Pearson Vue National Health Insurance
Practice Test
An insurer must provide claim forms to an insured within a MAXIMUM of how
many days after receiving notice of an Accident & Health claim?
A. Five
B. Fifteen
C. Twenty
D. Thirty - -b
-Under a group health plan, an employer may offer additional benefits to
classes of employees on the basis of all of the following factors EXCEPT:
A. length of employment
B. gender
C. salary grade
D. job category - -b
-Which of the following statements is CORRECT about a Waiver of Premium
provision in a Disability Income policy?
A. It allows the insurer to deduct premiums due from the disabled insured's
benefit payments.
B. It allows the insurer to increase the amount of premium during the
insured's time of disability.
C. It allows the insured to extend the length of the Grace Period while
disabled.
D. It allows the insured to maintain a policy in force while disabled and
unable to pay premiums. - -d
-Suicide, pre-existing conditions and self-inflicted injuries are dealt with in
which of the following policy features?
A. Extensions of coverage
, B. Benefits clause
C. Riders
D. Exclusions - -d
-An insured becomes disabled three years after his Disability Income policy
is issued. The disability is caused by a condition that existed prior to the
policy issue date but was not specifically excluded from coverage. In this
situation, the insurer will most likely take which of the following actions?
A. Pay the full claim
B. Pay the claim for a maximum of six months only
C. Deny the claim on the basis of misrepresentation
D. Deny the claim because it involves a pre-existing condition - -a
-A health care plan that reimburses a flat fee for medical care it provides at
a clinic it owns and operates is referred to as:
A. Health Maintenance Organization
B. Medicaid
C. Medicare
D. Multiple Employer Trust (MET) - -a
-Which of the following laws requires an insurer to notify an applicant in
writing that an investigative consumer report may be made on the applicant?
A. Uniform Provisions Law
B. Freedom of Information Act
C. Medical Information Bureau Disclosure Act
D. Fair Credit Reporting Act (Insurance Information and Privacy Protection
Act) - -d
-Under a Guaranteed Renewable Accident & Health policy, an insurer retains
the right to:
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