Download FLORIDA LIFE HEALTH AND ANNUITIES 2-15 EXAM 2025-2026|WITH QS AND AS 100% |A+ GRADED and more Exams Business Finance in PDF only on Docsity!
FLORIDA LIFE HEALTH AND ANNUITIES 2-15 EXAM
2025-2026 TEST BANK|WITH 172 QUESTIONS AND
ANSWERS 100% DETAILED|A+ GRADED
True Significance of Insurance: its promise to substitute future economic certainty for uncertainty and to replace the unknown with a sense of security. Multi-Line Insurers companies that write more than one line of insurance. (private insurers) Mono-Line Insurers companies that only sell one type of insurance. Stock Insurers private organization organized and incorporated under state laws for the purpose of making a profit for its stockholders.
Mutual Insurers (Participating Companies) organized and incorporated under state laws but they have no stockholders, instead the owners are the policyholders. They pay policy dividends so policy owners can share in company earnings. Policy Dividends intentional return of premium not taxable or guaranteed. Assessment Mutual Insurers typified by the way in which they charge premiums. Pure Assessment Mutual Company operates on the basis of loss sharing by group members, no premium is payable in advance, instead each member is assessed an individual portion of losses that actually occur. Advance Premium Assessment Mutual
a mutual insurance company formed to insure people in the same business, occupation, or profession. (pharmacists, dentists, or engineers) Fraternal Benefit Societies a nonprofit with a lodge system that includes ritualistic work and maintain a representative form of government with elected officers, issues insurance certificates and annuities and not policies. Home Service Insurers (Debit Insurers) companies that specialize in a particular type of insurance called INDUSTRIAL INSURANCE which is characterized by relatively small face amounts with premiums paid weekly. Service Providers an organization that provides health coverage by contracting with service providers to provide medical services to subscribers who pay in advance through premiums.(HMOs and PPOs) Health Maintenance Organization (HMO)
service provider that provides financing for health care and health care itself and are known for stressing PREVENTIVE health care and early treatment programs. Preferred Provider Organization (PPO) service provider that emphasizes CURATIVE health care and is a group desiring health care services from certain select health care providers in exchange for referring its employees or members to them. Social Insurance Programs federal and state governments are also insurers ranging from crop insurance to bank and savings and loan deposit insurance and are funded with taxes and serve national and state social purposes. Risk Pooling or Spreading also known as loss sharing, by spreading a risk or sharing the possibility of a loss, a large group of people can substitute a small certain cost for a large unknown risk. The risk is transferred from an individual to a group.
is to provide economic protection against losses that may be incurred due to a chance happening or event such as death, illness, or accident. Make you whole again. Risk uncertainty regarding loss. Speculative Risks involve the chance of both loss and gain. Pure Risks involve only the chance of loss, there is never a possibility of gain or profit. Only _____ risks are insurable. Perils the cause of a risk.
Hazard any factor that gives rise to a peril. Three Basic Types of Perils: physical hazards, moral hazards, and morale hazards. Physical Hazards individual characteristics that increase the chance of peril. (blindness and deafness) Moral Hazards tendencies that people may have that increase risk and the chance of loss. (drug addiction) Morale Hazards individual tendencies that arise from an attitude or state of mind causing indifference to loss. (driving recklessly)
selection "against the company". tendency of less favorable insurance risks to seek or continue insurance to a greater extent than others. A lot of bad risk, insurance company raises rates Agents represent a particular company(insurer) and has an agent's contract. Also known as a captive or career agent. Brokers not tied to any particular company and can represent many companies products and represent the buyer, must have a broker's contract. Also known as an independent agent. 3 Systems That Support The Sale of Insurance Through Agents and Brokers: career agency system, personal producing general agency system, and the independent agency system. Career Agency System
branches of major stock and mutual insurance companies that are contracted to represent the particular insurer in a specific area. Insurance agents are recruited, trained, and supervised by either a manager employee or a general agent. Focuses on building sales staffs. Personal Producing General Agency System do not recruit, train, or supervise career agents. Primarily sell insurance, although they may build small sales force to assist them these agents are employees of the PPGA and not the insurance company. Independent Agency System also known as the american agency system, is a creation of the property casualty industry, doesn't tie a sales staff or agency to any one particular insurance company rather independent brokers represent any number of insurance companies through contractual agreements. 1945- The McCarran- Ferguson Act every state regulates its own insurance.
also known as guarantee funds that all states have to support insurers and to protect consumers if an insurer becomes insolvent. National Association of Insurance and Financial Advisors(NAIFA) and National Association of Health Underwriters(NAHU) organizations of health and life insurance agents that are dedicated to supporting the life and health insurance industries and advancing the quality of service provided by insurance professionals. For A Contract To Be Legally Binding, It Must Contain Certain Elements: an offer and acceptance, consideration, legal purpose, and competent parties. Consideration value given in exchange for the promises saught( application and premium) 3 Possible Exceptions To Being Competent:
minors, mentally infirm, and those under the influence of alcohol or narcotics. Aleatory all insurance contracts are ______ in that (1)there is an element of chance for both of the contracting parties and (2) the dollar values exchanged may not be equal. Adhesion this is the price, take it or leave it. Unilateral only one party has an obligation, if you pay the premium they have to pay the benefit even if you don't pay premiums. Valued Contract pays a stated sum, regardless of the actual loss incurred when the contingency insured against occurs. (life insurance contracts)
Waiver the voluntary giving up of a legal, given right. Estoppel the legal impediment to one party denying the consequences of its own actions or deeds if such actions or deeds result in another party acting in a specific manner or if certain conclusions are drawn. "the loss of defense". Parol Evidence Rule what you write is more important than what you say. Void Contract an agreement without legal effect. Voidable Contract an agreement which for a reason satisfactory to the court, may be set aside by one of the parties to the contract.
Reimbursement Approach policy owners obtain medical treatment from whatever source they feel is most appropriate and per the terms of their policy submit their charges to their insurer for reimbursement. Right of Assignment built into most commercial health policies and lets policyowners assign benefit payments from the insurer DIRECTLY to the health care provider, thus relieving the policyowner of first having to pay the medical care provider. Service Providers offer benefits to subscribers in return for the payment of a premium, benefits are in the form of services provided by the hospitals and physicians in the plan. Blue Cross traditionally has been a hospital service plan.
each member of the group pays a premium, a fixed sum per month, whether or not the person uses the services of the HMO. Encourages preventive medicine. Preferred Provider Organizations (PPO) health insurance provider that is a collection of health care providers, such as physicians, hospitals, and clinics who offer their services to certain groups at prearranged prices in exchange the group refers their members to the preferred providers for health care services. More freedom than an HMO, emphasizes curative medicine and get discounts for using their network. Medicare purpose is to provide hospital and medical expense insurance protection to those aged 65 and older, to those of any age who suffer from chronic kidney disease, or to those who are receiving social security disability benefits. (care for elderly) Social Security Disability Income disability income benefits are available to covered workers when the impairment is expected to last at least 12 months or result in an earlier
death and a 5 month waiting period is required before an individual will qualify for benefits, during which time they must remain disabled. Medicaid title 19 of the social security act, with a purpose of providing matching federal funds to states for their medical public assistance plans to help needy persons, regardless of age. (care for needy) Medicare Part A Coverage's covers eligible person over age 65 and those under age 65 who are eligible for social security disability benefits. Benefits are for hospital expenses and related expenses. Provides inpatient hospitalization, post-hospital skilled facility care, and home care. First 60 days 100%coverage. Mandatory. Medicare Part B Coverage's voluntary additional coverage for physician services, diagnostic tests, physical and occupational therapy, medical supplies. Required to pay a premium and deductable but get 80/20 co-insurance. Financed by monthly premiums paid by the insured and supplemented by the federal government.
