Question 1

What is the difference between short-rate and pro-rata cancellation?

Accepted Answer

Pro-rata charges the insured only for the time the policy was on risk, so the refund is proportional. Short-rate applies a penalty on top, historically to recover acquisition costs, so the refund is smaller. Pro-rata usually applies when the insurer cancels and short-rate when the insured cancels. On a 2,400 dollar annual policy cancelled at day 120, the difference is roughly 161 dollars at a 90 percent short-rate factor.

Question 2

What does it mean when an insurance submission is referred?

Accepted Answer

A referral means an underwriting rule has been triggered and a person must review the risk before terms can be confirmed. In InsureFlow no premium figures are shown at all while a risk is referred, and a broker cannot release their own referral. Only an underwriter can.

Question 3

Why do Canadian dental practices need software built for Canada?

Accepted Answer

Canadian practices bill against provincial fee guides, route claims through CDAnet, and handle CDCP eligibility, under PIPEDA and provincial health privacy law. Most dental software was built for the United States first and handles these awkwardly.

Question 4

How is a patient portion calculated on a dental claim?

Accepted Answer

Take the treatment cost, subtract any deductible still owing, apply the plan co-insurance percentage, then cap the result at the remaining annual maximum. Whatever the plan does not pay is the patient portion.

Question 5

What is a managing general agent?

Accepted Answer

A managing general agent holds delegated authority from an insurer to underwrite, price and bind risks without case-by-case approval. That authority is the reason an MGA's systems must be able to prove every decision was made inside its limits.

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