Louisiana Life and Health Insurance Exam
All of the following are correct about the required provisions of a health insurance policy EXCEPT
A. The entire contract clause means the signed application, policy, endorsements, and attachments constitute the entire contract.
B. A reinstated policy provides immediate coverage for an illness.
C. Policies become incontestable after being in force for 3 years.
D. A grace period of 31 days is found in an annual pay policy. - correct answer B. A reinstated policy provides immediate coverage for an illness.
Accidental injury is covered immediately, but to protect the insurer against adverse selection, losses resulting from sickness are covered only if the sickness occurs at least 10 days after the reinstatement date.
An insured pays a monthly premium of $100 for health insurance. What would be the duration of the grace period under the policy?
A. 15 days
B. 30 days
C. 60 days
D. 7 days - correct answer B. 30 days The grace period is 30 days for all health insurance policies in Louisiana.
Question 11 of 15 An applicant for an individual health policy failed to complete the application properly. Before being able
to complete the application and pay the initial premium, she is confined to a hospital. This will not be covered by insurance because she has not met the conditions specified in the
A. Insuring Clause.
B. Pre-existing Conditions Clause.
C. Eligibility Clause.
D. Consideration Clause. - correct answer D. Consideration Clause.
The consideration clause specifies that both parties to the contract must give some valuable consideration. The payment of the premium is the consideration given by the applicant. Because the applicant had not paid an initial premium, she is not covered by insurance.
Question 12 of 15 Under the mandatory uniform provision Notice of Claim, the first notice of injury or sickness covered under an accident and health policy must contain
A. An estimate of the total amount of medical and hospital expense for the loss.
B. A complete physician's statement.
C. A statement that is sufficiently clear to identify the insured and the nature of the claim.
D. A statement from the insured's employer showing that the insured was unable to work. - correct answer C. A statement that is sufficiently clear to identify the insured and the nature of the claim. The Insurance Code requires that each policy must include, "Written notice of claim must be given to the
insurer within 20 days after the occurrence or commencement of any loss covered by the policy, or as soon thereafter as is reasonably possible".
Question 13 of 15 The expense for an autopsy covered under the physical exam and autopsy provision is paid by
A. The estate of the insured.
B. The insurer.
C. The state's autopsy fund.
D. The limits of coverage under the health insurance policy. - correct answer B. The insurer
Where not forbidden by state law, the insurer, at its own expense, may cause an autopsy to be performed on a deceased insured.
An insured notifies the insurance company that he has become disabled. What provision states that claims must be paid immediately upon written proof of loss?
A. Time of Payment of Claims
B. Incontestability
C. Physical Exam and Autopsy
D. Legal Actions - correct answer A. Time of Payment of Claims The Time of Payment of Claims provision specifies that claims are to be paid immediately upon written proof of loss.
Which renewability provision allows an insurer to terminate a policy for any reason, and to increase the premiums for any class of insureds?
A. Conditionally renewable
B. Cancellable
C. Guaranteed renewable
D. Optionally renewable - correct answer D. Optionally renewable
The renewability provision in an optionally renewable policy gives the insurer the option to terminate the policy for any reason on the date specified in the contract (usually a renewal date). Furthermore, this
provision allows the insurer to increase the premium for any class of optionally renewable insureds.
When an insurer issues an individual health insurance policy that is guaranteed renewable, the insurer agrees
A. To charge a lower premium every year the policy is renewed.
B.Not to change the premium rate for any reason.
C. To renew the policy indefinitely.
D. To renew the policy until the insured has reached age 65. - correct answer D. To renew the policy until
the insured has reached age 65.
All of the following are correct about the required provisions of a health insurance policy EXCEPT
A. The entire contract clause means the signed application, policy, endorsements, and attachments constitute the entire contract.
B. A reinstated policy provides immediate coverage for an illness.
C. Policies become incontestable after being in force for 3 years.
D. A grace period of 31 days is found in an annual pay policy. - correct answer B. A reinstated policy provides immediate coverage for an illness.
Accidental injury is covered immediately, but to protect the insurer against adverse selection, losses resulting from sickness are covered only if the sickness occurs at least 10 days after the reinstatement date.
An insured pays a monthly premium of $100 for health insurance. What would be the duration of the grace period under the policy?
A. 15 days
B. 30 days
C. 60 days
D. 7 days - correct answer B. 30 days The grace period is 30 days for all health insurance policies in Louisiana.
Question 11 of 15 An applicant for an individual health policy failed to complete the application properly. Before being able
to complete the application and pay the initial premium, she is confined to a hospital. This will not be covered by insurance because she has not met the conditions specified in the
A. Insuring Clause.
B. Pre-existing Conditions Clause.
C. Eligibility Clause.
D. Consideration Clause. - correct answer D. Consideration Clause.
The consideration clause specifies that both parties to the contract must give some valuable consideration. The payment of the premium is the consideration given by the applicant. Because the applicant had not paid an initial premium, she is not covered by insurance.
Question 12 of 15 Under the mandatory uniform provision Notice of Claim, the first notice of injury or sickness covered under an accident and health policy must contain
A. An estimate of the total amount of medical and hospital expense for the loss.
B. A complete physician's statement.
C. A statement that is sufficiently clear to identify the insured and the nature of the claim.
D. A statement from the insured's employer showing that the insured was unable to work. - correct answer C. A statement that is sufficiently clear to identify the insured and the nature of the claim. The Insurance Code requires that each policy must include, "Written notice of claim must be given to the
insurer within 20 days after the occurrence or commencement of any loss covered by the policy, or as soon thereafter as is reasonably possible".
Question 13 of 15 The expense for an autopsy covered under the physical exam and autopsy provision is paid by
A. The estate of the insured.
B. The insurer.
C. The state's autopsy fund.
D. The limits of coverage under the health insurance policy. - correct answer B. The insurer
Where not forbidden by state law, the insurer, at its own expense, may cause an autopsy to be performed on a deceased insured.
An insured notifies the insurance company that he has become disabled. What provision states that claims must be paid immediately upon written proof of loss?
A. Time of Payment of Claims
B. Incontestability
C. Physical Exam and Autopsy
D. Legal Actions - correct answer A. Time of Payment of Claims The Time of Payment of Claims provision specifies that claims are to be paid immediately upon written proof of loss.
Which renewability provision allows an insurer to terminate a policy for any reason, and to increase the premiums for any class of insureds?
A. Conditionally renewable
B. Cancellable
C. Guaranteed renewable
D. Optionally renewable - correct answer D. Optionally renewable
The renewability provision in an optionally renewable policy gives the insurer the option to terminate the policy for any reason on the date specified in the contract (usually a renewal date). Furthermore, this
provision allows the insurer to increase the premium for any class of optionally renewable insureds.
When an insurer issues an individual health insurance policy that is guaranteed renewable, the insurer agrees
A. To charge a lower premium every year the policy is renewed.
B.Not to change the premium rate for any reason.
C. To renew the policy indefinitely.
D. To renew the policy until the insured has reached age 65. - correct answer D. To renew the policy until
the insured has reached age 65.
