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Life & Health Insurance Exam Ch 11 & 12 (Health Insurance Underwriting & North Carolina Statutes Questions and Answers Fully Solved $13.99   Add to cart
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Life & Health Insurance Exam Ch 11 & 12 (Health Insurance Underwriting & North Carolina Statutes Questions and Answers Fully Solved
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  • North Carolina Accident And Health Insurance

Life & Health Insurance Exam Ch 11 & 12 (Health Insurance Underwriting & North Carolina Statutes

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  • October 14, 2024
  • 6
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

Subjects

  • life health insurance exam ch 11 12 health in

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  • North Carolina accident and health insurance
  • North Carolina accident and health insurance

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Life & Health Insurance Exam Ch 11 & 12
(Health Insurance Underwriting & North
Carolina Statutes and Regulations Pertinent
to Accident & Health Insurance)

Ambulatory Surgery - answer Surgery performed on an outpatient basis.

Case Management - answer The professional arrangement and coordination of health
services through assessment, service plan development, and monitoring.

Disability Income Insurance - answerA type of health insurance coverage that provides
for the payment of regular, periodic income should the insured become disabled from
illness or injury.

Mandatory Second Opinion - answerTo control costs, many health policies provide that,
in order to be eligible for benefits, insureds must get a second opinion before receiving
nonlife-threatening surgery.

Medical Cost Management - answerThe process of controlling how policyholders utilize
their policies.

Medical Expense Insurance - answerPays benefits for nonsurgical doctors' fees
commonly rendered in a hospital; sometimes pays for home and office calls.

Precertification - answerThe insurer's approval of an insured's entering a hospital. Many
health policies require precertification as part of an effort to control costs.

Premium Factors - answerMorbidity, interest, and expenses.

Risk Factors - answerPhysical condition, moral hazards, and occupation.

Substandard Risk - answerPerson who is considered an under-average or impaired
insurance risk because of physical condition, family or personal history of disease,
occupation, residence in unhealthy climate or dangerous habits.

Alien company - answerA company incorporated or organized under the laws of any
jurisdiction outside of the United States

, Commissioner - answerThe Commissioner of Insurance of North Carolina or an
authorized designee of the Commissioner

Company or insurance company or insurer - answerIncludes any corporation,
association, partnership, society, order, individual or aggregation of individuals
engaging or proposing or attempting to engage as principals in any kind of insurance
business, including the exchanging of reciprocal or interinsurance contracts between
individuals, partnerships and corporations.
"Company" or "insurance company" or "insurer" does not mean the State of North
Carolina or any county, city, or other political subdivision
of the State of North Carolina.

Department - answerThe Department of Insurance of North Carolina

Domestic company - answerA company incorporated or organized under the laws of
North Carolina

Foreign company - answerA company incorporated or organized under the laws of the
United States or any jurisdiction within the United States other than the State of North
Carolina

NAIC - answerThe National Association of Insurance Commissioners

Person - answerAn individual, partnership, firm, association, corporation, joint-stock
company, trust, any similar entity, or any combination of the foregoing acting in concert

Accident, accidental injury, and accidental means - answerMust be defined to imply
"result" language and may not include words that establish an accidental means test

Agent - answerA person licensed to solicit applications for, or to negotiate a policy of,
insurance. A person not duly licensed who solicits or negotiates a policy of insurance on
behalf of an insurer is an agent, and thereby becomes liable for all the duties,
requirements, liabilities and penalties to which an agent is subject, and the company by
compensating such a person through any of its officers, agents or employees for
soliciting policies of insurance must accept and acknowledge the person as its agent in
such a transaction.

Adjuster - answerAny individual who, for salary, fee, commission, or other
compensation of any nature, investigates or reports to his principal relative to claims
arising under insurance contracts other than life or annuity. An attorney at law who
adjusts insurance losses from time to time incidental to the practice of his profession or
an adjuster of marine losses is not deemed to be an adjuster.

Broker - answerA person who, being a licensed agent, procures insurance for a party
other than himself through a duly authorized agent of an insurer that is licensed to do
business in the State but for which the broker is not authorized to act as agent. A

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