Short Term Insurances

Front 1

Doctrine of Proximate Cause

Back 1

A loss is only covered if and only if a covered peril is the proximate cause of a covered consequence

Front 2

First part of Automobile insurance

Back 2

Third party bodily injury and property damage

Front 3

Second part of Automobile Insurance

Back 3

Medical payments (tort); personal injury protection (no-fault)

Front 4

Third part of Automobile Insurance

Back 4

Unidentified, underinsured, uninsured, motorists protection

Front 5

Fourth part of Automobile Insurance

Back 5

Collision and other than collision

Front 6

What are the 4 things workers can expect from Workers Compensation?

Back 6

1. Medical care benefits

2. Disability income benefits

3. Death benefits

4. Rehabilitation services and benefits

Front 7

What 3 things made it difficult for workers to get compensation for injury/illness prior to the passage of workers comp laws?

Back 7

1. Doctrine of contributory negligence

2. Fellow servant doctrine

Assumption of Risk doctrine

Front 8

What does standard file policy (SFP) cover?

Back 8

Direct loss from fire and lightning, and at least one of the following:

1. Personal coverage

2. Commercial coverage

3. Increased covered perils

4. Increased covered loss

Front 9

What does inland marine insurance cover?

Back 9

1. Domestic shipments

2. Instrumentalities of transportation (bridges, tunnels, etc)

3. Personal property floater risks

Front 10

Liability insurance

Back 10

Low frequency, high severity claims with potentially high litigation costs

Front 11

Liability: claims made basis:

Back 11

Losses covered only if reported during policy period; insurer may offer tail coverage

Front 12

Liability: Occurence:

Back 12

Losses only covered even if reported after policy period

Front 13

When is it common for carriers to build their own provider networks?

Back 13

It’s common for carriers with geographically concentrated insureds

Front 14

When is it common for provider networks to hire their own networks?

Back 14

It’s common for carriers with geographically diverse insureds

Front 15

Comprehensive major medical insurance:

Back 15

Covers small frequent and large infrequent costs and has small deductibles

Front 16

Catastrophic major medical:

Back 16

Covers expenses higher than regular major medical expenses and has very high deductibles

Front 17

Short Term medical:

Back 17

Single limited term, simpler underwriting, lower insurer cost

Front 18

High risk pool plan:

Back 18

Insures people with no insurance due to pre-existing condition

Front 19

Consumer directed plan:

Back 19

High deductible plan + personal spending account

Front 20

Claim Payment P with the coinsurance provision for homeowner’s insurance

Back 20

If I

If I>=cF: [min, I,L]

Front 21

For Homeowner’s Insurance, what does I represent?

Back 21

The insured amount

Front 22

For Homeowner’s Insurance, what does F represent?

Back 22

The full value of the house at the time of loss

Front 23

For Homeowner’s Insurance, what does c represent?

Back 23

The coinsurance provision

Front 24

For homeowner’s insurance, what does L represent?

Back 24

The loss amount before the deductible

Front 25

ACA first provision

Back 25

Individual Mandate

(Must have insurance)

Front 26

ACA second bullet

Back 26

Partially subsidized insurance

Front 27

ACA third provision (EHB)

Back 27

Plans must cover 10 EHB’s

Front 28

ACA fourth mandate (cost sharing)

Back 28

No cost sharing for preventive services

Front 29

ACA 5th provision (metal)

Back 29

Plans must meet AV (actuarial value) metal level

Front 30

ACA provision (MOOP)

Back 30

Plans must set out of pocket limit below government limit

Front 31

ACA provision (exchanges)

Back 31

Plans sold on public exchanges must satisfy certain tests/standards

Front 32

Why are dental policies usually group policies (2 reasons)

Back 32

1.) High Frequency, low severity

2.) Tax Subsidy

Front 33

Induced utilization product design drivers dental

Back 33

Over utilize benefits because insurance coverage is present

Front 34

Accumulated untreated conditions product design drivers dental

Back 34

Ability to postpone treatment until insurance is present

Front 35

Product design drivers dental Anti-Selection

Back 35

Individuals choose dental coverage that benefits them the most

Front 36

Product design drivers dental ACA pediatric dental coverage

Back 36

Pediatric dental coverage is required

Front 37

Standard Fire Policy covers direct loss from what two things?

Back 37

Fire and lightning

Front 38

SFP covers at least one of the following first bullet (starts with a p)

Back 38

Personal coverage

Front 39

SFP covers at least one of the following things second billet. (Starts with a c)

Back 39

Commercial Coverage

Front 40

SFP covers at least one of the following (starts with increased)

Back 40

Increased covered perils

Front 41

SFP covers at least one of the following 4th bullet (starts with increased)

Back 41

Increased covered loss