Health Insurance certification

The stated amount or percent of liquid assets that an insurer must have on hand that will satisfy future obligations to its policyholders is called: Reserves An insurance applicant MUST be informed of an investigation regarding his/her reputation and character according to the: Fair Credit Reporting Act A nonprofit incorporated society that does not have capital stock and operates for the sole benefit of its members is known as: A fraternal benefit society What I the name...

A medical expense policy that establishes the amount of benefit paid based upon the prevailing charges which fall within the standard range of fees normally charged for a specific procedure by a doctor of similar training and experience in that geographic area is known as Usual, customary and reasonable What provision would prevent an insurance company from paying a reimbursement claim to someone other than the policyowner? Payment of Claims All of the following are true about gr...

Rules of Construction Help to identify and establish the intent of the parties to the contract Utmost good faith Each party is entitled to rely on the representation of the other, and each party should have a reasonable expectation that the other is acting in good faith without attempts to conceal or deceive. Aleatory Contract A contract under which one party's performance is contingent on an uncertain event. property and casualty agent has the power to bind the insurer...

Final Exam: California Life, Accident, and Health Insurance 2023 with complete solution 1. What is considered the most common type of specified disease insurance policy?: Cancer 2. Minimum participation standards exist for a group health insurance plans in order to: Prevent Adverse Selection 3. How does underwriting differ between group life and individual life insur- ance?: Medical questions must be answered on individual life insurance 4. when handling premiums for an insured an agent is a...

What is meant by referring to an insurance policy as a uliteral contract? - Only one party makes a legally enforceable promise When must insurance records of insurance agents and brokers be made available to the insurance commissioner? - At all times Any situation that presents the possibility of a loss is known as... - A loss exposure Which of the following information is not required to be communicated with a life insurance contract? - Personal judgment Directed ration of insurance util...

An amount that must be paid after the basic health policy benefits are exhausted and before the excess coverage becomes effective is: A. Coinsurance B. Corridor deductible C. Extended benefits D. Co-payment - B. Used with a supplemental major medical policy What type of policy would have a corridor deductible? A. Medicare B. Supplemental major medical policy C. Comprehensive major medical policy D. Major medical policies - B What is not a feature of major medical policies? A. Deduct...

Final Exam: California Life, Accident, and Health Insurance 2023 with complete solution 1. What is considered the most common type of specified disease insurance policy?: Cancer 2. Minimum participation standards exist for a group health insurance plans in order to: Prevent Adverse

Which of the following is NOT a form of medical insurance? -Business overhead expense -Surgical expense -Hospital expense -Long term care Business overhead expense (Explanation:Business Overhead Expense insurance is designed to reimburse a business for overhead expenses in the event a business owner becomes disabled. Expenses such as rent, utilities, telephone, equipment, employees' salaries, etc.) All of the following are state or federal government programs that provide health ins...

An organization that transacts insurance only with its own members is a(n): Fraternal The ____________ has the power to issue rules and regulations to help enforce insurance laws. Commissioner, Superintendent, or Director All of the following are essential elements of a legal contract, EXCEPT: Representation Which of the following manufactures and sells insurance coverage in the form of insurance policies or contracts of insurance? Insurance companies The contract...