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2024 ACCIDENT AND HEALTH INSURANCE EXAM QUESTIONS WITH CORRECT ANSWERS
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2024 ACCIDENT AND HEALTH INSURANCE EXAM QUESTIONS WITH CORRECT ANSWERS
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2024 ACCIDENT AND HEALTHINSURANCE EXAM QUESTIONS
WITH CORRECT ANSWERS
The mandatory provision that stipulates the insurer's rights during
underwriting and proving fraud is the:
A: Proof of Loss provision
B: Physical Examination and Autopsy
C: Entire Contract Provision
D: Legal Action Provision - CORRECT ANSWERS-B: Physical Examination and
Autopsy
The insured should be aware of the issue date upon delivery a policy and the
date should be listed on:
A: the policy summary
B: the first page of the contract
C: the delivery receipt
D: upon conditional receipt - CORRECT ANSWERS-B: the first page of the
contract
The policy has all of the following rights EXCEPT:
A: Right to solely renew a guaranteed renewable policy.
B: Right to terminate a policy
C: Unilateral right to renew an Optionally renewable policy
D: Right to assign a contract - CORRECT ANSWERS-C: Unilateral right to
renew an Optionally renewable policy
The part of a contract that specifies which expenses may or may not be
covered is known as the:
A: Exclusion
B: Eligible Expense provision
C: Insuring Agreement
D: Consideration Clause - CORRECT ANSWERS-B: Eligible Expense provision
All of the following are true regarding Social Security disability EXCEPT:
A: A insured must wait 5 months before collecting benefits
B: To qualify an insured must be unable to do any job in the American
economy
C: To qualify an insured must be disabled for a year or longer or die within a
two year period.
,D: The insured must have a certain amount of Social Security credits based
off age. - CORRECT ANSWERS-C: To qualify an insured must be disabled for a
year or longer or die within a two year period.
A provision in a health policy that stipulates that any medical impairments
that occurred within a specific time before coverage began that will not be
covered under a policy is known as:
A: Exclusion
B: Waiver of Coverage
C: Preexisting Conditions
D: All of the Above - CORRECT ANSWERS-C: Preexisting Conditions
Y has group insurance through his employer. One day, while Y is walking up
the stairs to get to his office, he slips and falls down and suffers a few minor
injuries. After going to the doctor, he submits the claim through his group
insurance. Which of the following is most likely to happen?
A: The insurer will provide full coverage
B: The insurer will provide full coverage less deductible
C: The insurer will provide full coverage less deductible and Coinsurance
payment
D: The insurer will deny the claim - CORRECT ANSWERS-D: The insurer will
deny the claim
Workers' Compensation is regulated by:
A: State Government
B: The Employer
C: Federal Government
D: The Insurer - CORRECT ANSWERS-A: State Government
H has suffered a covered disability away from her job and will shortly begin
collecting benefits. The insurer sends a letter to H stating that she will not
receive any benefit amounts greater than her income. This clause is known
as:
A: Over-insurance clause
B: free look
C: relation of earning to insurance
D: relation of economic value - CORRECT ANSWERS-C: relation of earning to
insurance
Which of the following is considered to be a mandatory provision in a health
policy?
A: Time Limit on Certain Defenses
B: Change of Occupation
C: Illegal Occupation
,D: Intoxicant/Narcotic Usage - CORRECT ANSWERS-A: Time Limit on Certain
Defenses
Which of the following may be considered an eligible expense found in a
health policy?
A: Cosmetic Surgery
B: Premium payment
C: cold cream
D: Bus fare to receive treatment for a covered loss - CORRECT ANSWERS-D:
Bus fare to receive treatment for a covered loss
K has a policy that covers doctors visits but limits the number of visits per
calendar year and pays a limited indemnification limit per visit. K has:
A: Basic Medical Expense
B: Physician Nonsurgical Coverage
C: Basic Surgical Policy
D: Basic Hospital Coverage - CORRECT ANSWERS-B: Physician Nonsurgical
Coverage
All of the following are CORRECT about Medicare EXCEPT:
A: An insured who is age 30 but collecting Social Security disability for the
last two years is eligible for Medicare.
B: An insured who is age 60 and is at the end stage of renal failure is eligible
for Medicare.
C: An insured who turns age 65 and is still employed is eligible for Medicare.
D: An insured who has Medicare Part A is eligible to enroll for Medigap
policies within six months of enrolling in Part A. - CORRECT ANSWERS-D: An
insured who has Medicare Part A is eligible to enroll for Medigap policies
within six months of enrolling in Part A.
Under the Claim Forms provision in an Accident and Health policy, an
insurance company must supply an insured with claim forms within a
MAXIMUM of how many days after receiving notice of the loss?
A: 10
B: 15
C: 20
D: 30 - CORRECT ANSWERS-B: 15
The purpose of the Fair Credit Reporting Act is to:
A: protect the consumer from having an adverse action against them based
of obsolete credit information
B: to ensure that credit information used in underwriting is accurate and
updated
C: make sure that any financial institution handles an individual's credit in a
correct, proper manner
D: All of the Above - CORRECT ANSWERS-D: All of the Above
, Most Accident and Health policies require that claims must be paid _________
upon written proof of loss.
A: 30 days
B: Immediately
C: 60 days
D: 90 days - CORRECT ANSWERS-B: Immediately
A LTC policy that will only pay for ADL given occasionally by a licensed
professional is:
A: Skilled Care
B: Intermediate Care
C: Custodial Care
D: None of the Above - CORRECT ANSWERS-C: Custodial Care
Which of the following policy provisions are optional in a individual health
policy?
A: Entire Contract
B: Change of Occupation
C: Entire Contract
D: Reinstatement - CORRECT ANSWERS-B: Change of Occupation
Which of the following elements is part of the entire contract clause?
A: The exchange of value between the parties
B: The agreement between the policyholder and insurer
C: The amount of time the insured has to send a policy back for a full refund
D: None of the Above - CORRECT ANSWERS-D: None of the Above
All of the following are true regarding Social Security disability EXCEPT:
A: A insured must wait 5 months before collecting benefits
B: To qualify an insured must be unable to do any job in the American
economy
C: To qualify an insured must be disabled for a year or longer or die within a
two year period.
D: The insured must have a certain amount of Social Security credits based
off age. - CORRECT ANSWERS-C: To qualify an insured must be disabled for a
year or longer or die within a two year period.
Health Care FSA contributions are limited to _______ per year.
A: $5,000
B: $3,000
C: $2,700
D: $3,250 - CORRECT ANSWERS-C: $2,700
A noncancelable policy means the company
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