Chapter 2: Accident and Health Insurance Basics

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Across
  1. 3. Defined as an illness that first manifests itself while the policy is in force
  2. 8. Acronym for medically necessary services that an insured receives in a nursing home or their own home, but not care received in an acute care unit of a hospital
  3. 10. Risks that reflect average exposures and may be insured at standard rates and premiums
  4. 12. Someone relying on the insured for support
  5. 14. The portion of the loss that is to be paid by the insured before any claim may be paid by the insurer
  6. 15. Type of underwriting that is a function of the producer and helps to gather credible information from an applicant that would assist the underqriter in screening marginal or unacceptable risks before taking an application for an insurance policy
  7. 16. Health coverage that provides coverage for most types of medical expenses
  8. 17. Required by the proposed insured, policyowner, and the agent that solicits the insurance on every application
  9. 21. First step in the total process of insuring health risks and is used to minimize the problem of adverse selection
  10. 22. A person enrolled in a health insurance plan, an insured
Down
  1. 1. An arrangement in which an insured must pay a specified amount for services "up front" and the provider pays the remainder of the cost
  2. 2. Clauses added to the basic insurance policy to add, modify, or delete policy provisions
  3. 3. An attempt to persuade a person to but an insurance policy
  4. 4. Risks that reflect a reduced risk of loss and are covered at a reduced rate
  5. 5. Report completed by the agent that does not become part of the entire contract
  6. 6. Acronym for a membership corporation owned by member insurance companies that receives adverse medical information from insurance companies and maintains confidential medical impairment information on individuals
  7. 7. Risks that reflect an increased risk of loss
  8. 9. _____________ consumer report that includes information on an applicant's character, general reputation, personal habits, and mode of living that is obtained through investigation
  9. 11. When expenses are paid directly to the insured and the insured is responsible for paying medical expenses
  10. 13. Unable to meet financial obligations
  11. 18. Acronym for the report that is best for accurate information on the applicant's medical history
  12. 19. Acronym for a type of payment that is submitted electronically
  13. 20. The _________ contract includes the application and the policy