Docsity
Docsity

Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity


Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan


Guidelines and tips
Guidelines and tips

FLORIDA 240 LICENSE EXAM QUESTIONS, Exams of Public Health

FLORIDA 240 LICENSE EXAM QUESTIONS WITH VERIFIED CORRECT ANSWERS

Typology: Exams

2024/2025

Available from 01/15/2025

Andreas-best
Andreas-best 🇬🇧

726 documents

1 / 27

Toggle sidebar

This page cannot be seen from the preview

Don't miss anything!

bg1
FLORIDA 240 LICENSE EXAM
QUESTIONS WITH VERIFIED CORRECT
ANSWERS
“The stated amount or percent of liquid assets that an insurer must have on hand that will satisfy future
obligations to its policyholders is called: - Correct Answer Reserves"
"An insurance applicant MUST be informed of an investigation regarding his/her reputation and
character according to the: - Correct Answer Fair Credit Reporting Act"
"A nonprofit incorporated society that does not have capital stock and operates for the sole benefit of
its members is known as: - Correct Answer A fraternal benefit society"
"What I the name of the law that requires insurers to disclose information gathering practices and
where the information was obtained? - Correct Answer Fair Credit Reporting Act"
"Who elects the governing body of a mutual insurance company? - Correct Answer Policyholders"
"A group-owned insurance company that is formed to assume and spread the liability ricks of its
members is known as a: - Correct Answer Risk retention group"
"What type of reinsurance contract involves two companies automatically sharing their risk exposure? -
Correct Answer treaty"
"What year was the McCarran-Ferguson Act enacted? - Correct Answer 1945"
"Which of these describe a participating life insurance policy? - Correct Answer Policy owners are
entitled to receive dividends"
"At what point must a life insurance applicant be informed of their rights that fall under the Fair Credit
Reporting Act? - Correct Answer Upon completion of the application"
"Which of the following requires insurers to disclose when an applicant's consumer or credit history is
being investigated: - Correct Answer 1970 - Fair Credit Reporting Act"
"What type of reinsurance contract involves two companies automatically sharing their risk exposure? -
Correct Answer Treaty"
1 | P a g e
pf3
pf4
pf5
pf8
pf9
pfa
pfd
pfe
pff
pf12
pf13
pf14
pf15
pf16
pf17
pf18
pf19
pf1a
pf1b

Partial preview of the text

Download FLORIDA 240 LICENSE EXAM QUESTIONS and more Exams Public Health in PDF only on Docsity!

FLORIDA 240 LICENSE EXAM

QUESTIONS WITH VERIFIED CORRECT

ANSWERS

“The stated amount or percent of liquid assets that an insurer must have on hand that will satisfy future

obligations to its policyholders is called: - Correct Answer Reserves"

"An insurance applicant MUST be informed of an investigation regarding his/her reputation and

character according to the: - Correct Answer Fair Credit Reporting Act"

"A nonprofit incorporated society that does not have capital stock and operates for the sole benefit of

its members is known as: - Correct Answer A fraternal benefit society"

"What I the name of the law that requires insurers to disclose information gathering practices and

where the information was obtained? - Correct Answer Fair Credit Reporting Act"

"Who elects the governing body of a mutual insurance company? - Correct Answer Policyholders"

"A group-owned insurance company that is formed to assume and spread the liability ricks of its

members is known as a: - Correct Answer Risk retention group"

"What type of reinsurance contract involves two companies automatically sharing their risk exposure? -

Correct Answer treaty"

"What year was the McCarran-Ferguson Act enacted? - Correct Answer 1945"

"Which of these describe a participating life insurance policy? - Correct Answer Policy owners are

entitled to receive dividends" "At what point must a life insurance applicant be informed of their rights that fall under the Fair Credit

Reporting Act? - Correct Answer Upon completion of the application"

"Which of the following requires insurers to disclose when an applicant's consumer or credit history is

being investigated: - Correct Answer 1970 - Fair Credit Reporting Act"

"What type of reinsurance contract involves two companies automatically sharing their risk exposure? -

Correct Answer Treaty"

"A group-owned insurance company that is formed to assume and spread the liability risks of its

members is known as a: - Correct Answer risk retention group"

"All of the following are considered to be typical characteristics describing the nature of an insurance

contract, EXCEPT: - Correct Answer Bilateral"

"The part of a life insurance policy guaranteed to be true is called a(n) - Correct Answer warranty"

"Statements made on an insurance application that are believed to be true to the best of the applicant's

knowledge are called - Correct Answer representations"

"Q purchases a $500,000 life insurance policy and pays $900 in premiums over the first six months. Q dies suddenly and the beneficiary is paid $500,000. This exchange of unequal values reflects which of

the following insurance contract features? - Correct Answer Aleatory"

"When must insurable interest be present in order for a life insurance policy to be valid? - Correct

Answer When the application is made"

"A life insurance arrangement which circumvents insurable interest statutes is called: - Correct Answer

Investor-Originated Life Insurance" "Stranger Originated Life Insurance (STOLI) has been found to be in violation of which of the following

contractual elements? - Correct Answer Legal Purpose (Insurable Interest)"

"Who makes the legally enforceable promises in a unilateral contract? - Correct Answer Insurance

company"

"A policy of adhesion can only be modified by whom? - Correct Answer insurance company"

"When third-party ownership is involved, applicants who also happen to be the stated primary

beneficiary are required to have: - Correct Answer insurable interest in the proposed insured"

"Which of these is considered a statement that is assured to be true in every aspect? - Correct Answer

Warranty"

"Which of these require an offer, acceptance, and consideration? - Correct Answer contract"

"If a contract of adhesion contains complicated language, to whom would the interpretation be in favor

of? - Correct Answer insured"

"Insurance contracts are known as _____ because certain future conditions or acts must occur before

any claims can be paid. - Correct Answer conditional"

"The Consideration clause in a life insurance contract contains what pertinent information? - Correct

Answer The schedule and amount of premium payments"

"Which of the following consists of an offer, acceptance, and consideration? - Correct Answer

Contract"

"Which of the following consists of an offer, acceptance, and consideration? - Correct Answer

contract"

"Which of these is NOT considered to be an element of an insurance company? - Correct Answer

Negotiating"

"What is a warranty? - Correct Answer is a statement guaranteed to be true"

"A life insurance policy would be considered a wagering contract WITHOUT: - Correct Answer

insurable interest" "G is an accountant who has ten employees and is concerned about how the business would survive

financially if G became disabled. The type of policy which BEST addresses this concern is - Correct

Answer Business Overhead Expense"

"Which of the following claims are typically excluded from Medical expense policies? - Correct Answer

Intentionally self-inflicted injuries" "XYZ Company pays the entire premium for its group health plan. The MINIMUM percentage of eligible

employees that must be covered is - Correct Answer 100%"

"A Business Overhead Expense policy: - Correct Answer covers business expenses such as rent and

utilities" "A Business Overhead Expense policy would cover which of the following if a business owner becomes

disabled? - Correct Answer Utilities and office rent"

"What is issued to each employee of an employer health plan? - Correct Answer certificate"

"The benefits under a Disability Buy-Out policy are - Correct Answer payable to the company or

another shareholder" "A policy owner would like to change the beneficiary on a Life insurance policy and make the change

permanent. Which type of designation would fulfill this need? - Correct Answer irrevocable"

"Which contract permits the remaining partners to buy-out the interest of a disabled business partner? -

Correct Answer Disability Buy-Sell"

"T and S are named co-primary beneficiaries on a $500,000 Accidental Death and Dismemberment policy insuring their father. Their mother was named contingent beneficiary. Five years later, S dies of natural causes and the father is killed in a scuba accident shortly afterwards. How much of the death

benefit will the mother receive? - Correct Answer $0"

"Which of the following medical expenses does Cancer insurance NOT cover? - Correct Answer

arthritis"

"The difference between group insurance and blanket health policies is: - Correct Answer Blanket

health policies do not issue certificates" "Which type of policy would pay an employee's salary if the employer was injured in a bicycle accident

and out of work for six weeks? - Correct Answer Business Overhead Expense"

"On an Accidental Death and Dismemberment (AD&D) insurance policy, who is qualified to change the

beneficiary designation? - Correct Answer Policyowner"

"The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers (and their families) whose

employment has been terminated the right to: - Correct Answer continue group health benefits"

"K is the insured and P is the sole beneficiary on an Accidental Death and Dismemberment (AD&D) insurance policy. Both are involved in a fatal accident where K dies before P. Under the Common

Disaster provision, which of these statements is true? - Correct Answer Proceeds will be paid to P's

estate" "How would a contingent beneficiary receive the policy proceeds in an Accidental Death and

Dismemberment (AD&D) policy? - Correct Answer If the primary beneficiary dies before the insured"

"Which mode of payment is NOT used by health insurance policies? - Correct Answer Single Premium"

"G is an accountant who has ten employees and is concerned about how the business would survive

financially if G became disabled. The type of policy which BEST addresses this concern is - Correct

Answer Business Overhead Expense"

"Which of the following is the reimbursement of benefits for the treatment of a beneficiary's injuries

caused by a third party? - Correct Answer Subrogation"

"S is employed by a large corporation that provides group health coverage for its employees and their dependents. If S dies, the company must allow his surviving spouse and dependents to continue their

group health coverage for a maximum of how many months under COBRA regulations? - Correct

Answer 36"

"K has an Accidental Death and Dismemberment (AD&D) insurance policy where her husband is beneficiary and her daughter is contingent beneficiary. Under the Common Disaster clause, if K and her

husband are both killed in an automobile accident, where would the death proceeds be directed? -

Correct Answer daughter"

"Which of the following statements does NOT accurately describe the tax treatment of premiums and

benefits of individual Accident and Health insurance? - Correct Answer Disability income policy

premiums are tax-deductible"

"coordination of benefits provision - Correct Answer prevents an insured covered by two health plans

from making a profit on a covered loss" "Accidental Death coverage is provided to commercial airline passengers in which of he following types

of policies? - Correct Answer Blanket Accident policy"

"If the insured and primary beneficiary are both killed in the same accident and it cannot be determined who died first, where are the death proceeds to be directed under the Uniform Simultaneous Death

Act? - Correct Answer Insured's contingent beneficiary"

"Which of the following statements is correct regarding an employer/employee group health plan? -

Correct Answer the employer receives a master policy and the employees receive certificates"

"Which of the following is the reimbursement of benefits for the treatment of a beneficiary's injuries

caused by a third party? - Correct Answer Subrogation"

"All students attending a large university could be covered by - Correct Answer a blanket policy"

"Many small business owners worry how their business would survive financially if the owner becomes

disabled. The policy which BEST addresses this concern is - Correct Answer Business Overhead

Expense"

"How does group insurance differ from individual insurance? - Correct Answer Premiums are lower"

"P is an employee who quits her job and wants to convert her group health coverage to an individual

policy. After the expiration of COBRA laws, which of the following statements is TRUE? - Correct

Answer She does NOT need to provide evidence of insurability"

"An insured covered by AD&D insurance has just died. What will happen if the primary beneficiary had

already died before the insured and contingent beneficiary? - Correct Answer Proceeds will go to the

contingent beneficiary"

"All of the following statements regarding group health insurance is true, EXCEPT: - Correct Answer An

individual policy is given to each member" "What kind of Accidental Death and Dismemberment (AD&D) insurance beneficiary requires his/her

consent when a change of beneficiary is made? - Correct Answer Irrevocable beneficiary"

"Which statement is TRUE regarding a group accident & health policy issued to an employer? - Correct

Answer The employer receives the policy and each employee is issued a certificate"

"P is a new employee and will be obtaining non-contributory group Major Medical insurance from her

employer. Which of the following actions must she take during the open enrollment period? - Correct

Answer Sign an enrollment card"

"M purchased an Accidental Death and Dismemberment (AD&D) policy and named his son as beneficiary. M has the right to change the beneficiary designation at anytime. What type of beneficiary

is his son? - Correct Answer Revocable"

"T is covered by an Accidental Death and Dismemberment (AD&D) policy that has an irrevocable

beneficiary. What action will the insurance company take if T requests a change of beneficiary? -

Correct Answer Request of the change will be refused"

"Which of these types of coverage is best described as a short term medical policy? - Correct Answer

interim coverage"

"A Business Disability Buyout plan policy is designed: - Correct Answer to pay benefits to the

Corporation or other shareholders" "Group/voluntary long-term care policy premiums are typically deducted from the employee's income

and - Correct Answer are less costly as compared to individual long term care coverage"

"B has a $100,000 Accidental Death and Dismemberment policy that pays triple indemnity for common carrier death. If B is killed from an accident on a commercial flight, what will the policy pay B's

beneficiary? - Correct Answer $300,000"

"A policyowner's rights are limited under which beneficiary designation? - Correct Answer irrevocable"

"The reason for a business having a Business Overhead Expense Disability Plan is to cover - Correct

Answer fixed business expenses"

"Which statement is true regarding a minor beneficiary? - Correct Answer Normally, a guardian is

required to be appointed in the Beneficiary clause of the contract"

"A medical care provider which typically delivers health services at its own local medical facility is known

as a - Correct Answer Health maintenance organization (HMOs)"

"Which of the following statements is true about most Blue Cross/Blue Shield organizations? - Correct

Answer They are nonprofit organizations"

"Which of these is considered a true statement regarding Medicaid? - Correct Answer Funded by both

state and federal governments" "Which of the following types of organizations are prepaid group health plans, where members pay in

advance for the services of participating physicians and hospitals that have agreements? - Correct

Answer HMO"

"Which of these statements is INCORRECT regarding a Preferred Provider Organization (PPO)? - Correct

Answer PPO's are NOT a type of managed care systems"

"J is a subscriber to a plan which contracts with doctors and hospitals to provide medical benefits at a

preset price. What type of plan does J belong to? - Correct Answer health maintenance organization"

"Which of the following organizations would make reimbursement payments directly to the insured

individual for covered medical expenses? - Correct Answer Commercial insurer"

"The percentage of an individual's Primary Insurance Amount (PIA) determines the benefits paid in

which of the following programs? - Correct Answer Social Security Disability Income"

"Which type of provider is known for stressing preventative medical care? - Correct Answer Health

Maintenance Organizations (HMO's)"

"Which of the following statements BEST defines usual, customary, and reasonable (UCR) charges? -

Correct Answer The maximum amount considered eligible for reimbursement by an insurance

company under a health plan"

"Which of the following phrases refers to the fees charged by a healthcare professional? - Correct

Answer Usual, customary, and reasonable expenses"

"Comprehensive Major Medical policies usually combine: - Correct Answer Major Medical with Basic

Hospital/Surgical coverage"

"Which of these options can an individual use their medical flexible spending account to pay for? -

Correct Answer prescription drugs"

"Which of the following BEST describes a Hospital Indemnity policy? - Correct Answer Coverage that

pays a stated amount per day of a covered hospitalization"

"Which of the following is NOT a limited benefit plan? - Correct Answer Life insurance policies"

"An insured covered by a group Major Medical plan is hospitalized after sustaining injuries that resulted from an automobile accident. Assuming the plan had a $1,000 deductible and an 80/20 Coinsurance

clause, how much will the INSURED be responsible to pay with $11,000 in covered medical expenses? -

Correct Answer $3,000"

"Deductibles are used in health policies to lower: - Correct Answer overuse of medical services"

"All of the following statements about Major Medical benefits are true, EXCEPT: - Correct Answer

Benefits have no maximum limit"

"Major Medical policies typically: - Correct Answer contain a deductible and coinsurance"

"In Major Medical Expense policies, what is the intent of a Stop Loss provision? - Correct Answer Limits

an insured's out-of-pocket medical expenses"

"What type of policy would only provide coverage for specific types of illnesses (cancer, stroke, etc)? -

Correct Answer Dread disease insurance"

"Basic Hospital and Surgical policy benefits are: - Correct Answer lower than the actual expenses

incurred"

"Basic Medical Expense insurance: - Correct Answer has lower benefit limits than Major Medical

insurance" "T was treated for an ailment 2 months prior to applying for a health insurance policy. This condition was noted on the application and the policy was issued shortly afterwards.How will the insurer likely

consider this condition? - Correct Answer Insurer will likely treat as a pre-existing condition which may

not be covered for one year"

"Which of the following costs would a Basic Hospital/Surgical policy likely cover? - Correct Answer

Surgically removing a facial birthmark cosmetic surgery"

"A characteristic of Preferred Provider Organizations (PPOs) would be: - Correct Answer Discounted

fees for the patient"

"Which of the following situations does a Critical Illness plan cover? - Correct Answer leukemia"

"Which of the following individual health insurance policies will provide the broadest protection? -

Correct Answer major medical"

"For which of the following expenses does a Basic Hospital policy pay? - Correct Answer hospital room

and board"

"In order to establish a Health Reimbursement Arrangement (HRA), it MUST - Correct Answer be

established by the employer" "Which of the following health insurance coverages is BEST suited for meeting the expenses of

catastrophic illness? - Correct Answer major medical"

"Which of these is NOT a characteristic of a Health Reimbursement Arrangement (HRA)? - Correct

Answer Employee funds the HRA entirely"

"All of the following are limited benefit plans, EXCEPT: - Correct Answer Life insurance policies"

"The phrase "This policy will only pay for a semi-private room" is an example of a(n): - Correct Answer

Internal limit" "M has a Major Medical insurance policy with a $200 flat deductible and an 80% Coinsurance clause. If M incurs a $2,200 claim for an eligible medical expense, how much will M receive in payment for this

claim? - Correct Answer $1,600"

"Q is hospitalized for 3 days and receives a bill for $10,100. Q has a Major Medical policy with a $

deductible and 80/20 coinsurance. How much will Q be responsible for paying on this claim? - Correct

Answer $2,100"

"Which of the following types of health coverage frequently uses a deductible? - Correct Answer

Major Medical policy"

"Which of the following statements about Health Reimbursement Areangements (HRA) is CORRECT? -

Correct Answer If the employee paid for qualified medical expenses, the reimbursements may be tax-

free"

"A Health Reimbursement Arrangement MUST be established: - Correct Answer by the employer"

"J's Major Medical policy has a $2,000 deductible and an 80/20 Coinsurance clause. If J is hospitalized

and receives a bill for $10,000, J would pay: - Correct Answer $3,600"

"The first portion of a covered Major Medical insurance expense that the insured is required to pay is

called the - Correct Answer initial deductible"

"S wants to open a tax-exempt Health Savings Account. To qualify for this type of account, Federal law

dictates that S must be enrolled in a - Correct Answer High Deductible Health Plan"

"Which of the following services is NOT covered under a hospitalization expense policy? - Correct

Answer surgeon's fees"

"Which of the following medical expenses does Cancer insurance NOT cover? - Correct Answer

arthritis"

"A major medical policy typically: - Correct Answer provides benefits for reasonable and necessary

medical expenses, subject to policy limits" "M becomes disabled and is unable to work for six months. M dies soon after from complications arising from this disability. M has a Disability Income policy that pays $2,000 a month. Which of the following

statements BEST describes what is owed to her estate? - Correct Answer earned, but unpaid benefits"

"Which of these statements concerning an individual Disability Income policy is TRUE? - Correct

Answer Normally includes an Elimination period"

"When determining the monthly benefit amount for a Disability Income policy, the factor that limits the

amount a prospective insured may purchase is: - Correct Answer income"

"An insured owns an individual Disability Income policy with a 30-day Elimination Period for sickness and accidents and a monthly indemnity benefit of $500. If the insured is disabled for 3 1/2 months, what is

the MAXIMUM amount he would receive for an approved claim? - Correct Answer $1,250"

"J has a Disability Income policy that does NOT provide benefits for losses occurring as the result of his

employment. What kind of coverage is this? - Correct Answer Nonoccupational coverage"

"An individual Disability Income insurance applicant may be required to submit all of the following

information EXCEPT - Correct Answer spouse's occupation"

"V is insured under an individual Disability Income policy with a 30-day Elimination period. On July 1, he is involved in an accident and temporarily disabled. He returns to work on December 1. How many

months of benefit are payable? - Correct Answer 4 months"

"Disability policies do NOT normally pay for disabilities arising from which of the following? - Correct

Answer war"

"What is the elimination period of an individual disability policy? - Correct Answer Time period a

disabled person must wait before benefits are paid"

"The provision in a health insurance policy that interrupts premiums being paid to the insurer while the

insured is disabled is called the - Correct Answer Waiver of Premium"

"A Disability Income policyowner suffers a disability which was due to the same cause as a previous disability. Both disabilities occurred within a five-month period. The insurer may cover the second

disability without a new elimination period under the: - Correct Answer Recurrent Disability provision"

"When an insured has the same disability within a specified time period and the insurance company provides the same benefits without a new waiting period, the second disability is covered under which

of the following benefits? - Correct Answer Recurrent Disability"

"P received Disability income benefits for 3 months then returns to work. She is able to work one month before her condition returns, leaving her disabled once again. What would the insurance company most

likely regard this second period of disability as? - Correct Answer Recurrent Disability"

"A disability elimination period is best described as a - Correct Answer time deductible"

"Z owns a Disability Income policy with a 30-day Elimination period. Z contracts pneumonia that leaves him unable to work from January 1 until January 15. Z then becomes disabled from an accident on February 1 and the disability lasts until July 1 the same year. Z will become eligible to receive benefits

starting on - Correct Answer March 1"

"A CEO's personal assistant suffered injuries at home and as a result, was unable to work for four

months. Which type of policy will pay a monthly benefit to the personal assistant? - Correct Answer

Disability income"

"What is the primary factor that determines the benefits paid under a disability Income policy? -

Correct Answer wages"

"T was insured under an individual Disability Income policy and was severely burned in a fire. As a result, T became totally disabled. The insurer began making monthly benefit payments, but later discovered

that the fire was set by T in what was described as arson. What actions will the insurer take? - Correct

Answer The insurer will rescind the policy, deny the claim, and recover all payments made"

"Bryce purchased a disability income policy with a rider that guarantees him the option of purchasing additional amounts of coverage at predetermined times without requiring to provide evidence of

insurability. What kind of rider is this? - Correct Answer Guaranteed insurability rider"

"A physician opens up a new practice and qualifies for a $7,000/month Disability Income policy. What rider would the physician add if he wants the ability to increase his policy benefit as his practice and

income grow? - Correct Answer Guaranteed Insurability Option rider"

"Which of the following types of care is typically not covered in a Long-Term Care policy? - Correct

Answer acupuncture"

"How long is the typical free look period for Long Term care insurance policies? - Correct Answer 30

days" "Nursing home benefits must be provided for at least 12 consecutive months in which of the following

types of policies? - Correct Answer long term care"

"Under a Long Term Care policy, which benefit would be typically excluded or limited? - Correct

Answer Alcohol rehabilitation"

"The individual most likely to buy a Medicare Supplement policy would be a(n) - Correct Answer 68-

year old male covered by Medicare"

"Which Long Term Care insurance statement is true? - Correct Answer Pre-existing conditions must be

covered after the coverage has been in force for six months"

"Which of the following will a Long Term Care plan typically provide benefits for? - Correct Answer

home health care"

"Medicare Part C is: - Correct Answer Available to those who are enrolled in Medicare Part A and Part

B"

"What is the MINIMUM number of Activities of Daily Living (ADL) an insured must be unable to perform

to qualify for Long Term Care benefits? - Correct Answer 2"

"Long Term Care policies will usually pay for eligible benefits using which of the following methods? -

Correct Answer Expense incurred"

"Qualified Long-Term Care policies may take into consideration an applicant's pre-existing conditions for

a maximum of not more than __ month(s) prior to the effective date of coverage. - Correct Answer 6"

"The guarantee of insurability option provides a long-term care policyowner the ability to - Correct

Answer buy additional coverage at a later date"

"A "reimbursement policy" pays what amount of covered Long-Term Care expenses? - Correct Answer

Actual covered expenses up to the daily maximum"

"Medicare Part B does NOT cover - Correct Answer inpatient hospital services"

"If a retiree on Medicare required five hospital stays in one year, which policy would provide the best

insurance for excess hospital expenses? - Correct Answer Medicare Supplement"

"Health insurance benefits NOT covered due to an act of war are: - Correct Answer excluded by the

insurer in the contract provisions"

"The insuring clause - Correct Answer States the scope and limits of the coverage"

"With Accidental Death and Dismemberment policies, what is the purpose of the Grace Period? -

Correct Answer Gives the policyowner additional time to pay past due premiums"

"When an insurance company sends a policy to the insured with an attached application, the element

that makes the application part of the contract between the insured and the insurer is called the -

Correct Answer Entire Contract provision"

"An insured must notify an insurer of a medical claim within how many days after an accident? - Correct

Answer 20"

"What is the purpose of Time of Payment if Claims provision? - Correct Answer Prevents delayed claim

payments made by the insurer"

"Which health policy clause specified the amount of benefits to be paid? - Correct Answer Insuring"

"Which of these is considered a mandatory provision? - Correct Answer Payment of Claims"

"G is involved in an automobile accident as a result of driving while intoxicated and suffers numerous injuries. According to the Intoxicants and Narcotics exclusion in G's policy, who is responsible for paying

the medical bills? - Correct Answer insured"

"Which of the following statements describes what an Accident and Health policyowner may NOT do? -

Correct Answer Adjust the premium payments"

"S filed a written Proof of Loss for a Disability Income claim on September 1. The insurance company did

not respond to the claim. S can take legal action against the insurer beginning - Correct Answer

November 1" "When an insured changes to a more hazardous occupation, which disability policy provision allows an

insurer to adjust policy benefits and rates? - Correct Answer Change of occupation provision"

"Which of these statements accurately describes the Waiver of Premium provision in an Accident and

Health policy? - Correct Answer Premiums are waived after the insured has been totally disabled for a

specified time period"

"The Legal Actions provision of an insurance contract is designed to do all of the following EXCEPT -

Correct Answer protect the producer"

"What is considered to be a characteristic of a Conditionally Renewable Health Insurance policy? -

Correct Answer Premiums may increase at time of renewal"

"Which of the following statements about a Guaranteed Renewable Health Insurance policy is

CORRECT? - Correct Answer Premiums normally increase at time of renewal"

"In health insurance policies, a waiver of Premium provision keeps the coverage in force without

premium payments: - Correct Answer After an insured has become totally disabled as defined in the

policy" "An insurer receives proof of loss for an acceptable medical expense claim under an Individual Health

Insurance Policy. Under the Time of Payment of Claims provision, the insurer MUST pay the benefits -

Correct Answer immediately"

"An insurance company receives E's application for an individual health policy. E did not complete all of the medical history questions because she could not remember the exact dates. E signed the policy and submitted it to the insurance company anyway. A few weeks later, E suffers a heart attack and is hospitalized without completing the medical history questions and paying the initial premium. E is not

insured. Which of the following clauses details the conditions that E did not meet? - Correct Answer

Consideration clause" "What should an insured do if the insurer does not send claims forms within the time period set forth in

a health policy's Claims Forms provision? - Correct Answer Submit the claim in any form"

"P is a Major Medical policyowner who is hospitalized as a result of injuries sustained from participating

in a carjacking. How will the insurer most likely handle this claim? - Correct Answer Claim will be

denied" "An insured pays premiums on an annual basis for an individual health insurance policy. What is the

MINIMUM number of days for the Grace Period provision? - Correct Answer 31 days"

"Which of the following health policy provisions states that the producer does NOT have the authority to

change the policy or waive any of its provisions? - Correct Answer Entire Contract"

"An insurer must provide an insured with claim forms within __ days after receiving notice of a loss. -

Correct Answer 15"

"J purchased a Disability Income Policy that ONLY J can terminate and on which the rates will never

increase above those illustrated in the policy. Which of the following types of policies did J purchase? -

Correct Answer Noncancelable"