2/3 of your gross incomeb-1/2 of your incomec-100% of your incomed-3/4 of your income

a-2/3 of your gross incomeThe benefit is income-tax free as long as the insured pays the premium.

When a policy issues with a counter offer, which of the following is not needed at delivery?a-Statement of continued good health is signed by the ownerb-All are requiredc-Acceptance of the counter offer, signed by the ownerd-any additional premium required

b-All are required

Maggie just died. In which circumstance would an AD and D policy pay a death benefit?a-Maggie lost two legs from a car accident.b-Maggie died due to a heart attack.c-Maggie lost one arm from a car accident.d-Maggie died from an accident while traveling on a common carrier.

d-Maggie died from an accident while traveling on a common carrier.An accidental death and dismemberment policy pays a death benefit if the insured dies due to an accident.The dismemberment coverage of the policy pays for loss of limb, sight or hearing from an accident.

JoAnn has an accidental death and dismemberment policy with a Principal Sum of $300,000. While driving in her car, she has a heart attack causing her car to hit a pole and she dies. The AD and D policy will pay __________.a-$0b-$50,000c-$150,000d-$300,000

a-$0

Long-Term Care can be divided into two broad categoriesa-Skilled Nursing and Custodial Care.b-Skilled Nursing and Attentive Staffing.c-Custodial Care and Janitorial Care.d-Hospital Care and Skilled Nursing.

a-Skilled Nursing and Custodial Care.

An Accidental Death and Dismemberment policy paying twice the principal sum is known as __________.a-double indemnityb-double reimbursementc-double capitald-double consideration

a-double indemnity

Under an AD and D policy, the amount paid for the loss of one arm following an accident is known as the __________ sum of the policy.a-capitalb-primaryc-secondaryd-dismemberment

a-capitalThe benefit paid under an AD and D policy for accidental, partial dismemberment, is the capital sum.

Brandine has an AD and D policy. The Principal Sum pays $100,000 if death is due to any accident. However, Brandine dies on a city bus and the policy pays her beneficiary two times the benefit. This was probably done because she has a __________.a-Multiple Indemnity Riderb-Cost of Living Riderc-Waiver of Premiumd-Capital Sum Rider

a-Multiple Indemnity Rider

Evaluation of the applicant is based on all of the following, EXCEPTa-Ageb-Occupationc-Amount of protection requestedd-The ability to read English

d-The ability to read English

A critical illness plan, also known as a dread disease plana-May be used in place of a Major Medical plan.b-Should be purchased as a supplement plan only. They pay a lump-sum benefit to the insured.c-Pays directly to the healthcare provider.d-Will pay 100% for critical care.

b-Should be purchased as a supplement plan only. They pay a lump-sum benefit to the insured.This is a supplemental plan and does not coordinate with other healthcare policies towards indemnification. It pays in addition to what your other healthcare covers.

If the policy issues as requested, the effective date of coverage isa-The application dateb-The delivery datec-The issue dated-The insured's birthday

a-The application dateThe effective date of coverage (a.k.a. consideration) is the date that the client has paid 1 full month of premium and signed all required documents. If the policy is issued as requested, that is the application date. If the requested policy is met with a counteroffer, that is the delivery date.

All of the following are not true of the MIB, EXCEPTa-The Medical Information Bureau is a for-profit agency supported by insurance companies.b-An application may be denied based solely on the MIB report.c-A report may be run only when the consumer specifically requests one.d-The Medical Information Bureau is a non-profit agency supported by insurance companies.

d-The Medical Information Bureau is a non-profit agency supported by insurance companies.

Maryann filled out an application for Disability income on January 15. The policy issued with counteroffer on February 8. The policy was delivered, accepted, and any additional premium paid March 9. March 9 isa-Date the agent gets paidb-Issue datec-Effective dated-Underwriting date

c-Effective date