11) an illness of injury that prevents an insured person from performing one or more of the functions of his regular job is called
A. partial disability (Correct Answer)
B. permanent disability
C. total disability
D. resultant disability
Ans: A
12) a previous injury disease or physical condition that existed before the health insurance policy was issued is called
A. preexisting condition (Correct Answer)
B. prior exposure
C. foregoing condition
D. none of the above
Ans: A
13) one who belongs to a group insurance plan is called
A. third party payer
B. subscriber (Correct Answer)
C. carrier
D. none of the above
Ans: B
14) a sum of money provided in an insurance policy, payable for covered services is called
A. deductible
B. benefits (Correct Answer)
C. dues payable
D. premium
Ans: B
15) to prevent the insured from receiving a duplicate payment for losses under more than one insurance policy is called
A. fee for service
B. hospital benefits
C. coordination of benefits (Correct Answer)
D. non duplication benefits
Ans: C
16) a requirement under a health care policy dictated that the insured be responsible for a percentage of covered services, this is called
A. coinsurance (Correct Answer)
B. pre defined policy
C. comprehensive
D. in percent policy
Ans: A
17) Insurance designed to offset medical expenses resulting from catastrophic or prolonged illness or injury is called
A. primary insurance
B. major medical (Correct Answer)
C. whole life policy
D. comprehensive
Ans: B
18) An unexpected event which may cause injury is a(n)
A. dread disease rider
B. accident (Correct Answer)
C. adjuster
D. none of the above
Ans: B
19) A doctor who agrees to accept an insurance companies pre-established fee as the maximum amount to be collected is a(n)
A. subscriber
B. claim representative
C. participating physician (Correct Answer)
D. adjuster
Ans: C
20) Insurance plans that pay a physician's full charge if it does not exceed his normal charge or does not exceed the amount normally charged for the service is
A. usual, customary, and reasonable (Correct Answer)
B. comprehensive
C. dual choice
D. none of the above
Ans: A
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A. partial disability (Correct Answer)
B. permanent disability
C. total disability
D. resultant disability
Ans: A
12) a previous injury disease or physical condition that existed before the health insurance policy was issued is called
A. preexisting condition (Correct Answer)
B. prior exposure
C. foregoing condition
D. none of the above
Ans: A
13) one who belongs to a group insurance plan is called
A. third party payer
B. subscriber (Correct Answer)
C. carrier
D. none of the above
Ans: B
14) a sum of money provided in an insurance policy, payable for covered services is called
A. deductible
B. benefits (Correct Answer)
C. dues payable
D. premium
Ans: B
15) to prevent the insured from receiving a duplicate payment for losses under more than one insurance policy is called
A. fee for service
B. hospital benefits
C. coordination of benefits (Correct Answer)
D. non duplication benefits
Ans: C
16) a requirement under a health care policy dictated that the insured be responsible for a percentage of covered services, this is called
A. coinsurance (Correct Answer)
B. pre defined policy
C. comprehensive
D. in percent policy
Ans: A
17) Insurance designed to offset medical expenses resulting from catastrophic or prolonged illness or injury is called
A. primary insurance
B. major medical (Correct Answer)
C. whole life policy
D. comprehensive
Ans: B
18) An unexpected event which may cause injury is a(n)
A. dread disease rider
B. accident (Correct Answer)
C. adjuster
D. none of the above
Ans: B
19) A doctor who agrees to accept an insurance companies pre-established fee as the maximum amount to be collected is a(n)
A. subscriber
B. claim representative
C. participating physician (Correct Answer)
D. adjuster
Ans: C
20) Insurance plans that pay a physician's full charge if it does not exceed his normal charge or does not exceed the amount normally charged for the service is
A. usual, customary, and reasonable (Correct Answer)
B. comprehensive
C. dual choice
D. none of the above
Ans: A
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