Test Questions
An insured has an Accidental Death & Dismemberment policy with a principal value of $50,000. He loses sight in both eyes in a hunting accident. How much will he receive?
$50,000
An insured pays a monthly premium of $100 for her health insurance. What would be the duration of the grace period under her policy?
10 days
What is the dependent child age limit in Georgia?
19
All of the following are correct about the required provisions of a health insurance policy EXCEPT
A reinstated policy provides immediate coverage for an illness.
Under the mandatory uniform provision Notice of Claim, the first notice of injury or sickness covered under an accident and health policy must contain
A statement that is sufficiently clear to identify the insured and the nature of the claim.
What kind of LTC benefit would provide coverage for care for functionally impaired adults on a less than 24-hour basis?
Adult Day Care
Which of the following statements is NOT true, regarding health insurance policy provisions?
All additional provisions written by insurers are cataloged by their respective states.
In reference to the standard Medicare Supplement benefits plans, what does the term "standard" mean?
All providers will have the same coverage options and conditions for each plan.
Under which condition would an employee's group medical benefits be exempt from income taxes?
An employee's group medical benefits are generally exempt from taxation as income.
If an insurance company makes a statement that its policies are guaranteed by the existence of the Insurance Guaranty Association, that would be considered
An unfair trade practice.
The premium charged for exercising the Guaranteed Insurability Rider is based upon the insured's
Attained age.
What document describes an insured's medical history, including diagnoses and treatments?
Attending Physician's Statement
Which of the following is NOT true regarding Workers Compensation?
Benefits are offered by the insurer.
After a person's employment is terminated, it is possible to obtain individual health insurance after losing the group health coverage provided by the employer. Which of the following is NOT true?
By law, the new, individual policy must provide the same benefits as the group insurance policy.
Kevin and Nancy are married; Kevin is the primary breadwinner and has a health insurance policy that covers both him and his wife. Nancy has an illness that requires significant medical attention. Kevin and Nancy decide to legally separate, which means that Nancy will no longer be eligible for health insurance coverage under Kevin. Which of the following options would be best for Nancy at this point?
COBRA
A man is injured while robbing a convenience store. How does his major medical policy handle the payment of his claim?
Claim is denied if his policy contains the Illegal Occupation provision.
When delivering a policy, which of the following is an agent's responsibility?
Collect payment at time of delivery (if payment has not already been collected)
In any case where there is a controversy or dispute between the insurance company and the insured, the soliciting agent is the agent of the
Company.
An insurer neglects to pay a legitimate claim that is covered under the terms of the policy. Which of the following insurance principles has the insurer violated?
Consideration
Which of the following is NOT a characteristic or a service of a HMO plan?
Contracting with insurance companies
The gatekeeper of an HMO helps
Control specialist costs.
Which of the following is NOT an exclusion in medical expense insurance policies?
Coverage for dependents
Which of the following statements about occupational vs. nonoccupational coverage is TRUE?
Disability insurance can be written as occupational or nonoccupational.
Long-term care coverage may be available as any of the following options EXCEPT
Endorsement to a health policy.
A husband and wife both incur expenses that are attributed to a single major medical insurance deductible. Which type of policy do they have?
Family
An insured is involved in an accident that renders him permanently deaf, although he does not sustain any other major injuries. The insured is still able to perform his current job. To what extent will he receive Presumptive Disability benefits?
Full benefits
An association could buy group insurance for its members if it meets all of the following requirements EXCEPT
Has at least 50 members.
What are the 2 types of Flexible Spending Accounts?
Health care accounts and Dependent care accounts
Which of the following types of LTC is NOT provided in an institutional setting?
Home health care
Which of the following riders would NOT increase the premium for a policyowner?
Impairment rider
Which of the following entities has the authority to make changes to an insurance policy?
Insurer's executive officer
Concerning Medicare Part B, which statement is INCORRECT?
It is fully funded by Social Security taxes (FICA).
Which of the following is NOT true regarding a Certificate of Authority?
It is issued to group insurance participants.
Which of the following is true regarding a term health policy?
It is nonrenewable.
The provision which prevents the insured from bringing any legal action against the company for at least 60 days after proof of loss is known as
Legal actions.
Which of the following insurance coverages would be allowed with an MSA?
Long-term care
Under an individual disability policy, the MINIMUM schedule of time in which claim payments must be made to an insured is
Monthly
An insured is involved in a car accident. In addition to general, less serious injuries, he permanently loses the use of his leg and is rendered completely blind. The blindness improves a month later. To what extent will he receive Presumptive Disability benefits?
No benefits
Can a group that is formed for the sole purpose of obtaining group insurance qualify for group coverage?
No, the group must be formed for a purpose other than obtaining group insurance.
All of the following are the most common variations in a Long-Term Care policy EXCEPT
Number of family dependents.
In long-term care insurance, what type of care is provided with intermediate care?
Occasional nursing or rehabilitative care
Which of the below statements is FALSE regarding the process of completing and signing an application?
Only the insured is required to sign the application.
Which renewability provision allows an insurer to terminate a policy for any reason, and to increase the premiums for any class of insureds?
Optionally renewable
Which of the following provisions would prevent an insurance company from paying a reimbursement claim to someone other than the policyowner?
Payment of Claims
Which renewability provision are you most likely to see on a travel accident policy?
Period of time
Which of the following provisions is mandatory for health insurance policies?
Physical examination and autopsy
What is the initial period of time specified in a disability income policy that must pass, after the policy is in force, before a loss can be covered?
Probationary period
All of the following statements regarding continuing education requirements in this state are true EXCEPT
Producers may repeat the same courses to meet the required CE hours for a licensing period.
Which is true regarding the Uniform Individual Accident and Sickness Policy Provisions Law?
Provisions may be reworded by the insurer.
An agent offers his client free tickets to a sporting event in exchange for the purchase of an insurance policy. The agent is guilty of
Rebating.
Which provision states how much time must pass between two like illnesses in order for the second one to be covered under a new set of benefits?
Recurrent Disability Provision
Which of the following is NOT provided by an HMO?
Reimbursement
A provision found in insurance policies which prevents the insured from collecting twice for the same loss is called
Subrogation.
Medicare supplements specifically exclude all of the following EXCEPT
Surgical expenses of persons eligible for Medicare.
Which of the following is NOT the consideration in a policy?
The application given to a prospective insured
In insurance, an offer is usually made when
The application is submitted.
Which of the following best describes the "first-dollar coverage" principle in basic medical insurance?
The insured is not required to pay a deductible.
Under a health insurance policy, benefits, other than death benefits, that have not otherwise been assigned, will be paid to
The insured.
Which of the following is NOT a feature of a guaranteed renewable provision?
The insurer can increase the policy premium on an individual basis.
Which of the following is NOT a feature of a noncancellable policy?
The insurer may terminate the contract only at renewal for certain conditions.
An agent tries to sell insurance over the phone to an applicant who appears to be confused, but is eventually able to give enough information for the application to be completed. After the policy was issued, the agent talked to the insured's family, and they explained that the insured was recovering from a surgery and might have been under the influence of medication at the time of application. Which of the following is true?
The policy may be voided if it can be proven that the applicant was not capable of making a buying decision at the time of application.
Under what condition are group disability income benefits received by an employee NOT taxable as income?
When the benefits received are equal or less than the employee's percentage of the contribution.
