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Q&A: Test Your Knowledge

Q&A: Test Your Knowledge

Questions ranging from the language of medicine to the management of claim operations.

C1 Language of Medicine

Burt Coleman had a premalignant skin lesion on his thigh that was the result of many years of sun damage. Because the lesion could progress to squamous cell carcinoma if not removed, Mr. Coleman underwent a two-part treatment procedure to remove the lesion. In the first part of the treatment, a physician used a sharp spoon-shaped instrument to scrape away the lesion. Next, the physician destroyed any remaining skin lesion tissue by burning it with an electric spark. The two aspects of this treatment procedure are known, by definition, as:

  1. shave biopsy and electrodesiccation.
  2. shave biopsy and cryosurgery.
  3. curettage and electrodesiccation.
  4. curettage and cryosurgery.

C2 Life and Health Insurance law

When Tai Chen purchased an insurance policy on his life, he named his father as the beneficiary of the policy. Four years later, Mr. Chen changed the beneficiary designation to his wife by following the method specified in the policy, which required him to submit a form to the insurer noting his intent to change the beneficiary and the identity of the new beneficiary. The insurer then entered the change in its files. This information indicates that Mr. Chen changed the beneficiary of his life insurance policy using the beneficiary change method called the:

 

  1. testamentary method.
  2. endorsement method.
  3. assignment method.
  4. recording method.

C3 Claim Administration

One nonproportional plan of reinsurance is stop-loss reinsurance. Under a stop-loss reinsurance plan, the reinsurer agrees to pay:

  1. the ceding company a proportionate share of the ceded policy's face amount of insurance.
  2. benefits after the ceding company has paid benefits for a specified period, such as three months.
  3. the ceding company for a specified part of the amount of loss on an individual claim above an established limit of loss.
  4. the ceding company for a specified part of total claim losses beyond a set point, which may be either a predetermined dollar amount or a percentage of the ceding company's expected losses.

C4 Management of Claim Operations

The Octagon Life and Health Insurance Company is designing a new automated claim-processing system and has assigned an information-systems project team and a claim-administration project team to develop the requirements for the new system. Because the two project teams do not agree about what functions the new system should have, Octagon has hired Leo Foo, a management consultant, to help the project teams resolve their differences and lead them through the change. From the answer choices below, select the response that correctly identifies both Mr. Foo's role in the change process and the organization development (OD) intervention technique that he is likely to use to assist the teams during the change process.

  1. change agent / third-party peacemaking.
  2. change agent / survey feedback.
  3. sponsor / third-party peacemaking.
  4. sponsor / survey feedback.

Answer Key:

C1 - C
C2 - D
C3 - D
C4 - A