Insurance 2026 Exam
Questions and Answers |
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Accident - ANSWER ✔✔An unplanned, unforeseen event which
occurs suddenly and at an unspecified place.
Accident Insurance - ANSWER ✔✔A type of insurance that protects
the insured against loss due to accidental bodily injury
Accidental Death and Dismemberment - ANSWER ✔✔An insurance
policy which pays a specified amount or a specified multiple of the
,insured's benefit if the insured dies, loses sight, or loses two limbs due to
an accident
Accidental Death Benefits - ANSWER ✔✔A policy rider that states
that the cause of death will be analyzed to determine if it complies with
the policy description of accidental death
Actual Charge - ANSWER ✔✔The amount a physician or supplier
actually bills for a particular service or supply
Adhesion - ANSWER ✔✔A contract offereed on a take it or leave it
basis by an insurer, in which the insured's only option is to accept or
reject the contract. Any ambiguities in the contract will be settled in favor
of the insured
Admitted (Authorized) Insurer - ANSWER ✔✔An insurance company
authorized and licensed to transact insurance in a paricular state
Adult Day Care - ANSWER ✔✔A program for impaired adults that
attempts to meet their health, social, and functional needs ins a setting
away from their homes
Adverse Selection - ANSWER ✔✔The tendency of risks with higher
probability of loss to purchase and maintain insurance more often than
the risks who present lower probability
,Aleatory - ANSWER ✔✔A contract in which participating parties
exhange unequal amounts. Insurance contracts are aleatory in that the
amount the insured will pay in premiums is unequal to the amount the
insurer will pay in the event of a loss
Alien Insurer - ANSWER ✔✔An insurance company that is
incorporated outside the United States.
Apparent Authority - ANSWER ✔✔The appearance or the
assumption of authority based on the actions, words, or deeds of the
principal or because of circumstances the principal created.
Approved Amount - ANSWER ✔✔The amount Medicare determines
to be reasonable for a service that is covered under part B of Medicare.
Assignment - ANSWER ✔✔A claim to a provider or medical supplier
to receive payments directly from Medicare
Attained Age - ANSWER ✔✔The age of the insured at a determined
date.
Attending Physician's Statement (APS) - ANSWER ✔✔A statement
usually obtained from the applicant's doctor.
Avoidance - ANSWER ✔✔A method of dealing with risk by
deliberately keeping away from it (e.g. if a person wanted to avoid the
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, risk of being killed in an airplane crash, he/she might choose never to fly
in a plane).
Basic Hospital Expense Insurance - ANSWER ✔✔Coverage that
provides benefits for room, board and miscellaneous hospital expenses
for a certain number of days during a hospital stay.
Basic Medical Expense Insurance - ANSWER ✔✔Coverage for
doctor visits, x-rays, lab tests, and emergency room visits; benefits,
however, are limited to specified dollar amounts.
beneficiary - ANSWER ✔✔The person who receives the proceeds
from the policy when the insured dies
Benefit Period - ANSWER ✔✔Length of time during which benefits
are paid
Birthday rule - ANSWER ✔✔The method of determining primary
coverage for a dependent child, under which the plan of the parent
whose birthday occurs first in the calendar year is designated as primary.
Blanket Medical Insurance - ANSWER ✔✔A policy that provides
benefits for all medical costs, including doctor visits, hospitalization, and
drugs.