FINAL EXAM QUESTIONS AND
ANSWERS FOR HEALTH AND LIFE
INSURANCE
What is the maximum Social Security Disability benefit amount an insured can receive?
- Answer-100% of the insured's Primary Insurance Amount (PIA)
During the appeal period, an agent may successfully appeal license termination due to
continuing education requirements if - Answer-proof of compliance is provided
Insurance agents MUST maintain premiums in a fiduciary capacity and remit them -
Answer-in the ordinary course of business
Which of the following individuals is required to hold an appointment with an insurance
company which they represent? - Answer-An agent
The policy provision that entitles the insurer to establish conditions the insured must
meet while a claim is pending is: - Answer-Time Limit on Certain Defenses
Which of the following does Social Security NOT provide benefits for? - Answer-
Dismemberment
In Virginia, records must be kept for each of the following insurance transactions
EXCEPT - Answer-Premium quotes not accepted by the insured or prospective insured
According to the Mandatory Uniform Policy Provisions, what is the maximum amount of
time after the premium due date during which the policy remains in force even though
the premium has not been paid? - Answer-31 days
After a hearing, the State Corporation Commission may order an agent who willfully
violates any provision of the insurance code to pay a MAXIMUM penalty per violation of
- Answer-5000 $
Which of these statements is INCORRECT regarding a Preferred Provider Organization
(PPO)? - Answer-PPO's are NOT a type of managed care systems
What action should a producer take if the initial premium is NOT submitted with the
application? - Answer-Forward the application to the insurer without the initial premium
An assignment of benefits of a Health Policy: - Answer-transfers payments to someone
other than the policyowner
,When soliciting a Medicare Supplement policy, an insurance agent should advise an
applicant that the - Answer-agent is there to determine what, if any, policy is appropriate
for the purchaser, considering existing coverage
All of the following statements about Major Medical benefits are true, EXCEPT: -
Answer-beneFITS HAVE NO MAXIMUM LIMIT
The act of offering an applicant something of value as an inducement to purchase a
policy of insurance is - Answer-rebating
What should an insured do if the insurer does not send claims forms within the time
period set forth in a health policy's Claims Forms provision? - Answer-submit the claim
in any form
In an insurance contract, the insurer is the only party who makes a legally enforceable
promise. What kind of contract is this? - Answer-unilateral
Which Accident and Health policy provision addresses preexisting conditions? -
Answer-Time Limit on Certain Defenses
The Legal Actions provision of an insurance contract is designed to do all of the
following, EXCEPT: - Answer-protect the producer
Which of the following actions is considered an Adverse Underwriting Decision? -
Answer-Terminating insurance coverage
A Qualified Long Term Care policy requires the Free Look provision to refund 100% of
premiums paid within how many days of policy delivery? - Answer-30 days
Insurance companies and agents must implement an information security program to
accomplish each of the following EXCEPT - Answer-provide policyholder lists to the
Commissioner of Insurance
Which of the following statements about a Guaranteed Renewable Health Insurance
policy is CORRECT? - Answer-Premiums normally increase at time of renewal
Who makes the legally enforceable promises in a unilateral insurance policy? - Answer-
Insurance company
What type of renewability guarantees premium rates and renewability? - Answer-
Noncancellable
Each agent shall complete all continuing education requirements by no later than
November 30, and shall be given a final opportunity to complete such requirements by -
Answer-December 31 every even year
, A Business Overhead Expense policy would cover which of the following if a business
owner becomes disabled? - Answer-Utilities and office rent
J has an Accidental Death and Dismemberment policy with a principal sum of $50,000.
While trimming the hedges, J cuts off one of his fingers. What is the MAXIMUM J will
receive from his policy? - Answer-$25,000
Which of the following actions will an insurance company most likely NOT take if an
applicant, who has diabetes, applies for a Disability Income policy? - Answer-Issue the
policy with an altered Time of Payment of Claims provision
When does a Probationary Period provision become effective in a health insurance
contract? - Answer-30 days after the policy's inception
The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers (and
their families) whose employment has been terminated the right to: - Answer-continue
group health benefits
Which of the following is NOT included in the policy face? - Answer-Exclusions
An insurance agent's license may be suspended or revoked if the agent has - Answer-
engaged in twisting
A CEO's personal assistant suffered injuries at home and as a result, was unable to
work for four months. Which type of policy will pay a monthly benefit to the personal
assistant? - Answer-Disability Income
A person who issues false written or oral statements that are maliciously critical of the
financial condition of an insurance company may be found guilty of - Answer-defamation
An insurer must provide an insured with claim forms within __ days after receiving
notice of a loss. - Answer-15 days
Testimonials used in Accident & Health insurance must meet all of the following
requirements EXCEPT - Answer-They must be approved by the Virginia Commissioner
of Insurance
The provision in a Group Health policy that allows the insurer to postpone coverage for
a covered illness 30 days after the policy's effective date is referred to as the: - Answer-
Waiting Period
Which Long Term Care insurance statement is true? - Answer-Pre-existing conditions
must be covered after the coverage has been in force for six months
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