Deck 12: Commercial Insurance

Question 1

Which type of automobile insurance reimburses medical expenses for covered individuals, regardless of fault, for treatment due to an automobile accident?

A) collision
B) comprehensive
C) liability
D) personal injury protection

Answer 1

personal injury protection

Question 2

Third-party recovery standards for investigation of liability coverage and the process for filing a lien in a potential liability case vary on a federal and state basis. A lien is defined as __________.

A) arbitrating requested payments from owners of liability insurance
B) mediating between parties involved in a liability case to resolution
C) processing submitted liability claims to remunerate injured parties
D) securing a debtor's property as security or payment for a debt

Answer 2

securing a debtor's property as security or payment for a debt

Question 3

Which is associated with "last resort" health insurance for individuals who cannot obtain coverage due to a serious medical condition?

A) association health insurance
B) high-risk pool
C) indemnity insurance
D) managed care

Answer 3

high-risk pool

Question 4

Which type of insurance covers losses to a third party caused by the insured, by an object owned by the insured, or on premises owned by the insured?

A) commercial
B) health
C) liability
D) workers' compensation

Question 5

Which type of automobile insurance pays for damage to a covered vehicle caused by hitting an object or being hit during an automobile accident?

A) collision
B) comprehensive
C) liability
D) personal injury protection

Question 6

When the same payer issues the primary, secondary, or supplemental policies, the correct procedure for submitting the claim would be to submit __________.

A) a separate claim for each policy
B) one claim for all policies
C) primary first, followed by secondary and supplemental
D) three separate claims

Question 7

Group health insurance is available through employers and other organizations, and all or part of the premium costs are paid by employers. Employer-based group health insurance __________.

A) covers all employees, regardless of health status, and cannot be canceled if an
Employee becomes ill
B) excludes COBRA continuation coverage upon employee resignation or another qualifying event and lasts for 18 to 36 months, depending on the employee's situation
C) prohibits employer-limited plan options, such as a prescription drug plan that covers a certain list of medications, which is called a formulary
D) requires exclusions for pre-existing conditions, which means the payer excludes all employees from coverage for pre-existing conditions

Question 8

Which type of insurance is a contract between an individual and an insurance company whereby the individual pays a premium and, in exchange, the insurance company agrees to pay for specific vehicle-related financial losses during the term of the policy?

A) automobile
B) commercial
C) liability
D) workers' compensation

Question 9

Which type of automobile insurance pays for accidental bodily injury and property damage to others, including medical expenses, pain and suffering, lost wages, and other special damages?

A) collision
B) comprehensive
C) liability
D) personal injury protection

Question 10

The base period of a disability policy usually covers 12 months and is divided into four __________ quarters.

A) concurrent
B) consecutive
C) equal
D) fiscal

Question 11

Which is traditional fee-for-service health insurance that covers a portion of services, such as inpatient hospitalizations or physician office visits, with the patient paying the remaining costs?

A) association health insurance
B) high-risk pool
C) indemnity insurance
D) managed care

Question 12

Which is offered to members and marketed to small business owners as a way to provide coverage to employees?

A) association health insurance
B) high-risk pool
C) indemnity insurance
D) managed care

Question 13

Which type of insurance is defined as reimbursement for income lost as a result of a temporary or permanent illness or injury?

A) commercial
B) disability
C) liability
D) workers' compensation

Question 14

Which includes health maintenance organizations and preferred provider organizations?

A) association health insurance
B) high-risk pool
C) indemnity insurance
D) managed care

Question 15

Which type of automobile insurance pays for loss of or damage to a covered vehicle, such as that caused by fire, flood, hail, impact with an animal, theft, vandalism, or wind?

A) collision
B) comprehensive
C) liability
D) personal injury protection

Question 16

If a patient is covered by two different policies, the usual procedure for submitting a claim would be __________.

A) a separate claim to each payer for each policy, submitted at the same time
B) one claim; the primary payer will submit a claim to the secondary payer
C) to submit to the primary payer first, followed by submitting to the secondary after primary payment is received
D) to submit all claims to all payers at the same time

Question 17

Which refers to the contractual right of a third-party payer to recover health care expenses from a liable party?

A) adjudication
B) arbitration
C) mediation
D) subrogation

Question 18

Which type of health insurance covers the medical expenses of individuals (e.g., private health insurance) and groups (e.g., employer group health insurance)?

A) commercial
B) disability
C) liability
D) workers' compensation