Life, Accident and Health Insurance
What is the minimum benefit. That must be offered by a long-term care policy A. 12 months b. 18 months c. 36 months d. 48 months
A. 12 months
Which of the following is a requirement for obtaining a Texas insurance agent's license a. Be honest trustworthy and reliable b. Be at least 21 years old c. Be a college graduate d. Be a high school graduate
A. Be honest, trustworthy and reliable
What is the minimum benefit period that must be offered by a long-term care policy a. 12 months b. 16 months c. 36 months d. 48 months
a. 12 months
Which of these is not relevant when determining the amount of personal life insurance needed a. Existing life insurance coverage b. Local unemployment rate c. Household income d. Household debt
b. Local unemployment rate
Which of these is not considered to be a right given to a policy owner a. Surrendering the policies cash value b. Modify a provision in the insurance contract c. Assignment of ownership d. Change the beneficiary if revocable
b. Modify a provision in the insurance contract
under what system do a group of doctors and hospitals in a designated area contract with an insurer to provide services at a pre-arranged class to the insured a. HMO b. PPO c. EPO d. P l h s o
b. PPO
Which of these require an offer, acceptance and consideration a. Warranty v. Estoppel c. Contract d period representation
c. Contract
which factors are taken into consideration when an insurance company determines the premium rate for a whole like policy on the applicant a. Geographical location b. Source of income c. Risk classification d. Marital status
c. Risk classification
Whole life insurance is sometimes referred to as straight life. What does the word straight indicate when using this phrase a. The incontestable period B. The ability to borrow against the cash value c. The grace period d. The duration of premium payments
d. The duration of premium payments
The consideration clause of an insurance contract includes a. The buyer's guide b. A summary of the coverage provided c. The name beneficiaries d. The schedule and amount of premium payments
d. The schedule and amount of premium payments
An example of an unfair claim settlement practice is a. making it mandatory that proof of loss be provided for each claim b. requiring a time limit for submitting a claim c. Paying a claim in a timely manner d. Turning down a claim without providing the basis of denial
d. Turning down a claim without providing the basis of denial
ABC insurance company is actively engaging in boycott, coercion, and intimidation that results in the unreasonable restraint of trade. ABC is committing a prohibited act under Texas insurance laws covering a. Twisting b. False advertising c. Rebating d. Unfair methods of competition
d. Unfair methods of competition
How long does an insurance company appointment remain in force a period 1 year b. 2 years c. 3 years d. Until terminated
d. Until terminated
When I misrepresentation on a life insurance policy application is discovered, what action May and insurance company take a. Void the policy if found during the contestable. B. Void the policy, no matter when it is discovered c. Void the policy at any time only if it is found to be material d. Void the policy only if it is discovered during the contestable period and proven to be material
d. Void the policy only if it is discovered during the contestable period and proven to be material
and life insurance application must be signed by all of these, except a period the policy owner b. The agent c. The insured (if an adult) d. beneficiary
d. beneficiary
Every 12 months after the initial enrollment period, and HMO must hold an open enrollment period of a. 10 days b. 31 days c. 45 days d. 60 days
B. 31 days
How much continuing education must be completed in the classroom or classroom equivalent a {period} 20% B {period} 50% c {period} 80% d {period} 100%
C. 50%
How long can a cash surrender value payment be deferred by the insurance company under the non-forfeiture law a. One month b. Four months c. 6 months d. 9 months
C. 6 months
the phrase transacting business includes a. Obtaining an insurance license b. Collecting premiums c. Setting insurance rates d. Advertising and new product and a trade journal
C. Collecting premiums
How often must an insurance agent license normally be renewed a. Every 6 months b. Every year c. Every 2 years d. Every 3 years
C. Every two years
The legal actions provision of an insurance contract is designed to do all of the following except a. Provide the insurer adequate time to research a claim b. Protect the insurance from having claim research delayed c. Protect the producer d. give the insured guidelines for pursuing legal action against the insurer
Protect the producer
X number of continuing education must be completed in the classroom or classroom equivalent a. 20% b. 50% c. 80% d. 100%
b. 50
Why would the insurance commissioner examine the records of an insurance company a. To determine the sovereignty of the company b. To set insurance rates for the company c. To assist in underwriting d. To assess the company's value
A. To determine the solvency of the company
A Medicare supplement policy may be canceled for which of the following reasons a. An insurer's claims were higher than expected for the fiscal year b. The premium has not been paid by the insured c. The insurers am best rating has dropped d. The insured's credit rating has dropped significantly
B. The premium has not been paid by the insured
What is the purpose of the time of payment of claims provision a {period} requires the insurer to wait 60 days after submitting proof of loss before falling a lawsuit B. prevents delayed claim payments made by the insurer c {period} requires a probation {period} for each claim filed by the insured d {period} protects the insurer from frivolous lawsuits
B. prevents delayed claim payments made by the insurer
okay failed to pay a renewal premium within the time of granted by the insurer. Kay then sends in the payment which the insurance of sequely accepts {period} which policy provision specifies that coverage may be restored in this situation a period free look B. reinstatement c {period} Grace {period} d {period} consideration
B. reinstatement
A foreign insurance company conducting insurance business in Texas a. Is not subject to Texas insurance laws b. Was formed under the laws of another state c. Was formed under the laws of another country d. Is only authorized to write business outside the United States
Be. Was formed under the laws of another state
Which of these statements about a guaranteed and insurability option writer is not true a. Coverage can be added as specific events such as marriage or having a child be. Evidence of insurability is not required when the option is exercised c. Evidence of insurability is required when the option is exercised d. Coverage can be added as specific ages
C. Evidence of insurability is required when the option is exercised
a domestic insurance company in Texas is considered a company that a. own real estate in Texas Bi-Rite Insurance on risk located only in Texas C is incorporated and formed in Texas D honestly Charter of the National Association of insurance Commissioners NAIC
C. is incorporated and formed in Texas
who is liable when an insured suffers a loss on a policy sold by an agent through an insurer not authorized to conduct business in Texas a. The insured b. The agent and the insurance c. The agent and the company d. The commissioner of insurance
C. the agent and the company
Which of the following groups may not be insured by a group life insurance policy A. Employees b. Supervisors c. Administrators d. individuals who are related by blood
D. Individuals who are related by blood
And insurance agent has a fiduciary responsibility to all of the following except: A. Applicants b. Insureds c. Insurers d. Other agents
D. Other agents
Which of the following types of care is typically not covered in a long-term care policy a. Acupuncture b. Skilled care c. Home health Care d. Custodial care
a. Acupuncture
the difference between group insurance and blanket health policies is a. Blanket health policies do not issue certificates b. Group health policies do not issue certificates c. Group health plans may be issued to an airline to cover its passengers d. Blanket health policies are sometimes called wholesale plans
a. Blanket health policies do not issue certificates
Which of these retirement plans can be started by an employee, even if another plan is in existence a. Individual retirement account IRA b. Defined plan c. Keogh plan d. 403 b plan
a. Individual retirement account IRA
K is in a new attent currently receiving payments. If she were to die before receiving payments equal to the correct value, a beneficiary will continue receiving payments until an amount equal to the contract value has been paid this is called a or an a. Installment refund annuity b. Joint refund annuity c. Straight refund annuity d. Equal value annuity
a. Installment refund annuity
Which of the following health insurance policy provisions specifies the healthcare services at policy will provide a. Insuring clause b. Usual, customary and reasonable clause c. Consideration clause d. Benefit clause
a. Insuring clause
During a sales presentation for a participating life insurance policy, an agent must a. Make a prospect understand the dividends are not guaranteed b. Make a prospect understand that dividends are guaranteed c. Over to the prospect a minimum return of investment d. Offer to the prospect a portion of the commissions
a. Make a prospect understand the dividends are not guaranteed
What is considered to be a characteristic of a conditionally renewable health insurance policy a. Premiums may increase at the time of renewal b. Premiums may increase at any time c. Policy may be renewed at the discretion of the insured d. Policy may be amended by insurer at any time
a. Premiums may increase at the time of renewal
An example of rebating would be a. Returning a portion of a premium as inducement to purchase insurance b. Advertising cheaper insurance rates than competitors c. And mutual insurance company paying dividends to its policy owners d. And offer of rated insurance coverage
a. Returning a portion of a premium as inducement to purchase insurance
the premiums paid by an employer for his employees group life insurance are usually considered to be a. Tax deductible to the employer b. Partially deductible to the employee c. Tax deductible to the employee d. Taxable income to the employee
a. Tax deductible to the employer
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 and what was described as arson. What actions will the insurance take a. The insurer will rescind the policy, deny the claim and recover all payments made b. Due to the policy not being post claim underwritten the intra must continue to pay this claim c. Claim will be rejected because of this criminal act but no recovery of payments will be made d. Claims will be denied but the policy will remain enforced without further premium payments due to the insured's total disability
a. The insurer will rescind the policy, deny the claim and recover all payments made
Before life insurance policy is issued, which of these components of the contract is required a. applicant signature on application b. Beneficiary signature c. A conditional receipt d. Attending physician statement
a. applicant signature on application
an example of rebating would be a. returning a portion of a premium as inducement to purchase insurance B {period} advertising cheaper insurance rates than other competitors c {period} a major will insurance company paying dividends to its policy owners d {period} and offer of rated insurance coverage
a. returning a portion of a premium as inducement to purchase insurance
Which of these is not an example of doing insurance business a. selling shares of stock B {period} receiving an insurance application c {period} collecting insurance premium d {period} delivering an insurance policy
a. selling shares of stock
To terminate an agent's appointment and insurance company must a. send termination notice to the Texas department of insurance b. Send termination notice to Governor c. Paid termination fee d. Request a hearing before the commissioner of insurance
a. send termination notice to the Texas department of insurance
to terminate an agent's appointment, and insurance company must a. send termination notice to the Texas department of insurance b. Send termination notice to Governor c. Pay a termination fee d. Request a hearing before the commissioner of insurance
a. send termination notice to the Texas department of insurance
all our true statements regarding the underwriting process except a. Signed consent from the applicant must be provided in order to test for AIDS and HIV virus b. AIDS and HIV virus exams can be conducted in a discriminatory fashion c. The cause of any examination is paid for by the insurer d. The original application is the primary source of information used in the underwriting process
b. AIDS and HIV virus exams can be conducted in a discriminatory fashion
An example of false advertising would be a. Paid testimonials from celebrity endorsements b. An insurer exaggerating its dividends and a magazine advertisement c. A producer spending more than $25 on marketing gifts for a client d. And insurer advertising in an insurance trade journal
b. An insurer exaggerating its dividends and a magazine advertisement
I plan through the marketplace may be purchased by a. Everyone over 18 years old b. Any legal resident except those in prison c. Any legal resident including those in prison d. Only those who might be eligible for Medicare
b. Any legal resident except those imprisoned
and life insurance, the needs approach is use mostly to establish a. Which type of life insurance a client should apply for b. How much life insurance a client should apply for c. Which company a client should use when applying for a life insurance d. What the maximum amount the client can spend on life insurance
b. How much life insurance a client should apply for
A licensed maybe denied, suspended or revoked if the licensee a period engages in replacement of an existing policy b. Is found guilty of misrepresentation and obtaining the license c. Files for bankruptcy d. Fails to meet a sales quota
b. Is found guilty of misrepresentation and obtaining the license
The coordination of benefits provision a. Allows an insured covered by two health plans to make a profit on a covered loss b. Prevents an insurance covered by two health plans for making a profit on the covered loss c. Allows an insurer to defer paying a claim for a work-related injury until workers compensation benefits have expired d. Prevents an insured to change insurers during a claim for a covered loss
b. Prevents an insurance covered by two health plans for making a profit on the covered loss
if an individual is covered under an accidental death policy and dies, and autopsy can be performed in all of these situations except a. When the cause of death is unknown b. When the state prohibits this by law c. When constant for the autopsy is not obtained d. When foul play was a contributing factor
b. When the state prohibits this by law
which of the following statements best describes what the legal actions provision of an accident and health policy requires a. An insurance claim within 60 days after proof of loss is submitted b. And insured must wait at least 30 days after proof of loss has been submitted before I lost you can be filed c. An insured must wait at least 60 days after proof of loss has been submitted before a lawsuit can be filed d. An insured must settle a claim within 30 days after proof of loss is submitted
c. An insured must wait at least 60 days after proof of loss has been submitted before a lawsuit can be filed
k applies for a life insurance policy on herself and submits the initial premium with the application. She is given a receipt by the agent stating that coverage begins immediately if the application is approved. What kind of receipt was used a. Binding b. Initial premium c. Conditional d. Contingent
c. Conditional
which of these is not a source of funding for social security benefits a. Self-employed individuals b. Employees c. Federal government d. Employers
c. Federal government
An applicant must receive an outline of coverage when the application is taken for a or an a. Endowment b. Annuity c. Medicare supplement policy d. Universal life policy
c. Medicare supplement policy
Who is authorized to assign a life insurance policy as collateral for a loan a. Beneficiary b. Insured c. Policy owner d. Lender
c. Policy owner
a primary beneficiary has died before the insured and a life insurance policy. A contingent beneficiary is also named in the policy. Which of the following will occur when the insured dies a. Proceeds will go to the primary beneficiary's estate b. Probate will decide who receives proceeds c. Proceeds will go to the contingent beneficiary d. Proceeds will go to the insured's estate
c. Proceeds will go to the contingent beneficiary
when does a life insurance contract become effective if the initial premium is not collected during the application process a {period} after all medical and personal information has been evaluated B {period} when the insurer receives initial premium from the producer c. when producer delivers policy and collects initial premium d {period} after application has been approved by the underwriters
c. when producer delivers policy and collects initial premium
A statement made by an insured in an insurance application that must be true to the best of one's knowledge and which becomes a part of the contract is known as a period and ensuring agreement b. A mutual assent c. A warranty d. A representation
d. A representation
Under a long-term care policy, which benefit would be typically excluded or limited a. Intermediate nursing b. Skilled nursing c. Home health Care d. Alcohol rehabilitation
d. Alcohol rehabilitation
In texas, which of these statements regarding the suicide clause is true a. An insurer may not use suicide as a defense against payment after the first year b. And insurer must always pay a death benefit when the call the cause of death was suicide see. And insurance company may only deny a suicide death claim if an exclusionary writer is attached to the policy d. An insurer may not use suicide as a defense against payment after the second year
d. An insurer may not use suicide as a defense against payment after the second year
How often can a policy owner make a premium payments a. Semi-annual b. Monthly c. Quarterly d. Annual
d. Annual. I'm writing out the description because I stupidly cut off the question. If the policy owner chooses to pay the premium more than once per year (example monthly, quarterly, semi-annually) there normally will be an additional charge because the company will have additional charges in billing and collecting the premium payments.
What type of life policy has a death benefit that adjusts periodically and is written for a specific period of time a. Modified whole life b. 20 year paid up policy c. Endowment d. Decreasing term
d. Decreasing term
After an insured gives notice of loss, what must he or she do if the insurer does not furnish forms a. Follow lawsuit b. Contact the insurer again requesting forms c. Nothing d. File written proof of loss
d. File written proof of loss
What is an organization that solicits insurance only to its members a. Domestic society b. Singular company c. Limited liability company d. Fraternal benefit society
d. Fraternal benefit society
A return of premium life insurance policy is a. Nonforfeiture option b. Whole life and increasing term c. Interest sensitive d. Variable life
Whole life and increasing term
Which of the following organizations would make reimbursement payments directly to the insured individual for covered medical expenditures a. Administrative services only plan b. Commercial insurer c. Preferred provider organization d. Health maintenance organization
b. Commercial insurer
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 or an a. Low deductible health plan b. Medicare supplement c. High deductible health plan d. Flexible savings plan
c. High deductible health plan
Variable Life products require a producer to a period guarantee not more than a 12% return per annum b. Hold a life in health insurance license c. Hold a life insurance license and a securities license d. Be regulated solely by state law
c. Hold a life insurance license and a securities license
these sections of an insurance contract which limit coverage are called a {period} waivers B {period} riders c. exclusions d {period} limitations
c. exclusions
which of the following health insurance policy provisions specifies the healthcare services of policy will provide a. Insuring clause b. Usual, customary and reasonable clause c. Consideration clause D. benefit clause
a. Insuring clause
Which of the following does social security not provide benefits for a. Survivorship b. Dismemberment c. Disability D period retirement
b. Dismemberment
What type of life policy covers two lives and pays to face amount after the first one dies a. Group life b. Joint life policy c. Family and comp policy d. Last survivor policy
b. Joint life policy
Any changes made on an insurance application requires the initials of home a period insured b. Agent c. Applicant D period beneficiary
c. Applicant
dividends paid from a life insurance policy are a. Guaranteed b. Non-taxable c. Issued by the insurer d. Issued by the department of insurance
c. Issued by the insurer
all of these are considered sources of underwriting information about an applicant except a period inspection report b. Credit report c. Rating services d. Medical information bureau
c. Rating services
Which mode of payment is not used by health insurance policies a period monthly premium b. Annual premium c. Single premium d. Semi-annual premium
c. Single premium
Which health policy clause specifies the amount of benefits to be paid a. Insuring b. consideration c. Free look deep. Payment mode
a. Insuring
Which of the following is the reimbursement of benefits for the treatment of a beneficiary injuries caused by a third party a. Indemnity b. Subrogation c. Legal action d. Consideration
b. Subrogation
an insurer May normally delay the payment of a cash value loan or surrender value for up to a. 2 months b. 4 months c. 6 months d. 8 months
c. 6 months
Whose life is covered on a life insurance policy that contains a pay or benefit clause a. Parent b. Beneficiary c. Child d. Spouse
c. Child
Which of these factors do not play a role in the underwriting of a life insurance policy a. Avocations b. Credit status c. Marital status d period occupation
c. Marital status
who is liable when an insured suffers a loss on the policy sold by an agent through an insurer not authorized to conduct business in Texas a. The insured b. The agent and the insured c. The agent and the company d. The commissioner of insurance
c. The agent and the company
as a condition for a loan, a bank requires the borrower to purchase credit insurance from a specific company. What is the bank guilty of a. Coercion B defamation c. Rebating d. Misrepresentation
a. Coercion
incompletes and application for life insurance but does not pay the initial premium. All of these actions must occur before ends policy goes into effect, except a. Policy is delivered b. Free look period has expired c. Insurance company issues policy d. Initial premium is collected
b. Free look period has expired
When advertising, and insurance company must use its a. Nickname b. Legal corporate name c. Service logo D period corporate mark
b. Legal corporate name
what is the minimum number of activities of daily living ADL and insured must be unable to perform to qualify for long-term care benefits a. One b. Two c. Three d. four
b. Two
Which unfair trade practice involves an agent telling a perspective client that a policy's dividends are guaranteed a. Twisting b. rebating c. Misrepresentation d. Sliding
c. Misrepresentation
A certificate of x permits an insurance company to transact business in Texas a. authenticity b. admission c. Permission d. Authority
d. Authority
which action will a life insurance company most likely take if an insured dies and it is discovered that the insurance age was misstated on the application a. Pay an amount reduced by a specified percentage of the face amount b. Pay nothing c. Pain amount the premiums would have purchased at the insurance actual age d. Pay 50% of the initial death benefit
C. Paying them out the premiums would have purchased at the insured's actual age
What does a guaranteed insurability rider provide a disability income policy owner a. They guarantee that premiums will never increase b. The guarantee that the policy would never be canceled c. The ability to periodically increase the amount of coverage without evidence of the insurability d. The ability to periodically increase the amount of coverage only with evidence of integrability
The ability to periodically increase the amount of coverage without evidence of insurability
Cute purchases a $500,000 life insurance policy and pays $900 in premiums over the first 6 months. q die suddenly and the beneficiary is paid $500,000. This exchange of unequal values reflects which of the following interns contract features a. Aleatory b. Adhesion c. Unilateral d. Consideration
a. Aleatory insurance contracts are Aleatory and that the amount the insured will pay in premiums is unequal to the amount that the insurer will pay in the event of a loss.
Under a graded premium policy, the premiums a. Are higher during the policy's early years b. Are lower during the policy's early years c. Are constant throughout the length of the policy d. Can be adjusted by the insured
a. Are higher during the policy's early years
What type of employee welfare plans are not subject to you e r i s a regulations a. Church plans b. Major medical plans c. Corporate d. Qualified plans
a. Church plans
a CEOs personal assistant suffered entries at home and as a result, wasn't able to work for 4 months. Which type of policy will pay a monthly benefit to the personal assistant a. Disability income b. Major medical c. Key employee d business overhead expense
a. Disability income
the claws and an accident and health policy which defines the benefit amounts the insurer will pay is called the a. Insuring clause b. Contestable clause c. Consideration clause d. Free look provision
a. Insuring clause
which of these is considered a mandatory provision a. Payment of claims b. Insurance with other insurers c. Misstatement of age d. Change of occupation
a. Payment of claims
Who owns a stock insurance company a. Board of directors b. Stockholders c. Agents d. Policy owners
b. Stockholders
What is the elimination period of an individual disability policy a. Time period and ensured must wait before coverage begins b. Time period a disabled person must wait before benefits are paid c. Time. After the policy issue date in which the provisions are still contestable d. The point in time when benefits are no longer payable
b. Time period a disabled person must wait before benefits are paid
Which of these is considered a statement that is assured to be true in every respect a. Estoppel b. Warranty see. Guarantee D period representation
b. Warranty
An individual has a major medical policy with the $5,000 deductible and an 80/20 co-insurance clause. How much will the insured have to pay if a total of $15,000 in covered medical expenses are incurred a. $2,000 b. $5,000 c. $7,000 d. $10,000
c. $7,000 In this situation, $5,000 + 20% of the remaining Bill equals $7,000
How often must an insurance agent license normally be renewed a period every 6 months b. Each year c. Every 2 years d. Every 3 years
c. Every 2 years
At what point does an informal contract become binding a period when one party makes an invitation and the other makes an offer b. When an offer is made by one party and the other party rejects the offer and makes a counter offer c. When one party makes an offer and the other party accepts the offer d. When one party makes the required payment
c. When one party makes an offer and the other party accepts the offer
Medicaid was designed to assist individuals who are a. Federal employees b. Disabled c. And poor health d. Below a specific income limit
d. Below a specific income limit
Company XYZ offers a group term life insurance plan to its employees. What does each employee covered under this plan receive a. Master policy b. Receipt of coverage c. Individual policy d. Certificate of insurance
d. Certificate of insurance
Which of the following is not a required provision in group Life policies a. Free look b. Incontestable c. Conversion d. Rights and loan
d. Rights and loan
What is the maximum social security disability benefit amount and insured can receive a. 50% of the insured primary insurance amount b. 75% of the insured primary insurance amount c. 100% of the insured primary insurance account d. 100% of the insured primary insurance amount minus any money is received from a retirement plan
100% of the insured primary insurance account
as a condition for a loan, a bank requires the borrower to purchase credit insurance from a specific company. What is the bank guilty of a. Coercion b. Defamation c. Rebating d. Misrepresentation
A. Coercion
Which statement regarding the Misstatement of age provision is considered to be true a. Coverage will be adjusted to reflect the insured true age if a mistakement of age is discovered b. Requires that a new policy must be applied for if a statement of age is found on the current policy see. Mistakement of age provision is valid only during the contestable period d. Ensure May void the policy if a mistakement of age is discovered
A. Coverage will be adjusted to reflect the insured true age if a Misstatement of age is discovered
Kay has an accidental death and dismayment insurance policy where her husband is the beneficiary and her daughter is the contingent beneficiary. Under the common disaster clause, if Kay and her husband are both killed in an automobile accident where would the death proceeds be directed A. Daughter b. Husband's estate c. K's estate d. Trust fund
A. Daughter
Which type of life insurance beneficiary requires his or her nonsense when a change of beneficiary is attempted by the policy owner A. Irrevocable beneficiary b. Tertiary beneficiary c. Primary beneficiary d. Revocable beneficiary
A. Irrevocable beneficiary
Which of the following is a valid reason for an enrollee to be canceled by a health and maintenance organization HMO plan? A. Non-payment of coverage B. Exceeding a specified number of claims C. Starting a cigarette habit D. drinking alcohol
A. Non-payment of coverage
At what time must the policy owner have insurable interest on the insured in order for the life policy to be valid a. After the contestable. B. When the policy proceeds are paid c. At the time of application d. When the insured dies
At the time of application
And insurance company organized under New York laws and license to do business in Texas is considered a or An a period reciprocal company B foreign company c. Alien company d. Export company
B. Foreign company
Which of the following is the reimbursement of benefits for the treatment of a beneficiary's injuries caused by a third party a. Indemnity B. subrogation c. Legal action d. Consideration
B. subrogation segregation is the right for an insurer to pursue a third party that caused an insurance loss to be insured. This is done as a means of recovering the amount of the claim pay to the insured for the loss
an evidence of coverage form may be issued by a health maintenance organization HMO after being approved by the a. Attorney general b. NAIC c. Commissioner d. National HMO association
C. Commissioner of insurance
Which of these provisions is not required in life insurance policies a period free look b. Grace period C. Extended term d. Entire contract
C. Extended term
Which of these provisions is not required in life insurance policies a. Free look b. Grace period C. Extended term d. Entire contract
C. Extended term
the insurance commissioner must give how many days notice prior to holding a hearing regarding an agent's unfair or deceptive practice a. Five b. Seven c. 10 d. 30
D. 30
An insurer is not required to provide information on fraudulent claims if requested by a period the Texas department of insurance b. The attorney general c. The commissioner d. An Insured
D. An Insured
With whom may and agent lickily share commissions a. The insured b. The applicant c. The beneficiary d. Another agent with the same line of insurance
D. Another agent with the same line of insurance
What is an organization that solicits insurance only to its members a period domestic society b. Singular company c. Limited liability company d. Fraternal benefit society
D. Fraternal benefit society
Which statement is true regarding a minor beneficiary a period normally the death proceeds are required to be held and trust under until the beneficiary reaches the age of 21 b. Normally a guardian is required to be appointed in the beneficiary clause of the contract c. The minor must pay the debts of the insured estate before receiving any of the proceeds d. The minor is entitled to receive the death proceeds immediately
Normally a guardian is required to be appointed in the beneficiary clause of the contract
A or n x number of benefits of a health policy transfers payments to someone other than the policy owner a. Assignment b. Transfer c. Allocation d. Designation
a. Assignment
A disability income policy owner recently submitted a claim for a chronic neck problem that has now resulted in total disability. The original neck injury occurred before the application was taken 5 years prior. The neck injury was never disclosed to the insurer at the time of application. How will the insurer handle this claim a. Claim will be paid and coverage will remain in force b. Claim will be denied and coverage will remain in force c. Claim will be denied and coverage will be canceled do you. Thing will be denied, the coverage canceled and they all premiums paid will be refunded
a. Claim will be paid and coverage will remain in force. reason why is because after a policy has been enforced for two or sometimes three years, it enters the incontestable period. In which the insurer may not deny a claim based on information not disclosed at the time of application
from what authority drives the requirement that an insurance application contains a disclosure stating that an investigative consumer report may be obtained on an applicant a. Fair credit reporting act b. Medical information bureau c. Part 3 of the application d. Life insurance buyer's guide
a. Fair credit reporting act
With accidental death and dismemberment policies what is the purpose of the grace period a. Gives the policy owner additional time to pay overdue premiums b. Gives the policy owner additional time to be file a lawsuit c. Gives the policy owner additional time to file a claim d. Gives the policy owner additional time to provide proof of loss
a. Gives the policy owner additional time to pay overdue premiums
Periodic health claim payments must be made at least a. Monthly b. Weekly c. Daily d. Annually
a. Monthly
K is the insured and p is the sole beneficiary on an accidental death and dismemberment policy. Both are involved in the fatal accident where k dies before p. Under the common disaster provision which of these statements is true a. Proceeds will be paid to P's estate b. Proceeds will be divided equally between k's and P's estate see. Proceeds will be paid to k's estate d. The courts will decide who will receive death benefits
a. Proceeds will be paid to P's estate
upon delivery of a rated life insurance policy, they producer must obtain each of the following except a. Signed HIPAA disclosure b. Signed amendment c. Signed statement of good health d. The required premium
a. Signed HIPAA disclosure
Which of the following types of permanent life insurance policies offers the highest initial cash value a. Single premium b. Limited pay c. Whole d. Interest sensitive
a. Single premium
when does a probationary period provision become effective in the health insurance contract a. at the policies inception B. 30 days after the policies inception c. When a claim is submitted D period when a covered loss occurs
a. at the policies inception
how did life insurance companies handle cases where the insurance commits suicide within the contract stated contestable period a. claims are denied under the suicide clause of the policy b. Company pays twice the face amount under the double indemnity clause c. Claims are paid in full d. Premiums are returned under the consideration clause
a. claims are denied under the suicide clause of the policy
Term insurance has which of the following characteristics a. expires at the end of the policy period b. Builds cash value c. Has non-forfeature options d. Endows at the end of the policy period
a. expires at the end of the policy period
under an individual health insurance policy, the time limit of certain defenses provisions states that non-fraudulent misstatements first become incontestable two years a. from the date that the policy was issued b. From the date that the application was signed c. From the date initial premium was collected d. From the date of the sales appointment
a. from the date that the policy was issued
which of the following types of health coverage frequently uses a deductible a. major medical policy b. Basic surgical policy c. Basic hospital policy d. Workers compensation
a. major medical
which of the following statements about the classification of applicants is incorrect a. substandard applicants are never declined by underwriters b. Substandard applicants are occasionally declined by underwriters c. Preferred risk applicants typically have better premium rates than standard risk applicants d. An applicant can be classified as substandard risk because of a hazardous job
a. substandard applicants are never declined by underwriters
Jay chooses a monthly premium payment mode on his whole life insurance policy. Which of these statements is correct a. the gross premium is higher on the monthly payment mode as compared to being paid annually b. The gross premium is lower on the monthly payment mode as compared to being paid annually see. The cash value from a life policy paid on the monthly basis bills quicker than one paid on an annual basis d. the face amount of a life policy paid on the monthly basis is higher than one paid on the annual basis
a. the gross premium is higher on the monthly payment mode as compared to being paid annually
an employee is covered under a company group life plan with a $50,000 death benefit. What is the maximum amount a spouse may be insured for under this program a. $10,000 b. $25,000 c. $40,000 d. $50,000
b. $25,000
a potential client, age 40, would like to purchase a whole life policy that will accumulate cash value at a faster rate in the early years of the policy. Which of these statements made by the producer would be correct a period straight life accumulates faster than limited pay life b. 20 pay life accumulates cash value faster than straight life c. Cash value accumulation of both 20 pay life and straight life depend on the insurers financial rating d. 20 pay life and straight life accumulate cash value at the same rate
b. 20 pay life accumulates cash value faster than straight life
A temporary agent's license issued by the commissioner of insurance is valid up to x number of days a. 60 b. 90 c. 120 d. 180
b. 90
A reimbursement policy pays what amount of coverage long-term care expenses a. All expenses regardless of the policy limits b. Actual covered expenses up to the daily maximum c. A daily dollar amount regardless of the actual incurred expenses d. The usual, customary and reasonable expenses regardless of the policy limits
b. Actual covered expenses up to the daily maximum
how long does the coverage normally remain on The limited pay life policy a. Age 65 b. Age 100 c. When premium payments stop d. Of the discretion of the insurer
b. Age 100
What action will an interior take if an interest payment on the policy loan is not made on time a. Cancel the policy if not paid within the grace period b. Automatically at the amount of interest due to the loan balance c. Subtract from any dividends owed d. This allow any further loans
b. Automatically at the amount of interest due to the loan balance
when an insured changes to a more hazardous occupation, which disability policy provision allows an insurer to adjust policy benefits and rates a. relation of earnings to insurance provision b. Change of occupation provision c. Conformity of State statutes provision d. Entire contract provision
b. Change of occupation provision
Major medical policies typically a. Pay 100% of covered expenses b. Contain a deductible and coinsurance c. Require use of in-network facilities only d. Do not contain a deductible and co-insurance
b. Contain a deductible and coinsurance
which of the following best describes a hospital indemnity policy a. Coverage that reimburses an insured for surgeon expenses b. Coverage that pays a stated amount per day of a covered hospitalization c. Coverage that replaces lost income due to hospitalization d. Coverage that pays for hospital room and board
b. Coverage that pays a stated amount per day of a covered hospitalization
which health policy clause stipulates that an insurance company must attach a copy of the application to the policy to ensure that it is part of the contract a. consideration b. Entire contract c. Free look d. Ensuring
b. Entire contract
how would a contingent beneficiary receive the policy proceeds and an accidental death and dismemberment policy a period if the primary beneficiary is a minor at the time of the insured death b. If the primary beneficiary dies before the insured c. If the insurance died of accidental causes d. If the insurance died of natural causes
b. If the primary beneficiary dies before the insured
a whole life insurance policy on it does not wish to continue making premium payments. Which of the following enables the policy owner to sell the policy for more than its cash value a. Cash surrender b. Life settlement contract c. Buy sell arrangement d. 1031 exchange
b. Life settlement contract
Which of the following characteristics is associated with a large group disability income policy a period no waiting periods b. No medical underwriting c. No elimination. D. No limit of benefits
b. No medical underwriting
Which of the following characteristics is associated with the large group disability and comp policy a. No waiting periods b. No medical underwriting c. No elimination periods d. No limit of benefits
b. No medical underwriting
The underwriting process involves all of these, except for a. Credit report b. Policy loan c. Risk classification d. Application
b. Policy loan
which of the following statements about a guaranteed renewable health insurance policy is correct a. Premiums normally decrease at time of renewal b. Premiums normally increase at time of renewal c. Policy can be renewed at any time by the company d. Policy can be canceled at any time by the company
b. Premiums normally increase at time of renewal
What is the purpose of the time of payment of claims provision A. Requires the insurance to wait 60 days after submitting proof of loss before falling a lawsuit b. Prevents delayed claim payments made by the insurer c. Requires a probation period for each claim filed by the insured d. Protects the insurer from frivolous lawsuits
b. Prevents delayed claim payments made by the insurer
A medical information report May disclose which of the following a period prior preferred rating b. Prior use of marijuana c. Prior labs and policy d. Prior bankruptcy judgment
b. Prior use of marijuana
What is the consideration given by an insurer in the consideration clause of a life policy A. Promise to never cancel coverage b. Promise to pay a death benefit to a named beneficiary c. Promise to not raise premiums d. Promise to accept an insured assignment of benefits
b. Promise to pay a death benefit to a named beneficiary
h&j takes an application and initial premium from an applicant and since the application and premium check to the insurance company. The insurance company returns to check back to Jade because the check is made out to j instead of the insurance company. What action should Jay take a. Deposit the applicants check into his account and make a personal check out to the insurance company from his personal account b. Return to the customer, collect a new check made out to the insurance company and send the new check out to the insurance company c. Cross off his name on the pay two portion of the check, right the name of the insurance company and send the check back to the insurance company d. Deposit the check into his personal account, use the phone to purchase a cashier's check and send the new cashier's check back to the insurance company
b. Return to the customer, collect a new check made out to the insurance company and send the new check out to the insurance company
Which of the following statements best describes dental care and indemnity coverage a. Services are reimbursed before they enter or receives a invoice b. Services are reimbursed after insurer receives the invoice c. In network dentists must always be used d. Very limited list of providers
b. Services are reimbursed after insurer receives the invoice
Which of the following statements best describes dental care indemnity coverage a period services are reimbursed before the insurer receives the invoice b. Services are reimbursed after insurer receives the invoice c. In network dentists must always be used d. Very limited list of providers
b. Services are reimbursed after insurer receives the invoice
Jay, and accidental death and dismemberment ad&d policy holder, dies after injury sustained in an accident. Jay's age, as stated on the application 5 years ago, was found to be understated by 10 years. Which of the following actions were the insurance company take A. The insurer will pay the original benefit stated in the policy b. The insurer will adjust the benefit to what the premiums paid would have purchased at the insured's actual age c. The insurer will pay the original face amount minus any premium deficiencies owed d. The insurer will deny the claim and refund premiums paid
b. The insurer will adjust the benefit to what the premiums paid would have purchased at the insured's actual age
A Medicare supplement policy may be canceled for which of the following reasons a. an insurers claims were higher than expected for the fiscal year b. The premium has not been paid by the insured c. The insurers am best rating has dropped d. The insured credit rating has dropped significantly
b. The premium has not been paid by the insured
The advantage of reinstating an original life policy is a. The premiums are based on the current age of the insured b. The premiums are based on the younger age c. The interest charged on policy loans will be lowered d. A new incontestable period will begin
b. The premiums are based on the younger
tea false Acclaim on his accident and health policy after being treated for an illness. The insurance company believes that t misrepresented his actual age on the initial insurance application and is therefore disputing the claims validity the provision that limits the time period during which the company May dispute a claims validity is called a. Ensuring b. Time limit on certain defenses c. Grace. D. Free look
b. Time limit on certain defenses
Which of the following benefits is not required under a group health plan for drug and alcohol treatment a. inpatient treatment b. Transportation to and from a treatment facility c. Group therapy d. Outpatient treatment
b. Transportation to and from a treatment facility
In Texas how long was the policy be enforced before an insurance company must pay death benefits for suicide a. 6 months the period 1 year c. 2 years d. 3 years
c. 2 years
M's insurance company denied a reinstatement application for her lapsed health insurance policy. the company did not notify Emma Vista now. How many days from the reinstatement application dates does the insurance company have to notify m of the denial before the policy will be automatically placed back and force a. 10 days b. 30 days c. 45 days d. 60 days
c. 45 days
How long can a cash surrender value payment be deferred by the insurance company under the non-forfeiture law a. One month b. 4 months c. 6 months d. 9 months
c. 6 months
L takes out a life insurance policy and dies 10 years later. During the claim process the insurer discovers that l had understated her age on the application. Under the misstatement of age provision the insurer will a. Pay the death benefit and full b. Adjust the death benefit to an increased amount c. Adjust the death benefit to A reduced amount d. Deny the claim
c. Adjust the death benefit to A reduced amount
T is the policy owner for a life insurance policy with an irrevocable beneficiary designation. If T wishes to change the beneficiary, T must obtain permission from the a period pair b. Agent c. Beneficiary d. Commissioner of insurance
c. Beneficiary
a health reimbursement arrangement must be established a period with employee funding b. With other employer sponsored benefit plans c. By the employer d. Only during specific open enrollment periods
c. By the employer
be the insurance agent tells his clients that their rights may be impaired if they fail to complete a release form within a given period of time. B may be found guilty of a. boycotting b. Rebating c. Coercion D. discrimination
c. Coercion
an evidence of coverage form may be issued by a health maintenance organization after being approved by the a. Attorney general b. NAIC c. Commissioner d. National HMO association
c. Commissioner
a prospective insured completes and signs application for health insurance when the intentionally conceals information about a pre-existing heart condition. The company issues the policy. Two months later, the insurance suffers a heart attack and some it's a claim. While processing the claim, the company discovers the pre-existing condition. In this situation, the company will a. Continue coverage but request a corrected application b. Deny coverage and increase premiums c. Continue coverage but exclude the heart condition d. Resend the coverage and return the premiums
c. Continue coverage but exclude the heart condition
Which of the following statements about health coverage for newborns is not true A. Coverage includes treatment of congenital defects b. Coverage continues after the first 31 days upon payment of the first premium c. Coverage is limited to only congenital defects d. Coverage begins at moment of birth
c. Coverage is limited to only congenital defects
Which of the following statements about health coverage for newborns is not true a. Coverage includes treatment of congenital defects b. Coverage continues after the first 31 days upon payment of its first premium c. Coverage is limited to only congenital defects d. Coverage begins at moment of birth
c. Coverage is limited to only congenital defects
Additional coverage can be added to a whole life policy by adding a or an a. Payor rider b. Accelerated benefit rider c. Decreasing term rider d. Automatic premium loan rider
c. Decreasing term rider
p, age 50, purchased an annuity that people fund with $500 a month for 15 years. The annuity will then pay p retirement payments after the 15 years. What type of annuity did P purchase a. Immediate b. Retroactive c. Deferred d. Universal
c. Deferred
B is a teacher who was injured in a car accident and cannot work. She is now receiving a monthly benefits as a result of this accident. What type of policy does bee have a. Major medical b. Blanket c. Disability income d. Indemnity
c. Disability income
What type of policy but only provide coverage for specific types of illnesses like cancer or stroke etc a. m e w a b. Blanket insurance c. Dread disease insurance d. Disability insurance
c. Dread disease insurance
Which of these statements is incorrect regarding the federal income tax treatment of Life insurance a. premiums are normally not taxed deductible b. Cash dividends are normally not taxed c. Entire cash surrender value is taxable d. Proceeds are received tax-free if there is a name beneficiary
c. Entire cash surrender value is taxable
A producer does not have the authority to change a policy or wave any of its provisions. The health provision that best describes the statement is called the a. Grace period b. And contestable c. Entire contract d. Time limit on certain defenses
c. Entire contract
S, while in the process of converting her group life insurance to an individual policy, dies. What happens to the claim her beneficiary submits a. No benefits are payable under the master contract b. Full benefits are payable under the master contract c. Full benefits are payable under the converted policy d. Benefits less required premium are payable under the converted policy
c. Full benefits are payable under the converted policy
Which type of provider is no for stressing preventative medical Care and routine physical examinations a. Multiple employer welfare arrangements m e w a b. Major medical provider c. HMO d. PPO
c. HMO
information obtained from a phone conversation to the proposed insured can be found in which of these reports a period agents report b. MIB report c. Inspection report d. Attending physicians report
c. Inspection report
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 a. Revocable b. Contingent c. Irrevocable d. Primary
c. Irrevocable
Dee needs life insurance that provides coverage for only a limited amount of time while also paying the lowest possible premium. What kind of policy is needed a. Limited pay life b. Graded premium c. Level term d. Endowment
c. Level term
The individual health insurance policy that offers the broadest protection is a or an x policy a. Surgical benefits b. Indemnity medical c. Major medical d. Hospital expense
c. Major medical
The benefits under a disability buyout policy are a period normally paid and installments b. Taxable to the beneficiary c. Payable to the company or another shareholder d. Normally paid after a short elimination period
c. Payable to the company or another shareholder
on an accidental death and dismemberment insurance policy, who is qualified to change the beneficiary digest Nation a. Payor b. Primary beneficiary c. Policy owner d. Insurer okay see
c. Policy owner
Which of these is not a type of agent authority a. Express b. Implied c. Principal D period apparent
c. Principal
which provision allows a portion of any used medical benefits to be restored following a particular amount of benefit has been used, or after the policy has been in effect for a particular period of time a. Reimbursement benefit b. Restoration of unused benefit c. Restoration of used benefit d. Medical offset benefit
c. Restoration of used benefit
a prepaid application for individual disability income insurance was recently submitted to an insurer. When the insurer received the medical information bureau MIB report, the report showed that the applicant had suffered a stroke 18 months ago, something that that was not disclosed on the application. Which of the following actions with the insurance company not take a. Send the initial premium back to the applicant b. Send a notice to the applicant that the coverage was declined c. Send a notice to the MIB that the applicant was declined d. Send a notice to the agent that the applicant was declined
c. Send a notice to the MIB that the applicant was declined
And immediate annuity consists of a or an a period variable premium B flexible premium c. Single premium d. Deferred premium
c. Single premium
which of the following correctly explains the actions and agents should take if a customer wants to apply for an insurance policy a. have the customer sign up the link application, then take the application back to his office to complete prior to sending it off to the insurance company b. complete the application over the phone with the customer, sign the application for the customer then send the application off to the insurance company c. complete the application and review the information with the customer prior to obtaining the customer signature then send the application off to the insurance company d. Have the customer fill out the application and send it to his office for him to sign then send it off to the insurance company
c. complete the application and review the information with the customer prior to obtaining the customer signature then send the application off to the insurance company
When an employee is terminated, which statement about a group of term life conversion is true a. Employee must convert group term life coverage into an individual term like policy b. Employee must provide evidence of incurability for conversion c. policy proceeds will be paid the employee dies during the conversion period d. Policy proceeds will not be paid if the employee dies during the conversion period
c. policy proceeds will be paid the employee dies during the conversion period
pee is self-employed and owns an individual disability and comp policy. He becomes totally disabled on June 1st and receives $2,000 a month for the next 10 months. How much of this income is subject to federal income tax a. $20,000 b. $14,000 c. $6,000 d. $0
d. $0
An insured May assign up to x number of policy ownership under an individual life insurance policy a. 25% b. 50% c. 75% d. 100%
d. 100%
A new agent must complete at least x number of hours of continuing education within 24 months of initial licensure a. 12 b. 16 c. 20 d. 24
d. 24
the insurance commissioner must give how many days notice prior to holding a hearing regarding an agent's unfair or deceptive practice a. 5 b. 7 c. 10 d. 30
d. 30
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 a period 7 b. 10 c. 20 d. 31
d. 31
in texas, an individual life insurance policy is required to have a grace period of a. 15 days b. 20 days c. 30 days d. 31 days
d. 31 days
a 66-year-old is covered under a group health plan while employed with a business that has 40 employees. If she enters herself while walking in the park, what coverage would be considered primary a. Medicaid b. Long-term care c. Medicare d. Her group health plan
d. Her group health plan
Which of the following groups may not be insured by a group life insurance policy A. Employees b. Supervisors c. Administrators d. Individuals who are related by blood
d. Individuals who are related by blood
credit life insurance is a. Illegal in the state b. Insurance issued on a debtor to cover outstanding loan balances c. Not regulated in this state d. Insurance issue to a creditor to cover outstanding loan balances
d. Insurance issue to a creditor to cover outstanding loan balances
What is the initial requirement for an insurance to become eligible for benefits under the waiver of premium provision a. Insured must be unemployed b. Insured must be hospitalized c. Insured must demonstrate financial need d. Insured it must be under a physician's care
d. Insured it must be under a physician's care
life insurance arrangement which circumvents insurable interest statutes is called a. Uncontracted adhesion b. And indemnity contract c. Key person insurance d. Investor originated life insurance
d. Investor originated life insurance
Stranger originated life insurance stoli Has been found to be in violation of which of the following contractual elements a. Consideration b. Competent parties c. Offer/acceptance d. Legal purpose (insurable interest)
d. Legal purpose (insurable interest)
Tea has disability income policy that pays a monthly benefit of $5,000. If tea becomes partially disabled what can he likely expect a. $5,000 per month benefit b. $10,000 per month benefit if the cause was accidental c. More than $5,000 per month benefit if caused was work-related d. Less than $5,000 per month benefit regardless of the cause
d. Less than $5,000 per month benefit regardless of the cause
dental Care coverage is designed to cover the cost of all of the following except a. Oral surgery b. Preventative care c. Orthodontia d. Lots of income
d. Lots of income
Z owns a disability income policy with a 30-day elimination period. Z contracts pneumonia that leaves him unable to work from January 1st until January 15th. Z then becomes disabled from an accident on February 1st and the disability lasts until July 1st the same year. Z will become eligible to receive benefits starting on a. January 1st b. January 15th see. February 1st d. March 1st
d. March 1st
Which of these do not constitute policy delivery a. Policy mail to applicant b. Policy mail to agent c. Policy delivered to the applicant by the agent d. Policy issued with a rating
d. Policy issued with a rating
Which of these characteristics is consistent with a straight-like policy a. Owner can adjust both premium and definition b. Premiums are lower for the first 5 years, increase the 6th gear, then levels off for the remaining length of the contract see. Owner has the option of converting to term insurance d. Premiums are payable for as long as there is insurance coverage in force
d. Premiums are payable for as long as there is insurance coverage in force
Which of these statements accurately describes the waiver of premium provision in an accident and health policy A. Past due premiums on elapsed policy are waived and coverage is restored b. The insured is paid a monthly benefit to keep insurance premiums current in the event of total disability c. Premiums are waived after the insured has been unemployed for specified time period d. Premiums are waived after the insured has been totally disabled for a specified time.
d. Premiums are waived after the insured has been totally disabled for a specified time.
With optionally renewable health policies the insurer may a. renew the policy only if no claims have been filed the previous year b. Renew the policy only with the insured's consent c. Review the policy whenever they please and determine whether or not to renew it d. Review the policy annually and determine whether or not to renew it
d. Review the policy annually and determine whether or not to renew it
Post tax dollar contributions are found in a period 401K investments B traditional IRA investments c. Simple investments d. Roth IRA investments
d. Roth IRA investments