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
