GUARANTEE EXAM - HEALTH INSURANCE

#1. What does the application of contract of adhesion mean? - Answer- Since the Insured does not participate in preparing the contract, any amblguities would be resolved in favor of the Insured Anapplicant for surplus lines authority must do all of the following EXCERT - Answer- Possess a certificate of authority In this state. What is the purpose of the impairment rider in a health insurance policy? - Answer- To exclude coverage for a specific impairment Under the Temporary Disability Law, two periods of disability due to the same cause and separated by not more than 14 days will be considered - Answer- One continuous period of disability, as long as the Insured earned wages during the 14-day period with the same employer before the first period of disablity When can an insured initiate legal action against the insurer? - Answer- 60 days after submitting proof of loss The "stop-loss" feature on a major medical policy is Intended to - Answer- Establish a maximum amount of out-of-pocket expense that an Insured will have to pay for medical expense in a calendar year. An insurance producer dies, and his wife takes over his business temporarily through an agreement with another producer. What is the maximum time that she can do this? - Answer- 180 days Medicare Part B covers all of the following EXCEPT - Answer- Long-term care services. some of an electronically submitted claim cannot be adjudicated due to missing data, the insurer must electronically notify the health care provider within what period - Answer- 7 days of that determination Under the common accident provision, how many deductibles would be paid if five family members covered under the same major medical pollicy are injured in the same accident? - Answer- 1 An elimin