#1
What is the primary function of insurance authorization?
To approve medical procedures or services
ExplanationApproval for medical procedures.
#2
Which document outlines the terms and conditions of an insurance policy?
Policy contract
ExplanationDocument detailing policy terms.
#3
What does the term 'co-pay' mean in insurance?
A fixed amount the insured must pay for a covered service
ExplanationFixed payment by insured.
#4
What is the purpose of an Explanation of Benefits (EOB) in insurance?
To provide a summary of medical services and their costs
ExplanationSummary of medical costs.
#5
What does the term 'underwriting' mean in the context of insurance?
Assessing and evaluating risks before issuing a policy
ExplanationRisk assessment for policy issuance.
#6
In insurance, what is a 'rider'?
An insurance policy provision that adds or modifies coverage
ExplanationCoverage modification provision.
#7
What is the 'elimination period' in disability insurance?
A waiting period before disability benefits begin
ExplanationWaiting period for benefits.
#8
In property insurance, what does 'actual cash value' represent?
The current market value of the property minus depreciation
ExplanationProperty value minus depreciation.
#9
What is 'moral hazard' in the context of insurance?
A hazard caused by unethical behavior of the insured
ExplanationHazard from unethical behavior.
#10
What is the purpose of an insurance claim adjuster?
To assess and evaluate insurance claims
ExplanationEvaluation of insurance claims.
#11
What is a pre-authorization in the context of insurance?
Approval obtained before seeking medical treatment
ExplanationAdvance approval for treatment.
#12
What information is typically included in an insurance authorization document?
Authorization period and approved services
ExplanationDetails of authorized services.
#13
What is 'coinsurance' in insurance terminology?
A percentage of covered expenses shared by the insured and the insurer
ExplanationShared expense percentage.
#14
What is the purpose of a certificate of insurance?
To verify the coverage and limits of an insurance policy
ExplanationVerification of policy coverage.
#15
What is the purpose of a loss ratio in insurance?
To determine the profitability of an insurance policy
ExplanationPolicy profitability assessment.
#16
What is 'reinsurance' in the insurance industry?
The process of transferring risk from one insurer to another
ExplanationRisk transfer between insurers.
#17
What is 'risk pooling' in insurance?
Combining various risks to reduce overall risk
ExplanationRisk reduction strategy.
#18
What is a 'binder' in the insurance industry?
A temporary insurance contract providing immediate coverage
ExplanationTemporary immediate coverage contract.
#19
What is 'self-insurance'?
Setting aside funds to cover potential losses instead of purchasing insurance
ExplanationFunds for potential losses.
#20
In health insurance, what is a 'pre-existing condition'?
A condition that occurs before the policy is issued
ExplanationCondition predating policy.
#21
In insurance, what is subrogation?
Transferring the right of recovery to the insurer
ExplanationTransfer of recovery rights.
#22
What is the difference between 'deductible' and 'copayment' in insurance?
Copayment is paid upfront, while deductible is paid after a claim
ExplanationTiming of payment.
#23
What is the role of an insurance broker?
Selling insurance policies to individuals and businesses
ExplanationSale of insurance policies.
#24
What is the purpose of 'umbrella insurance'?
To offer additional liability coverage beyond the limits of other policies
ExplanationAdditional liability coverage.
#25
What is the purpose of 'catastrophic insurance'?
To cover the costs of catastrophic events that result in significant financial loss
ExplanationCoverage for significant financial loss events.