Podcast
Questions and Answers
Which document provides the most comprehensive review of a patient's medical history for underwriting purposes?
Which document provides the most comprehensive review of a patient's medical history for underwriting purposes?
- Attending Physician's Statement (correct)
- Individual Medical Summary
- Comprehensive Medical History
- Physician's Review
What key information is typically included in an Attending Physician's Statement?
What key information is typically included in an Attending Physician's Statement?
- Current policy details
- Insurance premium costs
- Past diagnoses and treatments (correct)
- Patient's lifestyle choices
Which action is essential for an agent when replacing a health insurance policy?
Which action is essential for an agent when replacing a health insurance policy?
- Avoid discussing the benefits of the new policy
- Ensure the new policy aligns with the insured's needs (correct)
- Cancel the old policy without notifying the insured
- Only provide a summary of the old policy
Which document would NOT typically be used to evaluate an individual's medical history in underwriting?
Which document would NOT typically be used to evaluate an individual's medical history in underwriting?
What is the primary function of an Attending Physician's Statement in the underwriting process?
What is the primary function of an Attending Physician's Statement in the underwriting process?
What is the recommended method for correcting an application when changes are necessary?
What is the recommended method for correcting an application when changes are necessary?
Which of the following methods for changing incorrect answers is generally unacceptable?
Which of the following methods for changing incorrect answers is generally unacceptable?
What initial action is recommended if a mistake is made while filling out an application?
What initial action is recommended if a mistake is made while filling out an application?
What is the critical step after drawing a line through an incorrect answer?
What is the critical step after drawing a line through an incorrect answer?
When is it advisable to use a fresh application instead of making corrections?
When is it advisable to use a fresh application instead of making corrections?
Which factor is NOT considered in a replacement situation?
Which factor is NOT considered in a replacement situation?
What action does an insurer take when a completed application and first premium check are submitted?
What action does an insurer take when a completed application and first premium check are submitted?
What is a primary concern for agents during the replacement of a policy?
What is a primary concern for agents during the replacement of a policy?
Why might limitations be significant in a replacement insurance evaluation?
Why might limitations be significant in a replacement insurance evaluation?
What does a conditional receipt signify for an applicant after submitting her premium?
What does a conditional receipt signify for an applicant after submitting her premium?
What type of contract requires both parties to fulfill obligations for it to be enforceable?
What type of contract requires both parties to fulfill obligations for it to be enforceable?
Which characteristic best describes a personal contract?
Which characteristic best describes a personal contract?
In the context of insurance, which term describes a contract where the outcome is uncertain?
In the context of insurance, which term describes a contract where the outcome is uncertain?
What is a critical feature of an aleatory contract?
What is a critical feature of an aleatory contract?
Which document primarily contains an insured's comprehensive medical history?
Which document primarily contains an insured's comprehensive medical history?
What occurs when a health insurance applicant submits a completed application and first premium check?
What occurs when a health insurance applicant submits a completed application and first premium check?
What does a conditional receipt indicate to a policy applicant?
What does a conditional receipt indicate to a policy applicant?
Which statement describes the status of a policy after an applicant receives a conditional receipt?
Which statement describes the status of a policy after an applicant receives a conditional receipt?
What is a common misunderstanding regarding conditional receipts?
What is a common misunderstanding regarding conditional receipts?
What is the outcome if an insurer has not issued a policy after a conditional receipt is given?
What is the outcome if an insurer has not issued a policy after a conditional receipt is given?
What is the primary binding force in an insurance contract?
What is the primary binding force in an insurance contract?
Which principle of insurance involves the obligation to act honestly?
Which principle of insurance involves the obligation to act honestly?
What does the insurer promise to provide in an insurance agreement?
What does the insurer promise to provide in an insurance agreement?
Which term describes the insured's payment of premiums and representations made during application?
Which term describes the insured's payment of premiums and representations made during application?
Which principle focuses on the interpretation favoring the insured in ambiguities?
Which principle focuses on the interpretation favoring the insured in ambiguities?
What is essential to ensure when replacing an insured's health insurance policy?
What is essential to ensure when replacing an insured's health insurance policy?
Which statement regarding the gap between health insurance policies is accurate?
Which statement regarding the gap between health insurance policies is accurate?
What must an agent do before issuing a new health insurance policy?
What must an agent do before issuing a new health insurance policy?
Which action is NOT recommended when transitioning to a new health insurance policy?
Which action is NOT recommended when transitioning to a new health insurance policy?
Which of the following is crucial for insuring continuous health coverage?
Which of the following is crucial for insuring continuous health coverage?
What must happen for a conditional insurance contract to be valid?
What must happen for a conditional insurance contract to be valid?
What distinguishes a unilateral contract from a conditional contract?
What distinguishes a unilateral contract from a conditional contract?
Which of the following is NOT a characteristic of a conditional contract?
Which of the following is NOT a characteristic of a conditional contract?
Which term best describes a contract where one party makes a promise that the other can only accept?
Which term best describes a contract where one party makes a promise that the other can only accept?
In what scenario would a conditional contract become void?
In what scenario would a conditional contract become void?
Which term describes untrue statements made by insureds that could change the underwriting decision?
Which term describes untrue statements made by insureds that could change the underwriting decision?
What impact do material misrepresentations have on an insurance application?
What impact do material misrepresentations have on an insurance application?
Which of the following is not considered a material misrepresentation?
Which of the following is not considered a material misrepresentation?
In the context of insurance applications, what is the potential consequence of submitting material misrepresentations?
In the context of insurance applications, what is the potential consequence of submitting material misrepresentations?
Which statement best defines 'warranties' in the context of insurance applications?
Which statement best defines 'warranties' in the context of insurance applications?
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Study Notes
Application Changes
- Best practice for changing an application is to start over with a fresh application.
- If starting anew isn't feasible, draw a line through the incorrect answer, write the correct answer, and have the applicant initial it.
- Applications typically must be filled out in ink to ensure integrity.
Contract Types
- A conditional contract requires both parties to perform specific duties to be enforceable.
- Unlike unilateral contracts, a conditional contract relies on the fulfillment of stated conditions.
Medical History Documentation
- The Attending Physician's Statement (APS) is critical for underwriters to assess an insured's medical history.
- APS includes past diagnoses, treatments, recovery durations, and prognoses.
Health Insurance Policy Replacement
- Ensure the current policy remains active until the new policy is issued to cover any pre-existing conditions.
- A proper procedure during replacement does not include a cancellation of the old policy before the new one being active.
Replacement Considerations
- Important factors in a replacement policy situation include benefits, limitations, and exclusions.
- Comparison of these elements between the existing and proposed policies is essential; assets are not a primary consideration.
Insurance Application Process
- Upon receiving a completed application and premium check, issuing a conditional receipt does not mean the insurer has approved the application or issued the policy.
- The insurer has reviewed the application, but final decisions are pending.
Material Misrepresentation
- A material misrepresentation is an untrue statement on the application that could affect the insurer's underwriting decision.
- Distinction made between unintentional misrepresentation versus fraudulent statements.
Insurance Principles
- Binding force in contracts is based on consideration, which includes premium payments by the insured and the insurer's promise to pay upon loss.
- Neglecting to pay a legitimate claim contravenes the principle of consideration.
Conditional Contracts in Insurance
- A conditional contract requires both the insurer and policyowner to meet specific conditions for execution.
- Example scenario: death benefit payable to the beneficiary upon premium payment, pending policy approval, exemplifies conditional terms.
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