Retrospective rating - Study guides, Class notes & Summaries

What is *retrospective rating plan*? : The retrospective rating plan is based on the insured's actual loss experience during the policy term. The client and insurer agree on a formula under which the ultimate cost of claims will be borne by the insured. Min and Max premium, LO - Explain the difference between ratemaking and the rating process : *Ratemaking* is preformed by actuaries and involves analyzing stats of past claims, estimating cost of settling current outstanding claims, and...

Actual Cash Value - Replacement Cost-Depreciation Actuary - A person who uses complex statistical methods and technology to analyze loss and other data to determine rates and premiums. Brokers - represent policyholders to arrange coverage with syndicates. Legally represents insured. Ceding Company - The primary insurer that initially wrote the insurance. Cession - The amount of insurance ceded to the reinsurer. Claim Adjusting - The process of determining coverage, legal liability and dam...

Property & Casualty - PA – Basics Questions and Answers Rated A+ Property Insurance 2 party contract. Casualty Insurance 3rd party contract. Liability. Insurable Interest Financial someone has in someone or something. Required for coverage. Must exist AT THE TIME OF LOSS. Underwriting Gathers information. Issue policy, decide on rates, fees and credits, may change coverage in order to issue, may reject a policy completely. GOAL = avoid adverse selection. Rates Objective = es...

Property & Casualty - PA - Basics Property Insurance - correct answer 2 party contract. Casualty Insurance - correct answer 3rd party contract. Liability. Insurable Interest - correct answer Financial someone has in someone or something. Required for coverage. Must exist AT THE TIME OF LOSS. Underwriting - correct answer Gathers information. Issue policy, decide on rates, fees and credits, may change coverage in order to issue, may reject a policy completely. GOAL = avoid adverse selec...

Nj property and Casualty Insurance Exam With 100% Correct Answers 2024 Updated Aleatory Contract - Correct Answer-Insurance policy is based upon uncertainty of a loss, equal value is not given by the parties to the contract. Utmost Good Faith - Correct Answer-Parties to the contract rely upon the integrity of one another. Insuring Agreement - Correct Answer-The section of an insurance policy containing the insurer's promise to pay, the description of coverage provided and p...

Basis provision for all real property. In the event of a loss to real property, payment will be made to the insured and the mortgagee as their insurable interest appears. - Standard Mortgage Clause (losspayable clause) An individual who is domiciled and licensed as a resident producer in a state other than Washington. All that is needed is to provide proof to commissioner that the producer is licensed in his/her state of residence and they will wave the licensing attainment requirement. - No...

INSURABLE INTEREST - Answer-an economic interest in a property that must exist at the time of loss (you can insure the equity interest in your own home) UNDERWRITING - Answer-classifies the applicant based upon the underwriting requirements of the insurer; matches the risk presented with the premium charged by the insurer LOSS RATIO - Answer-percentage of claims paid in comparison to total premiums collected during a particular period of time RATES - Answer-set by the insurer at a level...

CEBS GBA2 Terms and Definitions Exam Questions and Answers Bounded Rationality - Answer-When the consumer is functional only up to a certain point after which his/her choices are constrained or bound by limed knowledge and understanding of the available choices. Free Market Basic Assumption - Answer-Rational consumers will make informed decisions about value, quality, and price Moral Hazzard - Answer-Consumer will spend someone else's money different than their own Transparency on c...

PREDICTIVE MODELING - ANSWER-is an analytical review of known data elements to establish a hypothesis related to the future health needs of patients or a population of patients Suspect Logic - ANSWER-Many organizations utilize a method such as this one to uncover diagnoses which are likely present but unreported or unknown Chart Reviews - ANSWER-Analysis of the information identified is used to target retrospective reviews to capture any unreported diagnoses Suspect Logic Factors - ANSW...

CRC EXAM QUESTIONS AND ANSWERS 100% PASS Risk Adjustment Data Element - Correct Answer ️️ -Age, Gende, Socioeconomic status, Disability status, Insurance status(Medicaid, dual-eligible,) Claims data elements such as procedure codes, place of service codes, special patient-specific conditions hospice, ESRD RAF - Correct Answer ️️ -Risk Adjustment Factor Scores Three main types of reviews - Correct Answer ️️ -Retrospective, Concurrent and prospective Retrospective - Correct Ans...