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NC Aflac State Exam Study Guide Verified Questions And Answers With Verified Updates
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What is Presumptive Disability? - The obvious total, permanent disability requiring no demonstration of the inability to work (i.e., loss of sight, hearing, speech, or the loss of two or more limbs) What is the purpose of Disability Income Insurance? - Provides income payments when the insured ...

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  • August 14, 2024
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  • 2024/2025
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NC Aflac State Exam Study Guide
What is Presumptive Disability? - The obvious total, permanent disability requiring no
demonstration of the inability to work (i.e., loss of sight, hearing, speech, or the loss of two or more
limbs)



What is the purpose of Disability Income Insurance? - Provides income payments when the
insured is unable to work because of sickness or injury



What are the two major types of losses? - 1. Loss of Income (disability)

2. Hospital/Medical expenses



How often does Disability Income policies pay out benefits? - Provides weekly or monthly benefits
to replace salary/wages lost while sick/injured



What is the maximum amount of benefits that is typically paid out for in a Disability Income policy? -
Typical maximum benefits will be 50% to 70% of gross income



What can a Disability Income policy also be referred to as? - Loss of time or loss of income policies



How much of a Disability Income policy can be taxable? - Only the amount that the employer pays



Total disability can be defined as what? - May arise from either illness or injury related occurences



What is the least restrictive total disability? - "Own" occupation



What is the most restrictive total disability? - "Any" occupation



What does "own occupation" mean? - The inability to perform duties of his/her OWN occupation

,What does "any occupation for which the insured is reasonably suited" mean? - The inability to
perform duties of any occupation for which he/she is reasonable suited for by EXPERIENCE



What does "any occupation" mean? - The inability to perform duties of ANY OCCUPATION



What protects the company from malingering? - Combination definitions (own + any = combined)



What is the only form of disability you can collect without being under a doctors care? -
Presumptive disability



What is Partial Disability? - The inability to perform one or more duties of an occupation and
working less than half of business time



How much is paid out for a Partial Disability? - Usual benefit will be 50% of the amount payable
for total disability, and are paid for a specified maximum amount of time (i.e., 6 months)



Partial Disability State Exam question: If X returns to work, but only earns 40% of his original pay of
$2000 a month, what will he be receiving from residual disability? - $1,200

(cut in pay percentage = 60%)

So, 60% x $2000 = $1,200



What is Recurrent Disability? - The onset of disability, after recovery from a preceding disability
period, resulting from the same accident/illness



For Recurrent Disability, it will be treated as a continuation of the previous disability if it occurs within
___________ . - Six months

(also, will not have to re-wait the Elimination Period)



For Recurrent Disability, when will the individual have to wait the Elimination Period over again? -
If the reoccurring accident/illness takes place longer than 6 months

, What is the Elimination (waiting) Period? - The time from onsite of a disability until benefit
payment begins or the number of days that an individual must be disabled before they will be paid (i.e.,
15 days, 30 days, etc.)



What is the Probationary Period? - The time from issuance to the effective date of policy



For Probationary Period, how long must an individual wait for a new policy to be in effect? - 30
days



What eliminates coverage for pre-existing conditions and protect against adverse selection? - The
Probationary Period



What is Non-occupational coverage? - Provides coverage for when the individual is not at work



What is Full coverage? - Provides coverage around the clock

What benefit feature offsets inflation? - The Cost of Living Adjustment (COLA)



How long must a person have been receiving disability benefits for before the COLA provision is
activated? - 12 months



What is Guaranteed Insurability? - The insured is allowed to purchase additional amounts of
benefits at selected, predetermined intervals WITHOUT having to prove evidence of insurability



What is Waiver of Premium? - The insurance company will make the premium payments on behalf
of the insured from the date of disability IF disabled for longer than the elimination period



What is the purpose of Basic Medical Expense Insurance? - It pays hospital confinement expenses
on a reimbursement basis (by paying benefits to the policy holder) or on a service basis (by paying those
who provide the service directly)

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