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. Fifteen
Under a group health plan, an employer may offer additional benefits to classes of employees on the
basi...
Pearson Vue National Health Insurance Practice
Test Updated |51 Questions with 100% Correct
Answers | Updated & Verified | 2024
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. Fifteen
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. gender
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.
It allows the insured to maintain a policy in force while disabled and unable to pay premiums.
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. Exclusions
, 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. Pay the full claim
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. Health Maintenance Organization
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