Virginia Insurance Virginia Life, Annuities, and Health Insurance Examination Series 1101 Exam Questions

A major medical policy is designed as a comprehensive health policy, covering a wide range of expenses, including hospital, surgical, physician, and prescription costs. It provides broader coverage than limited benefit plans such as dental or vision policies. Workers' compensation is not considered a general health policy because it specifically covers occupational injuries.

Exact Extract (Virginia Health Insurance Study Guide): ''Major medical insurance---provides comprehensive coverage for hospital, physician, surgical, and other medical expenses, subject to deductibles and coinsurance. Distinguished from limited health expense policies (dental, vision).''

Reference (Virginia Documents / Study Guide):

--- Virginia Health Insurance Examination Outline, Section 2.2 Comprehensive vs. Limited Policies

Twisting occurs when an agent uses misleading or incomplete comparisons to persuade a policyowner to lapse, surrender, or replace an existing insurance policy with a new one. This practice is unethical and prohibited because it may result in the consumer losing valuable benefits such as cash values, favorable policy provisions, or lower premiums. Rebating involves offering something of value not stated in the policy. Coercion involves force or threats. Defamation concerns false statements damaging another's reputation. Since the agent is encouraging replacement through misleading comparisons, the act is twisting.

An accelerated benefit rider allows the policyholder to access a portion of the death benefit while they are still alive, typically in cases where the insured is diagnosed with a terminal illness and is expected to die within a certain period (usually six months). This rider provides financial assistance during the policyholder's final stages of life, allowing them to cover medical expenses or other costs. It does not apply for minor surgeries or long-term rehabilitation.

Premiums for Medicare supplement plans are typically determined using the attained age rating, community rating, or issue age rating methods. Attained age rating adjusts premiums based on the insured's current age, community rating charges all policyholders the same premium, regardless of age, and issue age rating bases premiums on the age at which the policyholder first purchases the policy. Experience rating, however, is not used for Medicare supplement plans, as it is more commonly applied to group insurance policies based on the claims history of a group.

An accelerated benefit rider allows the policyholder to access a portion of the death benefit while they are still alive, typically in cases where the insured is diagnosed with a terminal illness and is expected to die within a certain period (usually six months). This rider provides financial assistance during the policyholder's final stages of life, allowing them to cover medical expenses or other costs. It does not apply for minor surgeries or long-term rehabilitation.