New York Accident & Health Insurance, Questions and answers, rated A. 2023 predictor

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New York Accident & Health Insurance, Questions and answers, rated A. 2023 predictor Independent Adjuster - ✔✔A person, firm or corporation acts on behalf of an insurer. (For profit) Insura... nce Company Public Adjuster - ✔✔A person, firm or corporation acts on behalf of an insured. Negotiating certain claims for loss of damage to property. Cancellable Health Insurance - ✔✔Insurance policies provide insurer right to cancel coverage at any time. Giving number of days notice. (as little as five days) Noncancellable Health Inusurance - ✔✔Contracts can't be cancelled by an insurer for any reason. Exceptions include fraudulent claim or non-payment of premium. Conditionally Renewable - ✔✔Policies provide insurer with the right to refuse to renew coverage for certain conditions stated in the policy. Can't refuse to renew on basis of declining health. ERISA - ✔✔Employee Retirement Income Security Act (1974) Insured's Notice of Claim - ✔✔Policyholder must give notice of a claim within 20 days or as soon as reasonably possible. Standard Claim Forms - ✔✔15 days after notice of claim Proof of Loss - ✔✔Required 90 days after the end of a period which the insurer is liable. Permanent total disability - ✔✔Most severe, insurer will never work again. Temporary total disability - ✔✔Renders insurer incapable of working for a certain time-frame. Recovery is seen Permanent partial disability - ✔✔Injury that is permanent but won't stop the individual from returning to work. (loss of leg, arm etc) Temporary partial disability - ✔✔Least severe, keeps individual out of work for a few days. Elimination period - ✔✔Time an injured person must be disabled before benefits take effect. Total Benefit - ✔✔Full amount specified in the insurance policy for the benefit period which he/she is qualified for. Partial Disability - ✔✔Inability for insured to carry on all the duties of his/her job. Benefits are paid on percentage of lost income. Residual Disability - ✔✔Based on the proportion of income that the insured has lost. Taking into consideration that he/she can work and earn a portion of their income. Lump Sum Benefits - ✔✔Dollar amount available for certain permanent partial injuries . Also known as Accidental Death and Dismemberment (AD&D) Comprehensive care - ✔✔Package of health care services including preventative care, routine physicals, immunizations, hospitalizations, and outpatient services. Health Maintenance Organizations (HMO'S) - ✔✔Prepaid health care plans with an emphasis on preventative care. Preferred Provider Organizations - ✔✔Group of physicians and hospitals that contract with employers, insurers, or third party organizations. Providing medical care services at a reduced fee. Annual open enrollment - ✔✔Period of time during which all members of a group health insurance plan have the opportunity to enroll in certain benefit programs. Medical Savings Account - ✔✔Employer funded account linked to a high deductible medical plan. Anterior - ✔✔Front of an individual Anteroposterior - ✔✔From head to opposite end of body Appendage - ✔✔A structure that extends ( moves separately) from the main body. Contralateral - ✔✔On the opposite side. (The left arm is contralateral to the right arm. Distal - ✔✔The tip of an appendage Dorsal - ✔✔Back (spine) of an individual. Dorosoventral - ✔✔From spinal column (back) to abdomen (front). Intermediate - ✔✔Between two other structures. (The navel is intermediate between left arm and right arm) Ipsilateral - ✔✔On the same side. (The left arm is ipsilateral to the left leg) Lateral - ✔✔On the same side Median - ✔✔Point in the center of the body. [Show More]

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