Chapter 6 Pt3

Question 1

Injured while robbing convenience store. Payment of claim?

Claim paid in full
Claim denied if policy contains illegal occupation provision
If not convicted claim will be paid

Answer 1

Claim denied if policy contains illegal occupation provision

Question 2

Excludes coverage for injuries incurred while performing an illegal act

Aleatory
Adhesion
Consideration
Illegal occupation provision

Answer 2

Illegal occupation provision

Question 3

Purchased policy as window washer; changed to managing library. If insurer is notified insurer should

Adjust benefit with decreased risk
Increase premium
Replace policy with new one

Answer 3

Adjust benefit with decreased risk

Question 4

Time limit of certain defenses provision prohibits insurers from denying claim due to misrepresentation as long as policy in force for

Six years
Six months
One year
Two years

Answer 4

Two years

Question 5

Allows ins co to limit insured’s benefits to insured’s average income over the last 24 months if necessary benefits are reduced on a pro rata basis

Insuring clause
Aleatory
Adhesion
Relation of earnings to ins

Answer 5

Relation of earnings to ins

Question 6

Total amount for single loss under all policies exceeds monthly earnings of insured or his avg monthly earnings for immedate prior two years, insurer will only be liable for

100 dollars
200 dollars
Proportionate amount of benefit
Disproportionate amount of benefit

Answer 6

Proportionate amount of benefit

Question 7

In no event may benefit be reduced to less than

5 dollars
200 dollars
No minimum
Discretion of emp

Answer 7

200 dollars

Question 8

Relation of earnings to ins provision allows ins co to limit benefits to his/her average income over last

24 months
36 months

Answer 8

24

Question 9

Which does insuring clause not specify

Covered perils
Ins com
Name of ins
List of available doctors

Answer 9

List of available doctors

Question 10

Lists the insured, ins co, what kind of losses and how much losses would be compensated

Covered perils
Ins company
Insuring clause
Consideration clause

Answer 10

Insuring clause

Question 11

Right to examine provision allows insured a period of several days to look over policy. Commonly

1 day
2 days
10 days

Answer 11

10 days

Question 12

They may return policy for full return based on

Consideration clause
Free look/right to examine provision
Aleatory contract

Answer 12

Free look/right to examine

Question 13

Applicant failed to complete application properly. Before being able to complete application and pay initial premium, confined to hospital. This will not be covered by ins bc she has not met conditions specified in the

Eligibility clause
Insuring clause
Consideration clause

Answer 13

Consideration clause

Question 14

Specifies that both parties to contract must give some valuable consideration

Answer 14

Consideration clause

Question 15

Insuring clause of disability policy usually states all of following except

Identities of ins co and insured
Ins against loss is provided
Types of losses covered
Method of premium payment

Answer 15

Method of payment

Question 16

General statement that defines ins agreement and identifies insured and ins co and states what kind of loss is covered

Type of losses covered
Executive contract
Buy loss contract
Insuring clause on first page of contract

Answer 16

Insuring clause on first page

Question 17

States that period of time must lapse before coverage for specified conditions goes into effect

Elimination period
Waiver of premium
Probationary period

Answer 17

Probationary period

Question 18

Type of deductible that is commonly found in disability income policies; period of days which must expire after the onset of illness or occurrence of accident before benefits will be payable

Waiver of premium
Probationary period
Elimination period

Answer 18

Elimination period

Question 19

Provision most commonly found in disability income policies; applies to new employees who must wait certain period of time before they can enroll in group playin to avoid unecessary administrative expenses in employee turnover

Elimination period
Probationary period
Consideration period
Executive consideration period

Answer 19

Probationary period

Question 20

Provision or rider is included with guaranteed renewable and noncancellable disability income policies; provides that in event of permanent and total disability premiums will be waived for duration of disability

Pre existing conditions clause
Waiver of premium
Probationary period
Elimination period

Answer 20

Waiver of premium

Question 21

To qualify for this insured must be totally disabled for specified period of time usually three to six months

Waiver of premium
Pre existing clause
Coinsurance clause
Deductible clause

Answer 21

Waiver of premium

Question 22

During this waiting period insured must continue to pay the policy premium but usually waiver is retroactive to date disability began and premiums paid during this waiting period will be refunded

Waiver of premium
Preexisting clause
Probationary period
Elimination period

Answer 22

Waiver of premium

Question 23

Rider generally expires when insured attains age 65; however as long as insured becomes disabled prior to 65 premiums will continue to be waived for duration of disability

Probationary period
Deductible period
Waiver of premium

Answer 23

Waiver of premium

Question 24

Hospitalized with back injury. Upon checking disability income policy learns he will not be eligible for benefits for at least thirty days. Indicates

Waiver of benefits period
Elimination period
Blackout period
Probationary period

Answer 24

Elimination period

Immediately following start of disability benefits are not payable; reduces cost of providing coverage and eliminates filing of many claims

Question 25

Which of following would be considered consideration on part of applicant for ins

Payment of premium
Promise to renew the policy at the end of policy period
Providing warranties on application

Answer 25

Payment of premium

Question 26

Two types of considerationon part of ins applicant are

Payment of premiums and representations on application
Payment of debts and policy cancellation
Providing warranties and promise to review

Answer 26

Payment of premiums and presentations on application

Question 27

Purpose of coinsurance provisions

To have insured pay premiums to more than one company
To guarantee payment to doctors and hospitals
To share liability among different ins companies
To help ins company to prevent over utilization of policy

Answer 27

To help ins company to prevent over utilization of the policy

Question 28

Waiver of premium provision may be included with which kind of health ins policy

Hospital indemnity
Dread disease
Disability income
Basic medical

Answer 28

Disability income

Question 29

Endured multiple surgeries and hospitalizations for illness during last few months. Insurer no longer bills her for medical expenses. Which of the following allows for that

Waiver of premium
Grace period
Stop loss limit
Maximum loss

Answer 29

Stop loss limit

Question 30

Specified dollar amount in which insured no longer shares expenses

Stop go limit
Stop help limit
Stop loss limit

Answer 30

Stop loss limit

Question 31

Provides for sharing of expenses between insured and ins company

Coinsurance
Stop loss
Deductible
Divided cost

Answer 31

Coinsurance

Question 32

With coinsurance the Larger percentage is paid by insured

Lower required premium will be

Higher required premium will be

Answer 32

Lower required premium will be