West Virginia Laws and Rules Insurance

Delivery Receipt

A ________ ________ is the signed document that starts the free-look period. Buyer's Summary Delivery Receipt Policy Guide Binding Receipt

be incorporated and formed in West Virginia

A domestic insurance company in West Virginia MUST own real estate in West Virginia write insurance on risks located only in West Virginia be incorporated and formed in West Virginia honor the charter of the National Association of Insurance Commissioners (NAIC)

100%

A group life insurance policy insured may assign up to _____ of the insured's coverage. 25% 50% 75% 100%

25

A labor union must have at LEAST ___ members to be issued a group life policy. 25 35 45 55

At the time of application

At what point must a producer deliver a Notice to Applicant Regarding Replacement of Accident & Sickness insurance? Within 5 days of the sales presentation After policy has been in effect for 30 days At the time of application When the policy is issued

the insured's estate

A life insurance policyowner recently died. The proceeds from this policy are NOT exempt from a creditor's claims when they are payable to the insured's spouse the insured's children the insured's estate the insured's business associates

Resident producer

A prelicensing course must be successfully completed for which of the following? Administrative Assistant to an officer Resident producer Head underwriter Nonresident producer

foreign company

In West Virginia, an insurer licensed to conduct business in West Virginia, but domiciled in New Jersey, is called? Non-admitted company foreign company domestic company alien company

Coercion

In West Virginia, which of the following is considered an Unfair Trade Practice? Replacement Coercion Aleatory Subrogation

send notice of the termination to the Commissioner

In order to terminate a producer's appointment, the insurer MUST send notice of the termination to the Commissioner receive the Governor's approval send notice of the termination to the NAIC request a hearing before the Commissioner of Insurance

$300,000

Life insurance death benefits up to ______ are guaranteed by the West Virginia Life and Health Guaranty Association. $50,000 $150,000 $300,000 $500,000

Alzheimer's disease or dementia

Limitations and exclusions may be placed on Long-Term Care policies sold in West Virginia for all of these conditions EXCEPT Alcoholism Acts of war Self-Inflicted injury Alzheimer's disease or dementia

31

Newborn children must initially be provided health coverage for ____ days. 7 10 15 31

closely regulated and requires full disclosure

One definition of replacement is "the act of replacing an existing insurance policy with another". Replacement is legal and requires no disclosure closely regulated and requires full disclosure not legal in the state of West Virginia allowed only if the policy originated outside the state of West Virginia

P can convert to a $25,000 Term policy

P is an employee covered under his employer's Group Life policy for $25,000. He quits after 1 year on the job. Which statement about his conversion options is NOT true? Conversion is guaranteed at the option of the insured The premium is based on P's attained age at the time of conversion P can convert to a $25,000 Term policy P must apply for conversion within 31 days of quitting

include a copy of the order

P the producer reports to the Insurance Commissioner a final disposition of an administrative action taken against him. This report must include a copy of the order include a written apology include a $500 fee be prepared by an attorney

12 months

What is the MINIMUM benefit period that must be offered by a Long-Term Care policy sold in West Virginia? 6 months 12 months 18 months 24 months

Obtain the beneficiary's signature

Which of these actions is NOT required when a producer replaces an existing individual life insurance policy? Provide the applicant a Notice Regarding Replacement of Life Insurance Provide the applicant the original or a copy of the proposals used in the sales presentation Obtain the beneficiary's signature Submit to the producer's insurance company a copy of the Notice Regarding Replacement of Life Insurance signed by the applicant

Bankruptcy

Which of these is NOT a valid reason for the Insurance Commissioner to deny a producer's license renewal? Incompetence Untrustworthiness Bankruptcy Violating a cease and desist order

6 months

pre-existing conditions may be excluded on a Medicare Supplement policy for up to 3 months 6 months 9 months 12 months

Misrepresentation

_________ can be defined as "making an unfair comparison of two insurance policies". Rebating Twisting Coercion Misrepresentation

is found guilty of misrepresentation

A license may be denied, suspended, or revoked if the licensee engages in replacement of an existing policy is found guilty of misrepresentation files for bankruptcy does not meet a sales quota

Notice Regarding Replacement

A producer has replaced an existing Accident and Sickness (A&S) policy with a new one for a client. Which of the following forms must be provided to the client prior to policy delivery? Notice Regarding Lapse Notice Regarding Renewal Notice Regarding Replacement Notice Regarding Nullification

"My insurer guarantees cash values"

A producer is making a sales presentation for a whole life insurance policy. Which of the following statements may the producer guarantee during the presentation? "My insurer guarantees dividends" "My insurer guarantees cash values" "I will guarantee a return of my commissions as an incentive" "I will guarantee you will not be declined for this policy"

30

A producer must notify the Insurance Commissioner within ___ days following the final deposition of an administrative action by any government agency. 10 20 30 40

$5,000

A producer who intentionally violates a cease and desist order could receive a fine of up to _______ per violation. $3,000 $4,000 $5,000 $6,000

$5,000

A producer who intentionally violates an Unfair Trade Practice law could receive a fine of up to _______ per violation. $3,000 $4,000 $5,000 $6,000

writes primarily controlled business

A producer's license may be suspended or revoked if the licensee writes primarily controlled business engages in replacement of an existing policy files for bankruptcy does not meet a sales quota

unfair claims practice

ABC Insurance Company failed to accept a valid Proof of Loss statement. This is considered to be a(n) instance of subrogation legal claims practice form of coercion unfair claims practice

turning down a claim without providing the basis of denial

An example of an unfair claims settlement practice is making it mandatory that proof of loss be provided for each claim requiring a time limit for submitting a claim paying a claim in a timely matter turning down a claim without providing the basis of denial

An insurer exaggerating its dividends in a magazine advertisement

An example of false advertising would be Paid testimonials from celebrity endorsements An insurer exaggerating its dividends in a magazine advertisement A producer spending more than $25 on marketing gifts for a client An insurer advertising in an insurance trade journal

returning a portion of a premium as inducement to purchase insurance

An example of rebating would be returning a portion of a premium as inducement to purchase insurance a mutual insurance company paying dividends to its policyholder reducing the premiums across the board for a specific risk class offering temporary insurance coverage

report the placement to his primary insurer

S the producer charged a fee for placing an insurance policy. Under West Virginia law, S must report the placement to his primary insurer document the fee with the Department of Insurance guarantee to the insured that the insurer will accept the risk report this act to the Insurance Commissioner

has authority to review policy forms if they will be issued for delivery in West Virginia

The Insurance Commissioner Remaining has no authority to review policy forms for use in West Virginia has authority to review policy forms from alien insurers only has no authority to review policy forms for insurers with a minimum surplus has authority to review policy forms if they will be issued for delivery in West Virginia

15

The Insurance Commissioner must give at least ___ days notice prior to holding a hearing regarding a producer's license. 15 20 25 30

6 months

The MAXIMUM time period that pre-existing conditions may be excluded in long-term care policies is 6 months 12 months 18 months 24 months

funded by insurance companies through assessments

The West Virginia Life and Health Insurance Guaranty Association is an entity that assists in underwriting large insurance policies funded by insurance companies through assessments funded by the state government administered by the Federal government

producer

The _______ must provide an insured with proper disclosure concerning the replacement of an existing policy. producer underwriter Commissioner adjuster

Claim payments of admitted, insolvent insurance companies

What does the West Virginia Life and Health Insurance Guaranty Association provide? Enforcement for West Virginia's insurance regulations Claim payments of admitted, insolvent insurance companies Underwriting services for high-risk insurance applicants Establishment of underwriting guidelines for admitted insurers

31 days

When an employee is terminated, how long does this employee have to convert group life coverage to an individual plan? 30 days 31 days 60 days 90 days

age, annual income, financial experience

When making a recommendation to a consumer to purchase an annuity, the producer must make reasonable efforts to obtain suitability information. Suitability information includes gender, place of employment, credit score credit score, age, health history annual income, gender, criminal background age, annual income, financial experience

At least 18 years old

Which of the following is a requirement to attain a West Virginia resident producer license? Graduate from high school U.S. citizen At least 18 years old Live in this state at least 5 years

Trustworthiness and competence

Which of the following is a requirement to attain a West Virginia resident producer license? Graduate from high school U.S. citizen Trustworthiness and competence Live in this state at least 5 years

Medical Service Corporation

Which of the following is considered to be a non-stock, nonprofit corporation? Health Maintenance Organization Medical Service Corporation Preferred Provider Organization Private insurer

Certificate of authority

Which of the following permits an insurance company to transact business in West Virginia? Certificate of admission Certificate of domestication Certificate of authenticity Certificate of authority

The Commissioner may examine them whenever it's deemed necessary

Which of the following statements is correct about the Insurance Commissioner's authority to examine the business records of a producer? The Commissioner has no authority to examine them The Commissioner may examine them whenever it's deemed necessary The Commissioner must examine them at least twice every five years The Commissioner must examine them at least twice every three years

Producer delivers the policy to an applicant more than 7 business days after they received it for delivery

Which of these actions taken by a producer is considered a violation of West Virginia insurance laws pertaining to Medicare Supplements? Producer gives prospective insured an Outline of Coverage when taking an application for a Medicare Supplement policy Producer determines the appropriateness of the Medicare Supplement policy for the proposed insured Producer delivers the policy to an applicant more than 7 business days after they received it for delivery Producer tells applicant there is a 30 day free-look period for a Medicare Supplement policy

"Nonforfeiture benefits will be available after a period of time"

Which of these statements may a producer make to a client about a Whole Life policy? "Your policy will begin to build cash value on day 1" "I will give you 25% of my commission in exchange for purchasing this whole life policy" "Dividends from this policy are guaranteed" "Nonforfeiture benefits will be available after a period of time"

To determine the solvency of the company

Why would the Insurance Commissioner examine the records of an insurance company? To determine the solvency of the company To set insurance rates for the company To assist in underwriting To assess the company's value