Hawaii Insurance Workers Compensation Adjuster License Practice Exam

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1. WOTF individuals is most likely to have a valid W/C claim?

Explanation

An employee injured while performing an operation for which he had not received training is most likely to have a valid workers' compensation claim. Workers' compensation typically covers injuries that occur during the course of employment, and this scenario suggests that the employee was engaged in work-related activities. Additionally, the fact that the employee was not trained for the operation further strengthens the argument that the injury was a result of the employer's negligence or failure to provide proper training.

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About This Quiz
Hawaii Insurance Workers Compensation Adjuster License Practice Exam - Quiz

In Hawaii, employers are expected to have insurance covers for their workers. For one to become a workers compensation adjuster, you need to have proper knowledge of claims, how to investigate them and negotiating settlements. Take the test below to gauge your knowledge on the insurance cover in preparation fo... see moregetting the license. see less

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2. In the case of a compensable injury in Hawaii, who normally chooses the physician for medical treatment?

Explanation

In the case of a compensable injury in Hawaii, the employee (EE) is normally the one who chooses the physician for medical treatment. This means that the injured employee has the right to select their own healthcare provider for treatment related to their work-related injury. The employee's choice of physician is important as it allows them to receive the necessary medical care and treatment that they deem fit for their injury.

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3. Under Hawaii law, for what period of time is an ER responsible to pay for an injured EE's medical care?

Explanation

Under Hawaii law, an employer is responsible for paying for an injured employee's medical care for as long as it is reasonably required. This means that there is no specific time limit set by the law, and the employer must continue to cover the medical expenses until the injured employee has fully recovered or no longer requires treatment. The duration of coverage will depend on the individual circumstances and the medical needs of the injured employee.

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4. An applicant for a WC adjuster license in Hawai must be at least how old?

Explanation

An applicant for a WC adjuster license in Hawaii must be at least 18 years old. This age requirement ensures that individuals applying for the license have reached a legal age and are considered adults, capable of taking on the responsibilities associated with being a workers' compensation adjuster. Being 18 years old also aligns with the minimum age requirement for many other professional licenses and certifications.

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5. What is the waiting period in Hawaii before an EE becomes entitled to receive TTD benefits?

Explanation

The waiting period in Hawaii before an EE becomes entitled to receive TTD benefits is 3 days. This means that an employee must wait for three days before they are eligible to receive temporary total disability benefits.

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6. WOTF basic WC benefits compensates for the loss of income or earning capacity suffered by an injured worker?

Explanation

Disability income benefits are designed to compensate for the loss of income or earning capacity experienced by an injured worker. These benefits provide financial support to individuals who are unable to work due to a disability or injury, helping to replace a portion of their lost wages. By receiving disability income benefits, injured workers can continue to meet their financial obligations and maintain their standard of living while they recover from their injuries. These benefits are an essential component of workers' compensation programs, ensuring that injured workers are not financially burdened by their inability to work.

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7. What coverage might a self-insured ER purchase to cover WC claims that exceeded their plan's pre-established limits?

Explanation

Excess insurance is a type of coverage that a self-insured ER might purchase to cover workers' compensation (WC) claims that exceed the limits set by their self-insurance plan. This coverage provides additional protection and helps the ER handle unexpected and high-cost claims that go beyond their self-insured plan's limits. By purchasing excess insurance, the ER can mitigate the financial risk associated with WC claims and ensure that they have adequate coverage in case of large claims.

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8. In the case of a compensable injury resulting in TTD, when does the injured EE become entitled to disability benefits?

Explanation

The injured employee becomes entitled to disability benefits beginning on the fourth day after the injury.

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9. In Hawaii, what percentage of an EE's AWW is paid in case of a work related claim that results in a PTD?

Explanation

In Hawaii, when an employee experiences a work-related claim that leads to Permanent Total Disability (PTD), they are entitled to receive 66.66% of their Average Weekly Wage (AWW) as compensation. This means that if an employee is unable to work due to a work-related injury or illness resulting in PTD, they will receive approximately two-thirds of their usual weekly earnings as financial support.

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10. WOTF is not an acceptable form of security for the payment of WC benefits?

Explanation

Requiring all employees to waive their rights to compensation benefits is not an acceptable form of security for the payment of workers' compensation benefits. This is because employees have a legal right to receive compensation for work-related injuries or illnesses, and waiving these rights would be a violation of labor laws. Acceptable forms of security include purchasing insurance from an authorized insurance company, depositing satisfactory funds with the state Director of Finance, or becoming a member of a valid workers' compensation self-insurance group.

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11. In Hawaii, how long must an insurer or a self-insured ER retain records of WC claims for the inspection of the insurance commissioner?

Explanation

Insurers and self-insured ERs in Hawaii are required to retain records of workers' compensation claims for 8 years for inspection by the insurance commissioner. This is likely to ensure that there is a sufficient record of past claims and to allow for any necessary investigations or audits by the insurance commissioner. The longer retention period also allows for any potential disputes or legal actions that may arise in the future to be properly addressed and resolved.

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12. It is possible that medical care benefits to an injured Hawaii EE may be suspended. WOTF would cause such a suspension?

Explanation

If an injured Hawaii employee refuses to accept or obstructs the service of a properly-selected physician, it may lead to the suspension of medical care benefits. This is because the employer or insurance provider has the right to select a physician to provide medical treatment for the injured employee, and if the employee refuses to cooperate with this selection, it can result in the suspension of their medical care benefits.

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13. WOTF would fall outside the scope of WC laws?

Explanation

The question is asking which scenario would fall outside the scope of workers' compensation laws. Workers' compensation laws typically cover injuries or illnesses that occur in the workplace or during work-related activities. In the given scenarios, all except for the one where an employee accidentally injured a bystander would generally be covered by workers' compensation. This is because the bystander was not an employee and the injury did not occur to the employee themselves.

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14. WOTF EE injury claims would most likely not be covered under Hawaii's WC law?

Explanation

Hawaii's workers' compensation law typically covers injuries that occur in the course of employment. However, intentionally self-inflicted injuries are generally not covered because they are considered to be outside the scope of normal work-related risks.

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15. WOTF work-related injuries would be deemed to be PTD in Hawaii?

Explanation

All of the mentioned work-related injuries would be deemed to be Permanent Total Disability (PTD) in Hawaii. These injuries, including permanent and total loss of sight in both eyes, loss of 1 hand and 1 foot, and a skull injury resulting in insanity, are severe and debilitating enough to render the individual permanently and totally disabled. Therefore, all of these injuries would qualify for PTD status in Hawaii.

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16. Would a claim under ER's liability insurance for an EE on business temporarily in France be covered?

Explanation

The correct answer is "Yes, since the EE was temporarily outside the coverage territory." This means that the liability insurance would cover a claim for an employee who is on business temporarily in France. Even though the employee is outside the coverage territory, the fact that it is a temporary situation allows for coverage under the insurance policy.

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17. An ER failing to provide WC coverage will be subject to a penalty of at least ___ for every day the failure continues.

Explanation

If an ER fails to provide workers' compensation (WC) coverage, they will be subject to a penalty of at least $250 for every day the failure continues. Additionally, they may also face a penalty of up to $10 per employee affected by the lack of coverage.

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18. Dependent children of a worker killed on the job will receive income benefits:

Explanation

Dependent children of a worker killed on the job will receive income benefits until they reach the age of 18. However, if they are still attending an accredited school at the age of 18, they may continue to receive the benefits until they complete their education or reach a higher age. This ensures that the children have financial support during their formative years and while they pursue their education.

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19. Making or publishing any oral or written statement or literature which is false, or maliciously critical of, or derogatory to the financial condition or any insurer, and which is calculated to injure any person engaged in the business of insurance is an illegal practice known as:

Explanation

Defamation refers to the act of making false statements or publishing literature that is maliciously critical or derogatory towards the financial condition of an insurer, with the intention of causing harm to individuals involved in the insurance business. This practice is considered illegal as it can damage the reputation and credibility of insurers, leading to financial losses and a loss of trust in the industry.

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20. An insurer has established a practice of settling Hawaii claims for lower amounts than reasonable person would feel the claimants are entitled to. What phrase below best describes this practice.

Explanation

The given correct answer, "An unfair claim settlement practice," best describes the insurer's practice of settling Hawaii claims for lower amounts than what a reasonable person would feel the claimants are entitled to. This phrase indicates that the practice is unjust and not in line with fair and reasonable standards. It implies that the insurer is engaging in unfair practices when it comes to settling claims, potentially causing harm to the claimants.

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21. WOTF claims would fall under the WC law?

Explanation

A disease which is proximately the result of employment would fall under the workers' compensation law. This means that if an employee develops a disease due to their work environment or conditions, they would be eligible for workers' compensation benefits. Workers' compensation laws are designed to provide financial compensation and medical benefits to employees who suffer from work-related injuries or illnesses. Therefore, a disease that is directly caused by the nature of the job would be covered under these laws.

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22. Records pertaining to WC claims transactions must be retained for ____ following the date of the completion of the transaction.

Explanation

Records pertaining to WC claims transactions must be retained for eight years following the date of the completion of the transaction. This is necessary to ensure that all relevant information related to the transaction is available for future reference, audits, or legal purposes. By retaining these records for a longer period, organizations can comply with regulatory requirements, track historical data, and have access to documentation if any issues or disputes arise in the future.

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23. In Hawaii, WOTF incidents would most likely not constitute a compensable W/C claim?

Explanation

All of the above incidents would most likely not constitute a compensable workers' compensation claim in Hawaii. In the first scenario, the employee was injured while driving his own car home from work, which typically falls outside the scope of employment. In the second scenario, the employee was injured while under the influence of alcohol, which is considered a violation of workplace safety policies and may disqualify the claim. In the third scenario, the employee intentionally injured herself at work, which is generally not covered under workers' compensation as it is considered self-inflicted.

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24. When a  EE sustains an injury requiring medical treatment beyond first aid, the ER must make a report to the Department within:

Explanation

The correct answer is 7 working days. This means that when an EE (employee) sustains an injury that requires medical treatment beyond first aid, the ER (employer) must report this to the Department within 7 working days. This timeframe allows for a reasonable amount of time for the ER to gather the necessary information and submit the report, ensuring that workplace injuries are properly documented and addressed in a timely manner.

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25. All of the following circumstances would be covered under W/C, except?

Explanation

The worker was injured while violating a company rule at lunch break would not be covered under Workers' Compensation (W/C) because the injury occurred while the worker was engaged in a violation of company rules. Workers' Compensation typically covers injuries that occur during the course of employment and are not the result of intentional misconduct or violations of company policies. Since the worker was injured while violating a company rule, it can be inferred that their actions were not in line with their employment responsibilities, and therefore, the injury would not be covered under W/C.

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26. A person who reviews or audits billings for medical services is:

Explanation

An independent bill reviewer is a person who reviews or audits billings for medical services. They are not appointed by the insurance commissioner or a public adjuster. They work independently to ensure that the billings are accurate and comply with the relevant regulations and guidelines.

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27. If an industrial accident results in sudden death of the EE, which is true regarding WC benefits?

Explanation

In the event of an industrial accident resulting in the sudden death of an employee, certain benefits will be paid to the surviving spouse until their death or remarriage. This implies that the spouse will receive financial support for a period of time after the employee's death. The other options mentioned in the question, such as no benefits beyond funeral expenses, certain benefits for surviving children, and funeral expenses not being compensable, are not applicable in this scenario.

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28. Failing to provide WC coverage in Hawaii can result in what immediate financial penalty?

Explanation

Failing to provide workers' compensation (WC) coverage in Hawaii can result in a financial penalty of $250, or up to $10 per employee per day that coverage is not in place. This means that the penalty can be a fixed amount of $250 or can vary depending on the number of employees and the duration of non-compliance.

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29. An EE is asked to operate a piece of machinery known to be in need of repair. The EE refuses and the ER insists that the EE operate the machine or face being laid off the job. The EE uses the machine and is severely injured and loses a limb. His wife sues the ER. What workers compensation coverage might protect the ER?

Explanation

In this scenario, the correct answer is "ER's liability coverage would respond." Liability coverage typically protects employers from claims made by employees who are injured on the job. In this case, the EE was injured while operating a piece of machinery that was known to be in need of repair. The EE's refusal to operate the machine was overridden by the ER, who insisted that they do so under the threat of being laid off. As a result, the EE suffered a severe injury and lost a limb. In this situation, the ER's liability coverage would likely respond to the lawsuit filed by the EE's wife, seeking compensation for the injuries sustained.

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30. WOTF best describes the reason for using various work classifications in the calculation of workers compensation premiums?

Explanation

The reason for using various work classifications in the calculation of workers compensation premiums is to accurately reflect the risks of each employer. Different types of work carry different levels of risk, and by classifying employers based on the type of work they do, insurers can determine the appropriate premium that reflects the level of risk associated with that particular employer. This ensures that employers are paying a fair and accurate premium based on the specific risks they pose, rather than a one-size-fits-all approach.

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31. Under Hawaii's W/C law, what amount, in addition to other prescribed benefits, could an EE receive when a work-related injury results in disfigurement?

Explanation

Under Hawaii's Workers' Compensation law, an employee could receive an additional amount of $30,000 in addition to other prescribed benefits when a work-related injury results in disfigurement.

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32. In Hawaii, failure by an insurer or self-insured ER to pay non-contested WC benefits w/in required timeframes may result in what penalty, if any?

Explanation

Failure by an insurer or self-insured ER to pay non-contested WC benefits within the required timeframes in Hawaii may result in an additional penalty equal to 20% of the unpaid compensation. This penalty serves as a deterrent for insurers and employers to ensure timely payment of workers' compensation benefits.

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33. WOTF is the most true regarding Hawaii WC benefits?

Explanation

The correct answer is "They are the sole remedy for work-related injuries." This means that Hawaii WC benefits are the only legal recourse for employees who sustain injuries or illnesses due to their work. It implies that employees cannot sue their employers for work-related injuries and must rely solely on the workers' compensation system for compensation and medical coverage.

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34. WOTF employments is subject to the WC law?

Explanation

The correct answer is "A firm employing only one part-time worker." This is because the workers' compensation (WC) law typically applies to employers who have a certain number of employees. In many jurisdictions, the number of employees required for WC coverage is more than one, so a firm employing only one part-time worker may not be subject to the WC law.

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35. ER's liability coverage under the workers compensation policy could cover the legal liability of an ER in which of the following situations?

Explanation

The correct answer is "All of the above". ER's liability coverage under the workers compensation policy can cover the legal liability of an ER in situations involving exempt employments, illegal employment, and non-compensable injuries. This means that the policy provides coverage for any legal liabilities that may arise in these situations, ensuring that the ER is protected financially.

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36. WOTF is true regarding the selection of a physician or surgeon in a compensable WC injury?

Explanation

The correct answer is that the injured employee may select any physician or surgeon practicing on the island where the injury occurred. This means that the employee has the freedom to choose their own healthcare provider for their compensable workers' compensation injury. The employer does not have the authority to dictate which physician or surgeon the employee must see.

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37. Secondary injury funds (also known as second or subsequent injury funds) are a part of most states' WC laws. WOTF most closely identifies their purpose?

Explanation

The purpose of secondary injury funds is to reimburse employers who hire employees with pre-existing partial disabilities and suffer a second injury. These funds provide financial support to employers who may face increased costs due to the additional injuries sustained by their employees.

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38. In Hawaii, how long must an insurer or a self-insured ER retain records of W/C claims for the inspection of the insurance commissioner?

Explanation

In Hawaii, an insurer or a self-insured ER must retain records of workers' compensation (W/C) claims for 8 years for the inspection of the insurance commissioner. This is important for ensuring compliance with regulations and allowing the insurance commissioner to effectively monitor and investigate claims. By retaining records for this length of time, the insurance commissioner can review past claims and identify any potential issues or patterns that may require further action.

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39. WOTF is true regarding W/C coverage in Hawaii?

Explanation

Workers' compensation (W/C) coverage in Hawaii can be obtained either from an authorized insurance carrier or through self-insurance. This means that employers have the option to purchase coverage from a licensed insurance company or choose to self-insure, which involves setting aside funds to cover their employees' workers' compensation claims. The answer states that W/C coverage can be purchased from an authorized insurance carrier or be self-insured, providing the correct information about the options available for obtaining coverage in Hawaii.

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40. WOTF is correct regarding the Foreign Coverage Endorsement?

Explanation

The correct answer is "All of the above". This means that all of the statements mentioned in the options are correct regarding the Foreign Coverage Endorsement. The coverage applies to employees hired within the limits of the USA while they are traveling or temporarily residing outside the US, its territories or possessions, or Canada. Employees hired outside the limits of the US are not covered. Additionally, employees hired within the US can be covered abroad for 90 days or less.

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41. In Hawaii, which party submits a closing report upon the termination of VR services?

Explanation

The correct answer is the provider of the services. In Hawaii, when VR services are terminated, it is the responsibility of the service provider to submit a closing report. This report summarizes the services provided and the outcomes achieved during the VR process. The provider is expected to document the progress made by the individual receiving services and any recommendations for future support or assistance. This report helps to ensure transparency and accountability in the VR system in Hawaii.

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42. When a Hawaii EE sustains an injury requiring medical treatment beyond first aid, how long does the ER have to report the accident to the director of the labor and industry relations?

Explanation

The ER has 7 working days to report the accident to the director of the labor and industry relations in Hawaii. This allows the ER enough time to gather all necessary information and documentation related to the injury before reporting it. It also ensures that the director is notified within a reasonable timeframe to take appropriate action if needed.

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43. WOTF is true regarding consultations because the situation is life threatening or could cause serious harm?I. The attending physician will notify the ER ASAPII. The consultant will provide a copy of the consultation report to the attending physicianIII. The copy of the consultation report must be given to the ER w/in 14 calendar days of the examination

Explanation

In situations where the consultation is necessary due to a life-threatening or potentially harmful situation, all three statements are true. Statement I states that the attending physician will notify the emergency room (ER) as soon as possible, which is crucial in urgent cases. Statement II states that the consultant will provide a copy of the consultation report to the attending physician, which is important for proper communication and coordination of care. Statement III states that the copy of the consultation report must be given to the ER within 14 calendar days of the examination, ensuring that the necessary information is documented and available for future reference.

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44. If an injury results in the immediate death of an EE, the ER has ____ to notify the Department.

Explanation

If an injury results in the immediate death of an employee, the employer has 48 hours to notify the Department. This means that the employer must inform the relevant department within two days of the incident. This requirement ensures that the department can promptly investigate the incident and take any necessary actions.

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45. Part I of the W/C ER Liability Insurance Policy describes:

Explanation

Part I of the W/C ER Liability Insurance Policy describes the insurer's duty to pay the benefits required by the Workers' Compensation (W/C) statute. This means that the insurer is obligated to promptly provide the benefits that the employer is required to give to the injured worker under the W/C laws. The policy outlines the insurer's responsibility to ensure timely payment of these benefits, which may include medical expenses, lost wages, and rehabilitation costs.

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46. WOTF types of policies will cover a contractor's EE for injuries sustained on the job?

Explanation

Workers' compensation (WC) policies will cover a contractor's employees for injuries sustained on the job. Workers' compensation insurance provides benefits to employees who are injured or become ill as a result of their work. It covers medical expenses, lost wages, rehabilitation, and other related costs. This type of policy is specifically designed to protect both the employer and the employee in case of work-related injuries or illnesses.

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47. The insured maintains a business where workers compensation coverage can be written by private insurance companies. If he has EE's going to a state that is monopolistic for this coverage, what must he do to cover his EE's for W/C coverage?

Explanation

The insured must purchase coverage for the EE's from the state because the state is monopolistic for workers compensation coverage. This means that private insurance companies cannot provide workers compensation coverage in that state. Therefore, the insured must obtain coverage directly from the state in order to cover his EE's for workers compensation.

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48. Part II of the ER's Liability Coverage, provides WOTF W/C coverage?

Explanation

Part II of the ER's Liability Coverage provides coverage for claims that are not subject to Workers' Compensation (W/C) laws. This means that if an employee gets injured or becomes ill due to work-related reasons, they would typically file a claim under Workers' Compensation. However, if the claim falls outside the scope of Workers' Compensation laws, such as if the injury was caused by a third party or if it is a personal injury claim, Part II of the ER's Liability Coverage would provide coverage for such claims.

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49. What WC benefits, if any, can dependent children of an EE killed in an industrial accident expect to receive in most states?

Explanation

Dependent children of an employee killed in an industrial accident can expect to receive income benefits until they reach the age of 21 and are enrolled full-time in school. This means that they will receive financial support until they complete their education or turn 21, whichever comes first. This is a common provision in most states' workers' compensation programs to ensure that the children of deceased employees are provided for financially during their formative years.

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50. The premium charged for a standard WC policy is based primarily on a company's:

Explanation

The premium charged for a standard WC policy is primarily based on a company's payroll. This is because workers' compensation insurance is designed to provide coverage for employees who are injured or become ill on the job. Payroll is a key factor in determining the level of risk and potential claims that a company may have. Companies with higher payroll figures generally have more employees and therefore a higher likelihood of workplace accidents or injuries, resulting in higher premiums to cover these potential claims.

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51. When an industrial injury results in death to a Hawaii EE, what funeral benefits, if any, are provided under the W/C law?

Explanation

When an industrial injury results in death to a Hawaii EE, the W/C law provides funeral benefits of up to 10 times the maximum week benefit rate. This means that the amount of funeral expenses that can be covered under the law is significantly higher, providing financial support to the family of the deceased employee during their time of mourning and loss.

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52. In Hawaii, how long will WC death/income benefits be paid to the surviving spouse of an EE, when an industrial accident results in death to the EE?

Explanation

The correct answer is "Until death or remarriage of the spouse." In Hawaii, WC death/income benefits will be paid to the surviving spouse of an employee until the spouse either passes away or gets remarried. This means that if the spouse remains unmarried, they will continue to receive the benefits for the rest of their life.

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53. WOTF basic WC benefits compensates a widow or other dependent family members of an EE whose death results from a work related injury?

Explanation

Survivor benefits are provided to the widow or other dependent family members of an employee who has died as a result of a work-related injury. These benefits are designed to provide financial support and assistance to the surviving family members who have lost their loved one and may be facing financial hardships as a result. Survivor benefits may include a lump sum payment, ongoing financial support, and other forms of assistance to help the family cope with the loss and adjust to their new circumstances.

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54. An ER is about to start working in a new state and will hire workers who reside there. Would the ER's current standard-form workers compensation policy automatically provide coverage for the new state?

Explanation

The ER's current standard-form workers compensation policy would automatically provide coverage for the new state if the new state was listed on the information page in part 3C, which covers other states insurance.

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55. For a claim to be compensable in Hawaii, written notice must be made to the director of labor and industry relations w/in how many years after the effects of the injury become manifest?

Explanation

In order for a claim to be compensable in Hawaii, written notice must be made to the director of labor and industry relations within 2 years after the effects of the injury become manifest. This means that if someone experiences an injury and the effects of that injury become evident, they must notify the director within 2 years in order for their claim to be considered compensable.

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56. Under a self-insured WC plan, what coverage should be purchased to cover a claim that is more than the insured's self-insured limits? 

Explanation

Under a self-insured Workers' Compensation (WC) plan, specific excess coverage should be purchased to cover a claim that exceeds the insured's self-insured limits. This type of coverage provides additional protection by paying for claims that exceed the predetermined self-insured amount. It is specifically designed to cover high-cost claims that may exceed the self-insured limits, ensuring that the employer is not solely responsible for the entire cost of the claim. This coverage kicks in once the self-insured limits have been reached, providing financial support and minimizing the employer's financial risk.

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57. All of the following are considered unfair claims settlement practices, except:

Explanation

Failing to make payment on an uncovered claim is not considered an unfair claims settlement practice because if a claim is not covered by the insurance policy, the insurance company is not obligated to make a payment. The other options listed are all examples of unfair claims settlement practices as they involve either delaying the claims process, misrepresenting information, or refusing to conduct a proper investigation before denying a claim.

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58. Under a standard WC policy, the insurer is considered to have received notice of a claim:

Explanation

The correct answer is "When the ER has notice of the claim." In a standard workers' compensation policy, the insurer is considered to have received notice of a claim when the employer (ER) is aware of the claim. This means that as soon as the employer becomes aware of an employee's claim, the insurer is deemed to have received notice. This is an important factor in determining the timeline for processing and handling the claim.

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59. All of the following are true about WC benefits, EXCEPT:

Explanation

The waiting period applies to medical and disability benefits. This means that there is a certain period of time that an injured worker must wait before they can start receiving medical and disability benefits. However, this statement is incorrect because the waiting period actually does not apply to medical and disability benefits.

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60. WOTF is false regarding deductibles in a WC policy in Hawaii?

Explanation

In a WC policy in Hawaii, deductibles are not permitted. This means that the policyholder cannot choose to have a deductible for their policy. Deductibles are a certain amount of money that the policyholder must pay out of pocket before the insurance coverage kicks in. However, in Hawaii, deductibles are not allowed in WC policies, meaning that the policyholder does not have the option to select a deductible.

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61. What is the penalty in Hawaii for an ER or insurance carrier which fails to properly pay total disability benefits?

Explanation

In Hawaii, if an ER or insurance carrier fails to properly pay total disability benefits, they may be required to make a payment of up to $2,500 into the special compensation fund. This fund is likely set up to provide financial assistance to individuals who have been denied their rightful disability benefits. By making this payment, the ER or insurance carrier is compensating for their failure to fulfill their obligations and ensuring that the affected individuals receive the support they are entitled to.

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62. WOTF EE's would be considered a Longshoreman?

Explanation

A Longshoreman is someone who works at the dock and is responsible for loading ships. They handle cargo, operate machinery, and ensure that the ship is properly loaded. This job requires physical strength and the ability to work in a fast-paced environment. Longshoremen play a crucial role in the shipping industry, as they ensure that goods are loaded safely and efficiently onto ships for transportation.

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63. WOTF is true regarding the payment of benefits for PTD or PPD after the death of an EE?

Explanation

In the case of PTD (Permanent Total Disability) or PPD (Permanent Partial Disability), the unpaid balance of benefits will be paid to the employee's spouse and dependents as long as the death was not a result of the injury for which benefits are being paid. This means that if the employee dies due to a cause unrelated to the injury, the remaining benefits will be paid to their spouse and dependents. However, if the death is a result of the injury, the payments will stop upon the death of the employee. Therefore, the correct answer is that the unpaid balance of benefits will be paid to the employee's spouse and dependents as long as death was not a result of the injury to which benefits are being paid.

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64. Whenever the Commissioner has reason to believe that any person has engaged in any unfair method of competition or any unfair or deceptive act or practice, the Commissioner may give notice and hold a hearing. The hearing must be held not less than ____ after the date notice is served.

Explanation

The Commissioner has the authority to hold a hearing if they have reason to believe that someone has engaged in unfair competition or deceptive practices. The hearing must be held within 15 days after the notice is served. This timeframe allows for a reasonable amount of time for both the Commissioner and the accused person to prepare for the hearing and present their respective cases. It ensures that there is a timely resolution to the matter while still allowing for adequate preparation.

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65. ER's must provide injured Hawaii EE's w/ info on the EE's right to select vocational rehab provider. Once an EE receives this information, how long do they have to make the selection?

Explanation

ER's must provide injured Hawaii EE's with information on the EE's right to select a vocational rehab provider. Once an EE receives this information, they have 30 days to make the selection.

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66. In Hawaii, all licensees must notify the commissioner of any change of address within ____ of the change.

Explanation

In Hawaii, licensees are required to inform the commissioner of any change in their address within 30 days of the change. This means that licensees have a month to update their address information with the commissioner. It is important for licensees to promptly notify the commissioner to ensure that their records are accurate and up to date. Failing to do so may result in penalties or difficulties in communication with the licensing authority.

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67. WOTF is the most correct concerning premiums in a standard WC policy?

Explanation

The correct answer states that the insurer has 3 years after the policy expires to audit the insured's payroll records and determine the final premium. This means that the premium shown on the information page is not necessarily the final premium, as it can be adjusted based on the audit findings. The other options do not mention the possibility of an audit or the timeframe for determining the final premium, making them less correct.

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68. As a result of a work injury, Tom has lost the use of his thumb. How long can he receive benefits for this PPD in Hawaii?

Explanation

Tom can receive benefits for this Permanent Partial Disability (PPD) in Hawaii for a duration of 75 weeks. This means that he will be compensated for the loss of use of his thumb for a period of 75 weeks.

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69. If a request for consultation with the same medical specialty has been denied, the attending physician may not resubmit the same request for consultation w/ the same medical specialty after _____ days.

Explanation

If a request for consultation with the same medical specialty has been denied, the attending physician may not resubmit the same request for consultation with the same medical specialty after 45 days. This means that if the physician's initial request for consultation was denied, they must wait for a period of 45 days before they can submit another request for consultation with the same medical specialty. This policy is likely in place to prevent excessive or unnecessary consultations and to ensure that resources are used effectively.

Submit
70. Hawaii's WC laws state quite specifically WHO is entitled to benefits, and to WHERE THE WORK TAKES PLACE in order for benefits to apply. In WOTF situations would the law not apply?

Explanation

The Hawaii WC laws state that benefits only apply to work injuries that occur within the state, regardless of the employee's residency. In the given situation, the employee was hired by a Hawaii employer while residing in another state, but the injury occurred in a different state. Since the injury did not take place in Hawaii, the employee would not be entitled to benefits under Hawaii's WC laws.

Submit
71. WOTF is true about the Jones Act?I. It allows injure crew members to sue the ER for negligenceII. It allows the personal representative of a deceased crew member to sue the ERIII. It was named after Williams Jones, who lost his life on the high seas in 1933

Explanation

The Jones Act allows injured crew members to sue the employer for negligence (I) and allows the personal representative of a deceased crew member to sue the employer (II). However, there is no information given in the question about the Act being named after Williams Jones, so option III cannot be considered true. Therefore, the correct answer is I and II only.

Submit
72. If an injury to a Hawaii EE is ultimately found to be the fault of a party other than the ER, WOTF is FALSE?

Explanation

If the EE wins damages from a party other than the ER, the EE can retain those monies in addition to the compensation received from the ER. This means that if the injury is found to be the fault of someone other than the employer, the employee or their dependents can seek damages from that party. If they are successful in obtaining damages, they are entitled to keep that money in addition to the compensation already received from the employer. There is no requirement for the employee to reimburse the employer for the compensation payments made.

Submit
73. WOTF is not true regarding a compensable WC claim that is the fault of a third party?

Explanation

The correct answer is that the ER may take action against the third party in lieu of paying for the worker's injury. This means that if a worker is injured due to the fault of a third party, the employer has the option to pursue legal action against the third party instead of paying for the worker's injury themselves. This allows the employer to seek compensation from the responsible party and potentially avoid paying for the worker's injury out of their own pocket.

Submit
74. The premium adjustment made for the current year of W/C coverage is sometimes based on prior years' loss experience. This is called:

Explanation

The premium adjustment made for the current year of W/C coverage is sometimes based on prior years' loss experience. This adjustment is known as the experience modification rating. This rating takes into account an employer's historical workers' compensation claims and compares them to the average claims experience for similar businesses. A higher experience modification rating indicates a higher likelihood of future claims, resulting in a higher premium, while a lower rating suggests a lower risk and a lower premium.

Submit
75. A contractor applying for WC insurance has traditionally worked in only one state, but is now bidding for work in several surrounding states. What provisions of the standard policy addresses this contractor's loss exposures that might develop during the policy period in these new states?

Explanation

The correct answer is "Other states insurance". Other states insurance is a provision in the standard policy that addresses the contractor's loss exposures that might develop during the policy period in new states. This provision provides coverage for work performed outside the contractor's home state, allowing them to bid for work in several surrounding states without having to add coverage by endorsement before starting work in each new state.

Submit
76. If the Hawaii insurance commissioner is to hold a hearing on an unfair or deceptive insurance practice, the commissioner must mail notices to each party that may be called to appear at the hearing. How many days in advance of the hearing must these notices be sent out?

Explanation

The Hawaii insurance commissioner is required to send out notices to each party that may be called to appear at a hearing on an unfair or deceptive insurance practice. These notices must be sent out 15 days in advance of the hearing.

Submit
77. If an insurance company intends to cancel a WC policy in Hawaii, the insurer must give how many days' notice to the insured?

Explanation

In Hawaii, if an insurance company intends to cancel a Workers' Compensation (WC) policy, they must provide the insured with a notice period of 10 days. This means that the insurer must inform the insured at least 10 days in advance before canceling the policy. This gives the insured enough time to make alternative arrangements or address any issues before the cancellation takes effect.

Submit
78. If a TTD claim in the state of Hawaii is not being contested, how long after the ER receives notice of the disability must benefits begin to be paid?

Explanation

In the state of Hawaii, if a temporary total disability (TTD) claim is not being contested, the benefits must begin to be paid within 10 days after the employer receives notice of the disability. This ensures that injured workers receive the necessary financial support in a timely manner to cover their medical expenses and lost wages.

Submit
79. WOTF is not considered in WC experience modification calculations?

Explanation

In workers' compensation experience modification calculations, the amount of employee payroll is not considered. The experience modification factor is determined based on the insured's actual losses, a credibility factor based on premiums paid by the insured, and the amount of losses expected for the same work classifications. The amount of employee payroll does not directly affect the calculation of the experience modification factor.

Submit
80. WOTF is covered under the Federal Employees Compensation Act?I. Federal employees exempt under state workers compensation lawsII. Active duty military membersIII. Members of the Merchant Marine under the Jones ActIV. Longshoremen and harbor workers

Explanation

The correct answer is "I only". This means that only federal employees who are exempt under state workers compensation laws are covered under the Federal Employees Compensation Act. The Act does not cover active duty military members, members of the Merchant Marine under the Jones Act, or longshoremen and harbor workers.

Submit
81. WOTF is NOT one of the common law defenses against ER's liability?

Explanation

Proximate cause is not one of the common law defenses against employer's liability. Proximate cause refers to the direct cause of an injury or harm, and it is not typically used as a defense by employers in cases of liability. The common law defenses against employer's liability include the fellow servant rule, which states that if an employee is injured by the negligence of another employee, the employer is not liable; contributory negligence, which states that if the employee's own negligence contributed to their injury, the employer is not liable; and assumption of risk, which states that if the employee voluntarily assumed the risk of a known danger, the employer is not liable.

Submit
82. ER's are required under Hawaii's WC law to make various reports to the director of labor, such as in the event of a serious industrial accident. What financial penalty, if any, is an ER subject to when willfully refusing or neglecting to make these reports?

Explanation

Under Hawaii's WC law, employers are required to make various reports to the director of labor, including in the event of a serious industrial accident. If an employer willfully refuses or neglects to make these reports, they are subject to a financial penalty of $5,000 per violation.

Submit
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WOTF individuals is most likely to have a valid W/C claim?
In the case of a compensable injury in Hawaii, who normally chooses...
Under Hawaii law, for what period of time is an ER responsible to pay...
An applicant for a WC adjuster license in Hawai must be at least how...
What is the waiting period in Hawaii before an EE becomes entitled to...
WOTF basic WC benefits compensates for the loss of income or earning...
What coverage might a self-insured ER purchase to cover WC claims that...
In the case of a compensable injury resulting in TTD, when does the...
In Hawaii, what percentage of an EE's AWW is paid in case of a...
WOTF is not an acceptable form of security for the payment of WC...
In Hawaii, how long must an insurer or a self-insured ER retain...
It is possible that medical care benefits to an injured Hawaii EE may...
WOTF would fall outside the scope of WC laws?
WOTF EE injury claims would most likely not be covered under...
WOTF work-related injuries would be deemed to be PTD in Hawaii?
Would a claim under ER's liability insurance for an EE on business...
An ER failing to provide WC coverage will be subject to a penalty of...
Dependent children of a worker killed on the job will receive income...
Making or publishing any oral or written statement or literature which...
An insurer has established a practice of settling Hawaii claims for...
WOTF claims would fall under the WC law?
Records pertaining to WC claims transactions must be retained for ____...
In Hawaii, WOTF incidents would most likely not constitute a...
When a  EE sustains an injury requiring medical treatment beyond...
All of the following circumstances would be covered under W/C, except?
A person who reviews or audits billings for medical services is:
If an industrial accident results in sudden death of the EE, which is...
Failing to provide WC coverage in Hawaii can result in what immediate...
An EE is asked to operate a piece of machinery known to be in need of...
WOTF best describes the reason for using various work classifications...
Under Hawaii's W/C law, what amount, in addition to other...
In Hawaii, failure by an insurer or self-insured ER to pay...
WOTF is the most true regarding Hawaii WC benefits?
WOTF employments is subject to the WC law?
ER's liability coverage under the workers compensation policy...
WOTF is true regarding the selection of a physician or surgeon in a...
Secondary injury funds (also known as second or subsequent injury...
In Hawaii, how long must an insurer or a self-insured ER retain...
WOTF is true regarding W/C coverage in Hawaii?
WOTF is correct regarding the Foreign Coverage Endorsement?
In Hawaii, which party submits a closing report upon the termination...
When a Hawaii EE sustains an injury requiring medical treatment beyond...
WOTF is true regarding consultations because the situation is life...
If an injury results in the immediate death of an EE, the ER has ____...
Part I of the W/C ER Liability Insurance Policy describes:
WOTF types of policies will cover a contractor's EE for injuries...
The insured maintains a business where workers compensation coverage...
Part II of the ER's Liability Coverage, provides WOTF W/C...
What WC benefits, if any, can dependent children of an EE killed in an...
The premium charged for a standard WC policy is based primarily on a...
When an industrial injury results in death to a Hawaii EE, what...
In Hawaii, how long will WC death/income benefits be paid to the...
WOTF basic WC benefits compensates a widow or other dependent family...
An ER is about to start working in a new state and will hire workers...
For a claim to be compensable in Hawaii, written notice must be made...
Under a self-insured WC plan, what coverage should be purchased to...
All of the following are considered unfair claims settlement...
Under a standard WC policy, the insurer is considered to have received...
All of the following are true about WC benefits, EXCEPT:
WOTF is false regarding deductibles in a WC policy in Hawaii?
What is the penalty in Hawaii for an ER or insurance carrier which...
WOTF EE's would be considered a Longshoreman?
WOTF is true regarding the payment of benefits for PTD or PPD after...
Whenever the Commissioner has reason to believe that any person has...
ER's must provide injured Hawaii EE's w/ info on the EE's...
In Hawaii, all licensees must notify the commissioner of any change of...
WOTF is the most correct concerning premiums in a standard WC policy?
As a result of a work injury, Tom has lost the use of his thumb. How...
If a request for consultation with the same medical specialty has been...
Hawaii's WC laws state quite specifically WHO is entitled to...
WOTF is true about the Jones Act?I. It allows injure crew members to...
If an injury to a Hawaii EE is ultimately found to be the fault...
WOTF is not true regarding a compensable WC claim that is the fault of...
The premium adjustment made for the current year of W/C coverage is...
A contractor applying for WC insurance has traditionally worked in...
If the Hawaii insurance commissioner is to hold a hearing on an unfair...
If an insurance company intends to cancel a WC policy in Hawaii, the...
If a TTD claim in the state of Hawaii is not being contested, how long...
WOTF is not considered in WC experience modification calculations?
WOTF is covered under the Federal Employees Compensation Act?I....
WOTF is NOT one of the common law defenses against ER's liability?
ER's are required under Hawaii's WC law to make various...
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