An applicant for accident and health insurance has a risk factor that is similar to a majority of the insurer's other applicants. What will be the likely outcome for this applicant?

An applicant for accident and health insurance has a risk factor that is similar to a majority of the insurer's other applicants. What will be the likely outcome for this applicant?

• A. Issued with a higher premium rate
• B. Issued with a standard premium rate
• C. Denied coverage
• D. Provided with a limited benefit

Answer: (B)

When an applicant for accident and health insurance presents a risk factor that aligns closely with that of a majority of the insurer's other applicants, it suggests that the applicant falls within a typical risk category. Insurers assess risks to determine how likely a policyholder is to file a claim, and a majority of risks within a certain range allow the insurer to establish a standard premium rate. Issuing a standard premium rate indicates that the insurer recognizes the applicant's risk as manageable and consistent with their overall pool of insured individuals. This approach is part of the insurer's effort to balance the risk pool, ensuring that premiums collected align with the anticipated claims. In contrast, significantly higher risk factors may prompt a higher premium rate or denial of coverage altogether due to the increased likelihood of claims. Conversely, limited benefits would typically apply to risks considered lower than standard, providing a way to accept applicants while managing potential losses. Therefore, having a risk factor similar to that of a majority of applicants leads to the conclusion that issuing a standard premium rate is the most likely outcome.

When an applicant for accident and health insurance presents a risk factor that aligns closely with that of a majority of the insurer's other applicants, it suggests that the applicant falls within a typical risk category. Insurers assess risks to determine how likely a policyholder is to file a claim, and a majority of risks within a certain range allow the insurer to establish a standard premium rate.

Issuing a standard premium rate indicates that the insurer recognizes the applicant's risk as manageable and consistent with their overall pool of insured individuals. This approach is part of the insurer's effort to balance the risk pool, ensuring that premiums collected align with the anticipated claims.

In contrast, significantly higher risk factors may prompt a higher premium rate or denial of coverage altogether due to the increased likelihood of claims. Conversely, limited benefits would typically apply to risks considered lower than standard, providing a way to accept applicants while managing potential losses. Therefore, having a risk factor similar to that of a majority of applicants leads to the conclusion that issuing a standard premium rate is the most likely outcome.