CH 8 - Test

An example of an unfair claims settlement practice is: 1. making it mandatory that proof of loss be provided for each claim 2. failing to promptly provide reasonable explanation to the denial of claims 3. requiring a time limit for submitting a claim 4. paying a claim in a timely manner

2. failing to promptly provide reasonable explanation to the denial of claims

A company that is authorized by the commissioner to transact insurance business in Louisiana is called a(n)

authorized insurer

A domestic insurance company in LA must

be organized under Louisiana insurance laws

coverage for newborns under an accident and health plan MUST include coverage for

birth abnormalities

A producer who sells most of his/her insurance policies to family members is said to be engaging in

controlled business

Jim recently sold his whole life insurance policy under a viatical settlement contract. The proceeds of this contract could be subject to the claims of:

creditors

Which of the following unfair trade practices involves a producer who makes malicious public statements regarding an insurers financial condition ? 1. Boycotting 2. defamation 3. unfair discrimination 4. misrepresentation

defamation

Advertising regulations exist in order to

demonstrate full and truthful disclosures to the public

A viatical settlement broker may NOT

make any transactions before being approved for a license

An insurance producer who convinces a prospective insured to purchase a policy by exaggerating the benefits of the policy may be found guilty of

misrepresentation

a business entity wishing to act as an insurance producer MUST

obtain a producers license

When a producer is replacing an existing ordinary life insurance policy, the producer must take all of the following actions EXCEPT 1. provide the application with a coy of the sales proposal 2. submit to the producer's insurance company a copy of the signed notice regarding replacement 3. obtain the beneficiary's signature 4. provide the applicant with a notice regarding replacement

obtain the beneficiary's signature

The Louisiana Life and health insurance guaranty association

protects insured's from insurance company insolvency

Karen the producer pays for her client's initial premium payment as an incentive for purchase. This act is considered

rebate, which is illegal

A nonresident producer from a state outside of Louisiana may become licensed in Louisiana IF a...

reciprocal arrangements exists with the state of domicile

which entity regulates claim settlement practices?

state insurance departments

When the commissioner of insurance request a producer's business records, they must be produced

upon request

The renewability provision for an individual long-term care insurance policy be located on the policy form's

First page

In Louisiana, legal action can be take for up to _____ year(s) against an insurer for failure to pay health insurance claims after proof of loss was submitted

1

if a health policy is reinstated after it had lapsed for nonpayment, there is a waiting period of _____ days before a claim covering sickness will be covered.

10 days

an insurer has ____ days to file a notice of appointment to the commissioner

15

An eligible employee can be excluded from health coverage for up to ____ months if he/she is considered a "late enrollee"

18 months

How many days is a temporary license valid ?

180 days

After an annuity has been in force for _____ year(s) it becomes incontestable

2

a life insurance policy sold in Louisiana can be contested by the insurer only during the first ______ years of the contract

2

How long after its effective date will an individual life insurance policy become incontestable ?

2 years

An insurer need NOT pay interest on death benefits if the proceeds of the life policy are paid within

20 days after the date of the death of the insured

All Louisiana licensed producers MUST complete which of the following continuation education requirements

24 hours every 2 years

After ____ years from date of issue, a policy can no longer be cancelled by the insurer for misstatements (except for fraud)

3 years for health

An insurer is REQUIRED to offer which of the following to each long term applicant at the time of purchase? 1. Lifetime level premiums 2. conditional renewability 3. inflation protection 4. deflation protection

3. inflation protection

A producer license is NOT required when 1. selling insurance 2. soliciting insurance 3. underwriting insurance 4 negotiating insurance

3. underwriting insurance

within how many days must a licensee submit a change in address ?

30

How many days must a producer submit a change in address ?

30 days

within _____ days after policy delivery, both Medicare supplement and Long-term care policies can be returned for a 100% premium refund

30 days

within how many days must a producer submit a change in address ?

30 days

An Arkansas resident producer who would like to solicit insurance in Louisiana MUST obtain a nonresident license in Louisiana. Which of these is NOT a requirement for obtaining a nonresident license ? 1. have good character 2. be competent 3. at least 18 yrs of age 4. pass LA state Licensing exam

4. pass LA state Licensing exam

As classified by the ACA (affordable care act) a silver plan offers

70%

In order for a business entity to be licensed as a producer

a licensed producer must be designated as responsible for compliance with state insurance laws

Long-term care policies or certificates issued in Louisiana are required to have

a nonforfeiture value

A licensed producer MUST be _______ by an insurer to be eligible for soliciting insuranc contracts

appointed

Before a producer may sell, solicit or negotiate insurance for an insurer, the producer must have an

appointment

A producer must notify the commission within _____ days of a felony conviction?

30

A life insurance applicant in Louisiana may backdate the application for up to____ months

6 mos

Kiara filled out a life ins application and was given a policy illustration that showed future premiums being paid out of nonguaranteed values. This illustration MUST disclose that

She may need to resume premium payments, depending on actual results

which of the following permits an insurance company to transact business in Louisiana 1. certificate of admission 2. certificate of authority 3. certificate of domestication 4. cert of authenticity

certificate of authority

An example of unfair discrimination would be

charging different premiums for policyholders in the same risk classification

How often must the commissioner examine each domestic insurance company?

every 5 years

Sharon the producer intentionally submitted a false statement in support of a claim. This is considered a form of:

fraud

Which of the following is NOT information found in a life insurance buyer's guide ?

how to take legal action against an insurance company

An alien insurer

is an insurer operating in the US but headquartered outside the US"

When a Medicare Supplement insurance policy is being replaced, who must sign the notice of replacement?

the producer and the applicant

Terminally-ill life insurance policyowners may sell their policy at a discount to a third party. This type of agreement is called a

viatical settlement

a DOMESTIC insurance company in Louisiana MUST

write insurance on risks located ONLY in Louisiana

which of these is a requirement for obtaining a resident insurance producer license in this state ? 1. pass the appropriate exam 2. graduate hs 3. graduate 4 year college 4. resident for 5 yrs

1. pass the appropriate exam

all of the following actions are considered rebating EXCEPT: 1. sharing commissions with other producers 2. offering a country club membership as an inducement to purchase insurance 3. offering employment as an incentive to purchase insurance 4. giving back commissions to a client

1. sharing commissions with other producers

All of the following are considered to be fraud EXCEPT 1. depositing premiums into a personal bank account for personal use 2. collecting an insurance charge that is less than what is required 3. intentionally collecting a higher premium payment that is required 4. Willfuly misappropriating premiums collected

2. collecting an insurance charge that is less than what is required

A hospital or medical expense policy will typically cover dental treatment expense under which circumstance? 1. After the annual limit of a dental policy's coverage is reached 2. dental treatment is needed to repair an injury 3. cosmetic dental treatment is performed 4. if treatment is performed at a in-network provider

2. dental treatment is needed to repair an injury

Written notice of health insurance claim should be given to the insurer within ____ days after the occurrence of any loss covered by the policy

20 days

On occasion, insurable interest may exist in the absence of economic interest. Which of the following example does this pertain to? 1. Business associates 2. business competitors 3. a husband and wife 4. students in a classroom

3. a husband and wife

Insurable interest does NOT exist between 1. A partner and partnership 2. a mother and a daughter 3. two unrelated neighbors 4. a husband and wife

3. two unrelated neighbors

An indemnity plan limitation that will pay the dental bills after a small amount is paid by the insured is called

coinsurance

An insurance producer decides to conduct business under an assumed name. The commissioner MUST be notified of this changed ....

prior to using the assumed name

A _________ sells, solicits or negotiates insurance on behalf of insurance companies for compensation

producer

the LA life and health ins. guaranty association .....

protects insureds from insurance company insolvency

Which license is REQUIRED in order to solicit Long Term Care insurance in the State of Louisiana? 1. Life Insurance Producer License 2. Long Term Care Insurance Producer License 3. Casualty Insurance Producer License 4. Health Insurance Producer License

4. Health Insurance Producer License