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practice exam 2 (accident and health insurance policy required provisions,…
practice exam 2
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peril
the immediate specific event causing loss and giving rise to risk. a peril is the cause of a risk. when a building burns, fire is the peril. when you become ill from a disease, the disease is the peril
subrogation
it is where the insurance company is taking legal action against a responsible third party -- a party that may be responsible for paying the costs of an injury
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12 months
under an expense incurred health policy is the maximum length of time after issuance of the policy that an insurer can exclude coverage for a pre-existing condition
health benefit plan
includes major medical policy, basic hospital policy, and surgical expense policy
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experience rating
underwriters use this to determine the appropriate coverage and final premium rate given to a group for a company that is getting a group health insurance policy for employees
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12% per annum is what the insurer has to pay when properly filed health claims are not timely paid from a date 60 days from satisfactory proof of loss
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