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:
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:
C3 Claim Administration
One nonproportional plan of reinsurance is stop-loss reinsurance. Under a stop-loss reinsurance plan, the reinsurer agrees to pay:
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.
C1 - C
C2 - D
C3 - D
C4 - A