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“Absolute Assignment - CORRECT ANSWER=> The assignment by the policy owner of all control and rights to a third party. This differs from collateral assignment, which allows all the rights and control to revert to the owner once a loan is paid off" "Accident - CORRECT ANSWER=> A fortuitous event; unforeseen and unintended" "Accidental Death Insurance - CORRECT ANSWER=> A form of health insurance that provides payment if death of the insured results from accident. Accidental death insurance is often combined with dismemberment insurance in a form called accidental death and dismemberment (AD&D)" "Accident and Sickness - CORRECT ANSWER=> Insurance against bodily injury, disability, or death by accident or accidental means, or expense thereof, or against disability or expense resulting from sickness and the insurance relating thereto"
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rights to a third party. This differs from collateral assignment, which allows all the rights and control to revert to the owner once a loan is paid off"
if death of the insured results from accident. Accidental death insurance is often combined with dismemberment insurance in a form called accidental death and dismemberment (AD&D)"
accident or accidental means, or expense thereof, or against disability or expense resulting from sickness and the insurance relating thereto"
accidental means definition, the mishap itself must be accidental. If a person does something to contribute to the accident, the claim would not be paid under this restrictive definition"
insured's lifetime, benefit amounts are fixed when accelerated, and the benefits, when paid, reduces the death benefit"
owner allows dividends to accumulate at interest with the company. Only the interest on the dividends is taxable as income (participating policies only)."
theory to insurance. This person sets expenses, and interest assumptions."
another variation called triple indemnity."
sometimes called and executor."
poorer risks to want insurance more often than standard risks."
effect, or countersign insurance contracts on its behalf."
the Latin idea of "rolling the dice.""
may receive more than paid in. This payment is dependent upon a fortuitous event. For example. a person pays the premium for a term policy for many years and does not die, thus, a claim is never filed."
United States"
rates are figured."
financial asset. 2. An agreement by an insurer to make periodic payments that continue during the survival of the annuitant(s) or for a specified period. Annuities are also accumulations vehicles that function much like savings accounts."
policy"
the insurer and on the basis of which the insurer decides whether to accept the risk, modify the coverage offered, or decline the risk."
those health policies designated as guaranteed renewable, or non-cancelable and guaranteed renewable."
act of the insurance company or insured, effected in accordance with provisions in the contract or by mutual agreement."
accidental dismemberment. It is typically half of the face amount of principal sum."
of the policy owner and that may be expected should the policy be surrendered for cash. Synonymous with cash value."
the coverage in general. Often used with group coverage."
underwriting or rating group into which a particular risk must be placed."
company will share covered losses in agreed proportion."
policy to a bank as collateral to settle the loan balance that may exist at the insured's death. This agreement is temporary."
that pvoides that the primary beneficiary must outlive the insured by a specified period of time in order to receive the proceeds. If not, the contingent beneficiary receives that proceeds. The provision is designed to protect the rights of the contingent beneficiary in the event of simultaneous death of the insured and the primary beneficiary. The time limit is up to 90 days, depending on state law."
that combines the coverage of major medical and basic medical exspenses crontracts into one broad contract that provides coverage for almost all types of medical expense with few internal limits. Usually subject to a corridor deductible for expenses after the first dollar base plan limits are exceeded, and to a co-insurance clause applicable to all or some of the remaining covered expenses."
materially affect an insurance risk or loss."
application, coverage shall be in for from the date of application, provided the insurance company would have issued the coverage on the basis of facts as revealed by the application and other usual sources of underwriting information. A physical does not have to be completed for the company to make this judgment"
insured may renew the contract to a stated date or an advanced age, subject to the right of the insurer to decline renewal only under conditions defined in the contract."
both the insured and the insurer"
health insurance, the consideration is the premium plus the statements in the application."
the insurance protection and the frequency of payment. Also called mode."
primary beneficiary is not alive."
an insurance policy."
premium."
and on the lives of such persons as the agent's relatives and business associates, or employees of a company in which an agent has an interest."
permanent type of coverage without proof of insurability"
that applies between benefits paid by the basic plan and the start of the major medical benefits"
a loan or the balance due if the insured dies or is disabled."
in a high deductible health insurance plan after the individual's personal deductible has already been met."
businesses that employ 50 or more people and do not offer health insurance will pay a tax penalty beginning 2015"
contract. Sometimes called a rider."
health insurance under the affordable care act. the qualified plans must be guarantee issue with a no pre-existing conditions and no lifetime benefit maxiumums"
known right, the waiver cannot be reversed."
covered and for which no benefits."
company."
insured uses the policy's cash value accumulation to purchase single-premium term insurance in an amount equal to the original policy face amount"
at death or when the policy matures."
services costs and has a limited choice of providers."
a fixed amount for an unspecified period of time. Payments continue until the principal and interest depleted."
a regular income for a specified period of time. At the end of the period, all principal and interest have been paid out."
state in which the insurance is written."
advantage of another."
in a given territory."
policy remains in force without penalty, even though the premium due has not been paid."
which the covered person complained during a utilization review, claims payment, handling, or reimbursement, or the contractual relationship with the carrier."
that covers a group of people identified as individuals by reference to their relationship to the entity. A group contract may be life insurance, health insurance, or an annuity."
through membership in a group. The group may not be formed just to buy insurance."
insurance company and provides the funds to pay for claims that the company is unable to pay."
permits the insured to buy addition prescribed amounts of insurance, at prescribed intervals, without evidence of insurablility."
in return for the timely payment of premiums for a substantial period of time. During that period of time, the insurer has no right to make any change in any provision of the contract other than a change in the premium rate for all insureds in the same class."
insuring company. May be physical or moral (health, occupation, dangerous sports, criminality, or immorality)"
disabling sickness or accident or accidental death or dismemberment, or loss of income due to disability."
financial condition enjoyed prior to a loss. The intent is to cover the amount of the actual loss only: the insured should not profit from a loss situation."
individual that covers him, and in certain instances (like health policies), Specified members of the househould"
with premiums collected monthly or more frequently by the agent in person. The grace period for this type of insurance is 28 days. Premiums were traditionally collected at the factory or workplace."
insurance."
the life of another by which there will be a loss if the insured dies. The interest may be based on either a family relationship or economic factor. Insurable interest must exist at the time of application, but not at the time of loss."
agrees, for a consideration, to indemnify or pay a specified amount for losses suffered by the insured."
It is commonly based on age at last birthday, age at next birthday, or age at nearest birthday."
insurance"
identified in the affordable care act and is performing these functions under a grant."
agreement between the insurer and insured."
whom, the insurance company agrees to indemnify for losses, provide benefits, or render service. In prepaid hospital service plans, the insured is called the subscriber."
provide services"
intent and benefits"
insurance proceeds and invests them on behalf of the beneficiary. The beneficiary receives the interest from the investment. The proceeds remain the property of the beneficiary. The proceeds are not taxable but the interest is."
consent, and the irrevocable beneficiary takes over owner-like rights to the policy."
the survivor continuing to receive payments after the first annuitant dies."
both live. On the death of either one, payments stop."
multiple, usually five, of the original face amount when the insured reaches 21."
death or disability would cause the employer financial loss. The insurance is usually owned by the payable to the employer."
homogeneous group. Risks are not usually considered insurable unless the insurer has a large enough base of previous loss experience to be able to accurately predict future losses. It is the law of large numbers that makes accurate predictions of similar risks possible. Mortality tables are based on groups of at least 10,000,000 people"
using he mortality table and a maximum assumed interest rate prescribed by state law."
same level (amount) throughout the life of the policy"
remains constant during the policy period."
because of disability resulting from accidental bodily injury or sickness. The loss of income may be real or presumptive."
premiums earned."
most types of medical expenses incurred up to a high limit, subject to a deductible. Such contracts may contain a percentage participation clause (sometimes called the co-insurance clause) A major medical policy pays expenses both in and out of the hospital"
vary from company to company. Can also refer to rates developed by the application of a recognized rating plan. Often called standard rates."
interest if held to maturity, but if surrendered before maturity could result in a higher or lower payout, depending upon current interest rates."
insurance plan."
important or essential to the underwriter's decision to issue or rate the policy."
Matures at age 100."
premiums paid into it in the first seven years, called the seven-pay test, and once a policy is marked as MEC, it can never be reversed"
by the federal government. Under this plan, various medical expenses will be paid to those who qualify, regardless of age, subject to an income/asset test"
security program. They apply to persons over 65 years of age and certain disabled beneficiaries under the social security disability income program."
insurance or in substantiation of a claim"
for medical, surgical, and hospital expenses. This term is used to include coverage under the names hospital surgical expense insurance and medical insurance."
medical information on risks reported to it by insurance companies that are members of the service. Information is reported to them as a source of underwriting information on applicants."
such as x-rays, drugs, lab fees, ect"
insurance company misrepresenting the risk, terms, coverage, benefits, privileges, or estimated future dividends of any policy, or the health of the insured."
after policy issue, the company can, if the insured is currently alive, adjust the premium amount on future premiums and request payment of the additional premium the policy owner should have paid. If the insured has died, the company can adjust the face amount of the policy to fit the premium that was paid at the correct age before paying the claim."
selected by the policy owner"
loss from peril"
to 120"
benefits are intended to pay off the balance due on a mortgage or meet the payments on a mortgage as they fall due upon or after the death or disability of the insured."
whose governing body is elected by the policy owners. The policy owners share in the success of the company through possible receipt of policy dividends."
the company purchase one-year term insurance with the dividend."
reserves the unrestricted right to terminate coverage at any anniversary or, in some cases, at any premium due date, but does not have the right to terminate coverage between such dates."
whole life"
and perils."
treatment."
matured by death or endowment."
policy dividends and added to the policy's face amount."
insured cannot perform all the duties of his occupation. Partial disability follows a period of total disability."
company. Sometimes called par."
the loss of business continuity caused by the death or disability of a partner."
premiums are waived if the payor of the premium (usually a parent) becomes disabled or dies while the child is still a minor."
and splitting the death benefit equally by the number of beneficiaries."
that beneficiary's heirs will split his share equally."
covered losses in agreed proportions. Also called co-insurance"
recover. When used as a definition of disability in a policy, permanent is presumed after a stated period of time."
which named called, and papers attached thereto and made a part thereof."
first-year acquisition cost rather thatn to amortize it over several years."
insurance cash value as collateral. May be deferred up to six months."
rights in the policy contract. Also called the contract holder."
recommended by, or received from, a provider of health care services, within six months preceding the effective date of coverage of an insured person."
keep a policy in force."
members who pay a flat fee for services, regardless of whether outpatient or hospital treatment is needed."
benefits, if living, when proceeds or benefits are due."
being adjusted in proportion to the exact time the portection has been in force."
policy and the date coverage begins for sickness."
accepts all or part of the risk of loss of the other."
insured's insurability."
expire."
to the best of his knowledge and belief."
outstanding policies and interest on those premiums, will enable the company to meet the future death claims that will arise because of those contracts of insurance."
excludes certain conditions from coverage."
possible. In the area of life insurance, death is certain, but time of death is uncertain."
provide specific types of liability insurance protection for the members, who typically engage in similar activities or businesses."
dismemberment treatments, ancillary expenses, etc. in health policies"
insured, usually not covered."
care services for serving convered persons. These arrangements may preclude or limit any additional charges for the defined services. Blue plans are the best known, but not the only, form of service insurers."
a lump sum."
individual health insurance policy in force according to the provisions of the affordable care act. The penalty amounts will change annually and be based on the income of the individual."
disease. Illness or disease does not include accidental bodily injury. Sickness insurance may provide benefits for loss of time or expense incurred by pregnancy.,"
premium is paid in one payment; it stays in force until death or maturity at the insured's age of 120"
and morals as the usual tabular risks on which the rate is based."
any cash value accumulation or its equivalent must be made available to the policy owner should he stop paying the premiums."
included in every health policy issued. Also called uniform policy provisions or mandatory policy provisions. Created with the cooperation of the NAIC"
rating or special restrictions"
behalf of the insured upon the occurrence of a defined loss"
also knows as healthy start, which is provided to uninsured children under the age of 19, whose families meet certain income poverty guidelines."
delivery and collection of the premium the applicant must complete and sign this form to verify his current health condition"
dividend into shares and owned by the shareholders. Dividends are paid to stockholders and subject to income tax"