Question 1

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

Accepted Answer

A)   adjudication
B)   arbitration
C)   mediation
D)   subrogationE) A) and D)
F) None of the above

Question 2

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?

Accepted Answer

A)   commercial
B)   health
C)   liability
D)   workers' compensationE) A) and D)
F) A) and C)

Question 3

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

Accepted Answer

A)   a separate claim for each policy
B)   one claim for all policies
C)   primary first, followed by secondary and supplemental
D)   three separate claimsE) A) and B)
F) All of the above

Question 4

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?

Accepted Answer

A)   collision
B)   comprehensive
C)   liability
D)   personal injury protectionE) All of the above
F) None of the above

Question 5

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

Accepted Answer

A)   concurrent
B)   consecutive
C)   equal
D)   fiscalE) B) and D)
F) A) and B) B

Question 6

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

Accepted Answer

A)   commercial
B)   disability
C)   liability
D)   workers' compensationE) B) and C)
F) A) and C)

Question 7

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

Accepted Answer

A)   collision
B)   comprehensive
C)   liability
D)   personal injury protectionE) A) and B)
F) A) and C)

Question 8

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

Accepted Answer

A)   commercial
B)   disability
C)   liability
D)   workers' compensationE) All of the above
F) A) and D)

Question 9

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

Accepted Answer

A)   association health insurance
B)   high-risk pool
C)   indemnity insurance
D)   managed careE) A) and B)
F) B) and D)

Question 10

Which includes health maintenance organizations and preferred provider organizations?

Accepted Answer

A)   association health insurance
B)   high-risk pool
C)   indemnity insurance
D)   managed careE) None of the above
F) B) and D)

Question 11

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?

Accepted Answer

A)   automobile
B)   commercial
C)   liability
D)   workers' compensationE) B) and D)
F) A) and C)

Question 12

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

Accepted Answer

A)   association health insurance
B)   high-risk pool
C)   indemnity insurance
D)   managed careE) All of the above
F) B) and C)

Question 13

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

Accepted Answer

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 timeE) B) and C)
F) C) and D)

Question 14

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 __________.

Accepted Answer

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 debtE) A) and B)
F) B) and D) D

Question 15

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?

Accepted Answer

A)   association health insurance
B)   high-risk pool
C)   indemnity insurance
D)   managed careE) A) and C)
F) None of the above

Question 16

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?

Accepted Answer

A)   collision
B)   comprehensive
C)   liability
D)   personal injury protectionE) A) and B)
F) None of the above B

Question 17

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 __________.

Accepted Answer

A)   covers all employees, regardless of health status, and cannot be canceled if anEmployee 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 conditionsE) A) and B)
F) None of the above

Question 18

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

Accepted Answer

A)   collision
B)   comprehensive
C)   liability
D)   personal injury protectionE) A) and C)
F) B) and C)

Exam 12: Commercial Insurance

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

Correct Answer
verified

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?

Correct Answer
verified

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

Correct Answer
verified

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?

Correct Answer
verified

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

Correct Answer
verified
B

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

Correct Answer
verified

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

Correct Answer
verified

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

Correct Answer
verified

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

Correct Answer
verified

Which includes health maintenance organizations and preferred provider organizations?

Correct Answer
verified

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?

Correct Answer
verified

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

Correct Answer
verified

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

Correct Answer
verified

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 __________.

Correct Answer
verified
D

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?

Correct Answer
verified

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?

Correct Answer
verified
B

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 __________.

Correct Answer
verified

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

Correct Answer
verified

Exam 12: Commercial Insurance

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

Correct AnswerverifiedShow Answer

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?

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

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?

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedB

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

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

Which includes health maintenance organizations and preferred provider organizations?

Correct AnswerverifiedShow Answer

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?

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

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 __________.

Correct AnswerverifiedD

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?

Correct AnswerverifiedShow Answer

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?

Correct AnswerverifiedB

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 __________.

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

Correct Answer
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Correct Answer
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Correct Answer
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Correct Answer
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Correct Answer
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B

Correct Answer
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Correct Answer
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Correct Answer
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D

Correct Answer
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B

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Correct Answer
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