PSI practice health and accident Exam
Questions With Verified Answers.
Which oft he following is a characteristic of preferred provider org (PPO)
A: prearranged costs for services rendered
B: providers receive a flat montlyh amount for each user
C: ability to receive care at the same cost from any provider
D: emergency treatment is restricted to pre-select hospitals - answer✔A: prearranged costs for
services rendered
how do most disability policies handle the case of a recurrent disability at least 90 days after the
first claim:
A: it is handled as a continuation of existing claim
B: it is excluded from coverage because the benefits have already been paid out
C: it must be handled as a new claim for a new period of disability, requiring a new elimination
period
D: it must be handles as a new claim for a new period of disability, without requiring a new
elimination period. - answer✔D: it must be handles as a new claim for a new period of disability,
without requiring a new elimination period.
how are issues of amigity usually resolved because insurance contracts are contracts of adhesion:
A: in favor of the insured because the insurance company drafts language in the contract
B: in favor of the insured bec insurance companies often do not adhere to the more specific
contract principles
C: in favor of the insurer because most issues arise from misrepresentation on the part of the
insured
D: in favor of the insurer bec the insured frequently does not adhere to the requirements of the
contract - answer✔C: in favor of the insurer because most issues arise from misrepresentation on
the part of the insured
what is the difference between copayment and coinsurance:
A: a copayment is a set percentage, while coin insurance is a set dollar amount
B: a copayment is a set dollar amount, while coininsurance is a percentage
C: a copayment is an amount of money that must be paid up front anually before benefits begin
D: coin insurance is an amount of money that must be paid up front anually before benefits begin
- answer✔B: a copayment is a set dollar amount, while coininsurance is a percentage
which policy provision permits the policyowner to take a specified number of days to examine
the contract, and all the cancellation and a full refund if the policyowner rejects the terms or
costs:
A: exclusions
B: free look
C: grace period
D: insuring clause - answer✔B: free look
According to the time of payment of claims provision, the insurer must make the payment
immediately after receiving proof of loss EXCEPT:
A: for claims involving periodic payments
B: if the death is a suicide or due to pre existing conditions
C: when the policy is in the incontestability period
D: if the insured is able to eventually return to work - answer✔C: when the policy is in the
incontestability period
A group conversion option may be used in all the following instances EXCEPT
1. the termination of the master policy
2. loss of coverage due to loss of employment.
3. loss of eligibility on the part of a class of insureds.
4. a life-changing event, such as marriage, divorce, or childbirth. - answer✔1. the termination of
the master policy
How do warranties differ from representations?
1. a warranty is guaranteed to be true, a representation is believed to be true to the best of one's
knowledge.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Brainbarter. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.49. You're not tied to anything after your purchase.
