Slide #9) In health insurance, the rate at which accident, sickness or disability will occur.
_______________________________________________________________________________________________
10)
The unintentional decrease in value of an asset due to a peril.
________________________________________________________________________________________________
11) What Is Risk Pooling or Loss Sharing?
Spreading a risk over a ____________________________, by substituting a _______________________ for a large unknown risk. (economic risk of dying)
Question:
12 )
What do we call the predicting of the approximate number of deaths or the likelihood of disability that will occur among a certain group during a certain period?
_________________________________________________________________________________________________
13)
The item insured in the policy.
_____________________________________________________
14)
What is the definition of RISK?
Uncertainty regarding _______________________________________
15)
What is Speculative Risk?
Speculative Risk involves both the chance of __________________ or _____________________
16)
What is Pure Risk?
Pure Risk has only the __________________ of loss. (injury, illness, and death) Only Pure Risks are insurable
17)
The condition of being prone to loss due to a hazard or uncertain event.
_________________________________________________________________________________________________
18)
3 basic types of Hazards
1. _____________________– blind, family traits
2. _________________– stealing, smoking, habits that increase the probability of loss 3. _________________ – jay walking, careless, the attitudE state of mind (It’s insured
so why worry, whatever!)
19)
6 elements of Insurable Risk that make Pure Risks Insurable: • LOSS MUST BE due to ________________________
• LOSS MUST BE definite and ___________________________
20)
6 elements of insurable risk
• LOSS Exposure to be insured MUST BE ____________________ • LOSS exposure MUST BE _____________________________________
21)
6 elements of insurable risk
• LOSS MUST BE ______________________________ • LOSS CANNOT be ______________________________
22)
What is a Peril?
The immediate specific event that _______________________________
What gives rise to a Peril?
_______________________________________________________
23)
What kind of hazard is it when an employee takes merchandise
without paying for it?
__________________________________________
24) What kind of hazard is it when you are late for an appointment?
______________________________________________________________________________________________
25) The application of laws, regulations, and legal court rulings which increase the chance or amount of loss.
_________________________________________________________________________________________________
26) The total amount the insurer will pay for an insured risk.
_________________________________________________________________________________________________
27)
4 options to handle Risk ARRT
A -‐ _____________________________ (don’t fly) R – _____________________________ (smoke alarm) R – ______________________________(self insured) T – ______________________________ (buys insurance)
28) What is a company called that helps an insurance company transfer a portion of its risk?
_________________________________________________________________________________________________
29)
Stock Company
Purpose is to make a profit for the __________________________________. .
• Structured the same as any corporation. • Pays __________dividends to policyholders.
30) Mutual Company
Owned By? __________________________
Issue Participating or Non Participating Policies
What is paid to the policyholders? _____________________________
31) What is a dividend?
Refund of _____________________________________
(Partial overpayment being returned to policyowner)
32) _________________________________ is also known as
Debit Insurer/Industrial Insurance (small face amounts, cash accepted as premiums, more expensive)
33)
Insurance which offers coverage to people through the individual market. _________________________________________________________________________________________________
34)
The entity that assumes the insured’s risk. Synonymous with insurance company.
_________________________________________________________________________________________________
35) Name 3 examples of Rating Services that demonstrate the financial strength and stability of insurance companies:
1. ____________________________ 2. Standard & Poor’s 3. ____________________________
36)
A Company doing business in the state in which it is incorporated. ___________________________________________________________________
A Company licensed to do business in a state in which it is not incorporated. __________________________________________________________________
37)
What does Alien Insurer mean?
Companies incorporated in a country _____________________________________.
38)
If a company is licensed in the state where it is incorporated, does it need to be licensed in the states where it does business?
________________________
39)
People who sell, solicit and negotiate insurance. It is an all-‐encompassing term which includes agents and brokers.
__________________________________________________
40
Definition: Illegally converting another person’s funds for your own use. _________________________________________________
41)
Who regulates the insurance industry? _______________________________________
42)
An intentional misrepresentation or concealment of material fact made by one party in order to cheat another party out of something that has economic value. ____________________________________
44) Name and Describe the elements needed for contracts to be legally valid and binding?
• L – __________________________
• O -‐ __________________________
• C – __________________________-‐$
• C –__________________________
• A -‐ __________________________
45) Name 3 groups of people who are Not competent to enter a legal contract: • M_________________________
• M_________________________
• Under the influence of _________________________________
46) A medical condition, whether physical or mental, resulting from accident or sickness preventing a person from being able to work.
__________________________________________________
47) This is the person who has all the ownership rights under the policy, pays premiums, and accepts the policy when delivered-‐ synonymous with policyholder. __________________________________________________
_______________________________________
49) What is it called when the values exchanged are not equal?
_______________________________Example= $50 prem./ $100,000 Death Benefit
50) When only one party prepares the contact it is called:
_______________________________=Basically policyower is “stuck” with the contract as it is.
51) _______________________________ is the type of contract that only reimburses or pays the amount of loss.
52)
What is called when information is guaranteed to be true? _____________________________________
53) What is it called when information is believed to be true?
___________________________________________ (statements made by client on application in relation to their health)
54) What is it called when both parties are trusted to reveal relevant facts?
55) What kind of contract pays a stated amount in the event of loss?
_____________________________________________________________________________________________
56) ____________________________________ is when an applicant fails to disclose known material facts.
57) Who must sign an application? Multiple Choice:
Insured, Policyowner, or Agent _________________________________________
58) This form is filled out by the agent and includes information about the proposed insured’s health history, occupation, and background.
_____________________________________________________________________________________________
59) They select, classify, and rate risks. ______________________________________________
60)
The process that insurers use to select, classify and rate risks so that they accurately reflect the amount of risk undertaken.
61)
An ____________________________ is considered a field underwriter.
62) What type of Underwriting Risk is this?_____________________________________
63)
Underwriting classification in which individuals are in average physical condition with average lifestyles and habits for people of their respective sex and age group.
_______________________________________________________________________________________________
64) This risk is also called a rated risk because they pose a higher risk to the insurer than standard risks. ______________________________________
65) Underwriting classification in which the risk is uninsurable because the applicant poses too great a risk for the insurer to provide coverage.
_________________________________________________________________
66) Defined as the possibility of a loss occurring. _________________________________
67) What are the 5 other reports an underwriter could use in determining an applicants insurability?
• Medical Report
• __________________________________ • Special Questionnaire
• Inspection Report
68) Who completes the medical report?
Physician Or Paramedic _______________________________________
69) What is the purpose of the MIB?
____________________________________________________________________
70) The MIB helps to prevent _____________________________
71) The buyer’s guide and policy summary must be give to the insured __________________ or at _____________________________________.
72)
The insurer’s costs which include: acquisition costs, staff salaries, retirement, contingency funds, and claims payments. __________________________________________
73)
The person who is covered under the policy ___________________________
74)
The insured’s notification that a payment is requested for a covered loss. ____________________________________
75) What is adverse selection?
__________________________________________________ (such as people in poor health) to seek or continue insurance to a greater extent than people in good health.
76)
Method used to establish premium rates for group health plan members, based on the claims experience of the group.
_____________________________________________________________________________________________
77) __________________________ insurance companies write more than one line of insurance.
78) Group Insurance Slide
79)
What is a policy called that is issued for Group Insurance? __________________________________________________
80) Employees/Members are covered by: __________________________________ and receive a___________________________________.
81)
Question:
How many employees must participate in a non-‐contributory plan? Answer:
_____________________________ if eligible employees, they all must be insured.
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