HS 311 Sample Exam 1 Flashcards
A loss exposure is defined as
(A) a loss that might occur
(B) an undesirable end result of a risk
(C) the largest possible loss
(D) the probability of a loss
(A) a loss that might occur
Which of the following statements concerning the beneficiary provisions in a life insurance policy is correct?
(A) Only one person may be named as a primary beneficiary, but several may be named as contingent beneficiaries.
(B) The primary beneficiary’s share of policy proceeds is generally reduced if the contingent beneficiary outlives the insured.
(C) The estate of the insured is commonly named as beneficiary to avoid transfer taxes.
(D) The contingent beneficiary will receive policy proceeds only if the primary beneficiary predeceases the insured.
The answer is (D). (A) is incorrect because one or more people or entities may be named as either primary or contingent beneficiaries. (B) is incorrect because the contingent beneficiary receives nothing and all proceeds go the primary beneficiary when the insured dies, unless the primary beneficiary predeceases the insured or loses entitlement to the benefits for some other reason. (C) is incorrect because transfer taxes may be incurred when the estate is the beneficiary.
Which of the following types of insurance is often sold by mortgage lenders to provide the funds necessary to pay off a 10-year mortgage loan if the insured dies?
(A) decreasing term
(B) increasing term
(C) modified whole life
(D) 10-year renewable term
The answer is (A). (B) is incorrect because the amount of insurance under an increasing term policy increases while the amount needed to pay off the mortgage decreases. (C) is incorrect because the amount of insurance under a modified whole life policy remains constant while the amount needed to pay off the mortgage decreases. (D) is incorrect because the amount of insurance under a 10-year renewable term policy remains constant for 10 years while the amount needed to pay off the mortgage decreases.
Which of the following is most likely to be a condition that will result in the payment of unemployment compensation benefits?
(A) unemployment because of a labor dispute
(B) unemployment as a result of voluntarily leaving a job without good cause
(C) unemployment resulting from discharge that was prompted by misconduct
(D) unemployment that results from adverse economic conditions
The answer is (D). (A), (B), and (C) are incorrect because common reasons for disqualification under unemployment compensation programs include involvement in a labor dispute, voluntarily leaving a job without good cause, and discharge for misconduct
Which of the following statements concerning inpatient hospital care under Part A of Medicare is correct?
(A) There is a $200 annual deductible.
(B) Benefits are paid in full after the 60th day of hospitalization.
(C) There is a lifetime limit on the number of days of treatment in psychiatric hospitals.
(D) There is coverage for up to 210 days of care in each benefit period.
The answer is (C). (A) is incorrect because hospital benefits are not subject to an annual deductible. However, there is a benefit period deductible, and it is much higher than $200. (B) is incorrect because benefits are paid in full for only the first 60 days in each benefit period, subject to the initial deductible. (D) is incorrect because Part A pays for hospital services in full for up to 60 days in each benefit period after the deductible has been met. It provides benefits for an additional 30 days subject to a daily patient copayment. There is also a lifetime reserve of 60 additional days, but once these days are used, they are not available for future benefit periods.
Insurance policies that give the policyowner the right to renew coverage but do not guarantee future rates are referred to as (A) cancelable (B) guaranteed renewable (C) non-cancelable (D) optionally renewable
The answer is (B). (A) is incorrect because the insurer has the right to cancel a cancelable policy during the period for which premiums have been paid. (C) is incorrect because future rates are guaranteed in a noncancelable policy. (D) is incorrect because the insurer has a right to refuse to renew an optionally renewable policy.
Which of the following statements concerning ethical decision-making is correct?
(A) Ethics and compliance are synonymous.
(B) Compliance is concerned with how we should behave.
(C) Ethics is concerned with how we should behave.
(D) All of the above
The answer is (C). (A) is incorrect because ethics and compliance are not synonymous. Compliance deals with follow rules and regulations. Ethics involves following a moral code. (B) is incorrect because compliance does not deal with how we should act, it only deals with following rules. (D) is incorrect, by definition.
The workers’ compensation benefits provided by a Workers Compensation and Employers Liability insurance policy are
(A) specified by state law
(B) scheduled in the policy
(C) determined by the courts
(D) subject to a dollar limit specified in the policy
The answer is (A). (B) and (C) are incorrect because benefits are specified by state workers’ compensation law. (D) is incorrect because the policy’s dollar limits apply only to employers liability coverage.
The standard amount of insurance for loss of use (Coverage D) under an unendorsed HO-3 policy is what percentage of the amount of insurance for the dwelling (Coverage A)? (A) 10 percent (B) 20 percent (C) 30 percent (D) 50 percent
The answer is (C). The standard limit for Coverage D is 30 percent of the Coverage A limit. Prior to 2000, the limit was 20 percent. The limit for Coverage B (other structures) is 10 percent of the Coverage A limit, while the limit for Coverage C (personal property) is 50 percent of the Coverage A limit.
Ken has a personal auto policy (PAP) with coverage limits of $500,000 for liability (Part A), $15,000 for medical payments (Part B), $50,000 for uninsured motorists (Part C), and no underinsured motorists endorsement. If Ken receives $100,000 in bodily injuries as a result of an auto accident with another driver who has only the minimum state requirement of $35,000 of liability coverage, how would the two policies cover Ken’s injuries if the other driver was at fault?
(A) Ken’s PAP would cover the entire $100,000 under Part A because the other driver’s coverage is inadequate to compensate Ken for his injuries.
(B) The other driver’s policy would pay its limit of $35,000 while Ken’s PAP would pay $15,000 under Part B and $50,000 under Part C.
(C) The other driver’s policy would pay its limit of $35,000 while Ken’s PAP would pay $50,000 under Part C with the remaining $15,000 not covered by either policy.
D) The other driver’s policy would pay its limit of $35,000 while Ken’s PAP would pay $15,000 under Part B with the remaining $50,000 not covered by either policy.
The answer is (D). Ken would collect $35,000 from the other party’s liability insurer. His own policy would also pay the full $15,000 medical payment limit. There is no coverage for the remaining $50,000 because Ken does not have coverage for underinsured motorists.
King purchased an insurance policy that will pay $200 for each day he is hospitalized, regardless of the amount billed by the hospital. This insurance policy is considered which of the following?
(A) a bilateral contract
(B) a contract of indemnity
(C) a valued contract
(D) an impersonal contract
The answer is (C). (A) is incorrect because insurance is a unilateral contract. (B) is incorrect because payments under a contract of indemnity reflect the amount of the loss. (D) is incorrect because insurance is a personal contract.
William is covered under his employer's major medical expense plan. The plan has a calendar-year deductible of $1,000, a 75 percent coinsurance provision that applies to the next $8,000 of covered expenses, and full coverage for any remaining covered expenses. If William incurs covered medical expenses of $15,000 during the year, how much will be paid by his employer's plan? (A) $10,500 (B) $12,000 (C) $13,000 (D) $14,000
The answer is (B). His employer’s plan will pay $12,000. If William incurs $15,000 of covered medical expenses, he must pay $1,000 out-of-pocket to meet the deductible. Of the remaining $14,000 of expenses, $8,000 of it is subject to the 75 percent coinsurance provision. This means that William must pay another $2,000 (.25 × $8,000 = $2,000) out-of-pocket for a total amount of $3,000 ($1,000 deductible + $2,000 coinsurance = $3,000). Subtracting $3,000 from $15,000 leaves $12,000 for the medical expense plan to cover.
Which of the following statements describes factors that should be considered in the argument whether it is better to buy term life insurance or to buy permanent insurance and invest the premium difference?
(A) The cash value of a life insurance policy can readily be liquidated.
(B) People are less likely to pay a life insurance premium than they are to make a voluntary investment.
(C) The life insurance industry has a questionable solvency record.
(D) Increases in life insurance cash values are subject to federal income taxes as they accrue.
The answer is (A). (B) is incorrect because people are more likely to pay a life insurance premium than they are to make a voluntary investment. (C) is incorrect because the life insurance industry has a solvency record unmatched by any other type of business organization. (D) is incorrect because increases in cash values are not subject to federal income taxes as they accrue, in contrast to the earnings in a separate investment program, which are often taxed as ordinary income.
Susan has a personal auto policy (PAP) with a liability limit of $500,000. She also has a personal umbrella policy with a limit of $1 million and a self-insured retention(SIR) of $1,000. How much will each policy pay if an injured person obtains a judgment of $800,000 against Susan as a result of an auto accident?
(A) The PAP will pay nothing, and the umbrella policy will pay $799,000.
(B) The PAP will pay nothing, and the umbrella policy will pay $800,000.
(C) The PAP will pay $500,000, and the umbrella policy will pay $299,000.
(D) The PAP will pay $500,000, and the umbrella policy will pay $300,000.
The answer is (D). (A) and (B) are incorrect because the umbrella policy pays only after the limits of the PAP are exhausted because the PAP is primary. (C) is incorrect because the self-insured retention (SIR) does not come into play when there is an underlying policy paying for part of the loss.
Insurance Services Office (ISO) is which of the following?
(A) an advisory organization that develops standard policies for homeowners insurance and other lines
(B) a credit bureau that maintains and disseminates credit information on applicants for property and liability insurance
(C) a private organization that gathers and maintains medical information disclosed by applicants for life insurance
(D) a voluntary association serving state insurance commissioners
The answer is (A). (B) is incorrect because ISO is not a credit bureau. (C) is incorrect because it describes MIB, Inc. (D) is incorrect because it describes the NAIC.
Jane, a restaurant critic on the staff of Local Newspaper, got a bad case of food poisoning while eating a tropical fruit salad at the Hungry Tiger restaurant she was reviewing. Because she was injured during the course of her employment, the insurance company providing Local Newspaper’s workers’ compensation insurance paid Jane’s hospital expenses. That insurance company then sued Hungry Tiger, thereby exercising its legal rights of recovery under which of the following legal bases?
(A) doctrine of indemnity
(B) doctrine of subrogation
(C) law of the jungle
(D) principle of adhesion
The answer is (B). (A) is incorrect because the doctrine, or principle, of indemnity refers to compensation that makes people whole following a loss.(C) is incorrect because the law of the jungle refers to unrestrained and ruthless competition. (D) is incorrect because the principle of adhesion deals with ambiguity in a contract.
Sam and Janet Evening wish to purchase an annuity that provides an income as long as at least one of them is alive. They have no children and no interest in passing their assets to heirs. Which of the following annuities is best suited for their purposes? (A) cash refund annuity (B) installment refund annuity (C) joint-and-last survivor annuity (D) joint-life annuity
The answer is (C). (A) is incorrect because providing a lump-sum cash refund to heirs is inconsistent with their goals. (B) is incorrect because providing an installment refund to heirs is inconsistent with their goals. (D) is incorrect because joint-life annuity payments would cease when either Sam or Janet dies, rather than providing an income as long as at least one of them is alive.
The extension-of-benefits provision under a group medical expense policy applies to which of the following persons when coverage terminates?
(A) anyone who is aged 21 or under
(B) anyone who is totally disabled as a result of an illness or injury that occurred while the person was covered under the contract
(C) the employee and any dependents if the employee is eligible for unemployment insurance or public assistance
(D) any employee who has at least 10 years of service
The answer is (B). (A), (C), and (D) are incorrect because the extension-of-benefits provision applies only to a covered employee or dependent who is totally disabled at the time of termination.
As of this year, Brad, aged 35, has 36 credits of covered employment under the Social Security program. These credits were all earned in the last 40 calendar quarters. What is Brad’s insured status under the program?
(A) He is currently, fully, and disability insured.
(B) He is disability insured, but neither fully nor currently insured.
(C) He is currently and fully insured, but not disability insured.
(D) He is currently insured, but neither fully nor disability insured
The answer is (A). Brad meets the criteria for being currently, fully, and disability insured.
A person who has a minimum of six credits is fully insured if he/she has at least as many credits as there are years elapsing after 1950 (or after the year in which he/she reaches age 21).
Which of the following statements concerning business uses of disability income insurance is correct?
(A) Benefits from key employee disability policies are designed to provide additional disability income to valuable employees.
(B) When the policy is used to fund a buy-sell agreement, the definition of disability in the policy should be the same as the definition used in the buy-sell agreement.
(C) Business overhead policies tend to have benefit durations of between 5 and 10 years.
(D) When the policy is used to fund formal salary continuation plans, the business must be both the owner and beneficiary of the policy.
The answer is (B). (A) is incorrect because key employee disability policies are designed to benefit the business that has lost the services of a key employee. (C) is incorrect because business overhead policies tend to be limited to benefit durations of 1 or 2 years. (D) is incorrect because either the business or the employee may be the beneficiary under a formal salary continuation plan.
Which of the following statements is correct if the life income settlement option in a cash value life insurance policy is exercised?
(A) The policy will provide an income to beneficiaries for as long as the insured lives.
(B) The policy’s death benefit will be increased.
(C) The policy’s death proceeds will be used to purchase a single-premium annuity for the beneficiary.
(D) The policy’s periodic premium will be increased.
The answer is (C). (A) is incorrect because settlement options are exercised when the insured dies. (B) is incorrect because the settlement option is a way of distributing the benefit, not of modifying its value. (D) is incorrect because settlement options are exercised after the insured dies, at which time no more premiums are payable.
Which of the following statements concerning the federal income tax treatment of insured group medical expense plans is correct?
(A) All employee contributions under a contributory plan are tax deductible to the employee as a medical expense.
(B) Benefits are taxable to an employee to the extent that the employer paid the cost of coverage.
(C) Contributions by the employer for an employee’s coverage create an income tax liability for the employee.
(D) Contributions by the employer for an employee’s coverage are generally tax deductible to the employer.
The answer is (D). (A) is incorrect because employee contributions are tax deductible only for employees who itemize deductions and then only to the extent that expenses exceed 7.5 percent of the employee’s adjusted gross income. (B) is incorrect because medical expense benefits are not taxable income to the employee unless they exceed any medical expenses incurred. (C) is incorrect because employer contributions do not create any tax liability for an employee.
Which of the following is the standard inflation provision in most long-term care insurance policies?
(A) a 3 percent simple annual benefit increase option
(B) a 5 percent compound annual benefit increase option
(C) a pay-as-you-go option without evidence of insurability
(D) an automatic annual increase option based on the consumer price index
The answer is (B). (A), (C), and (D) are incorrect because these inflation provisions are much less common.
Which of the following statements concerning prescription drug plans is correct?
(A) Nonprescription drugs are typically covered as long as they are ordered by a physician on a prescription form.
(B) Benefits are usually provided for the administration of drugs that cannot be self-administered.
(C) Most plans have a copayment for each prescription.
(D) A reimbursement approach is usually used to provide benefits.
The answer is (C). (A) is incorrect because prescription drug plans normally cover only those drugs that are required by either federal or state law to be dispensed by prescription. One frequent exception, however, is injectable insulin. (B) is incorrect because no coverage is provided for the charges to administer drugs. (D) is incorrect because a service approach is usually used to provide benefits. Prescriptions are filled upon receipt of a prescription, proper identification, and any required copayment.
Ohm Insurance Company, incorporated in Springfield, Illinois, was formed in 1952 by a group of investors who own shares in the company. Ohm is currently licensed to sell life insurance in the states of Illinois, Pennsylvania, and Maryland. When Ohm is doing business in Pennsylvania, which of the following would be a correct classification of Ohm? (A) alien insurer (B) foreign insurer (C) extraterritorial insurance company (D) non-admitted insurance company
The answer is (B). (A) is incorrect because an alien insurer is based in another country. (C) is incorrect because extraterritorial refers to out-of-state coverage, not an out-of-state insurer. (D) is incorrect because Ohm is licensed in Pennsylvania.
Which of the following statements concerning the elimination period in a long-term care insurance policy is correct?
(A) Most comprehensive policies have separate elimination periods for facility care and home health care.
(B) A tax-qualified policy must have an elimination period of at least 90 days.
(C) The effect of the elimination period is to reduce a policy’s maximum benefit period.
(D) The applicant typically selects the length of the elimination period from three to five available options.
The answer is (D). (A) is incorrect because most comprehensive long-term care insurance policies have a single elimination period that can be met with a combination of days from when an insured is in a long-term care facility or receiving home health care services. (B) is incorrect because a tax-qualified policy can have an elimination period of any length of time, assuming it is acceptable under state law. The only 90-day requirement is that the insured be certified as being unable to perform the required number of ADLs for at least 90 days. (C) is incorrect because the elimination period only postpones the date until benefits start. Once they start, the maximum benefit period applies.
Daisy does not own a car but occasionally borrows one from friends. The friends have little money, and if they have insurance at all, it is only for minimum limits. Daisy, on the other hand, is well-to-do. To protect herself against a liability claim while she is driving a friend’s car, Daisy can purchase a personal auto policy (PAP)with a(n)
(A) auto loan/lease coverage endorsement
(B) coverage for damage to your auto (maximum limit of liability) endorsement
(C) miscellaneous type vehicle endorsement
(D) named non-owner coverage endorsement
The answer is (D). (A) is incorrect because the auto loan/lease coverage endorsement would provide “gap” coverage in the event the actual cash value of an auto Daisy owns or leases is less than the amount she owes on the auto. (B) is incorrect because the coverage for damage to your auto (maximum limit of liability) endorsement provides stated amount coverage on an owned auto. (C) is incorrect because the miscellaneous type vehicle endorsement is used to cover motor homes, motorcycles, all-terrain vehicles, dune buggies, and golf carts.
Phantom Insurance Company employs claims representatives based in five Midwestern states but has no claims employees in California, where one of its policyowners is involved in a serious auto accident. Phantom will most likely use which of the following to adjust the claim? (A) independent adjuster (B) insurance agent (C) public adjuster (D) staff adjuster
The answer is (A). (B) is incorrect because insurance agents usually adjust only small, uncomplicated claims. (C) is incorrect because public adjusters represent the public, not insurers. (D) is incorrect because staff adjusters are employees of the insurer, and according to the question, Phantom has no employees in California.
Which of the following definitions of disability used in a group disability income plan is the most restrictive or harshest for the insured employee?
(A) the inability of the employee to perform each and every duty of his or her own occupation
(B) the inability of the employee to engage in any occupation for compensation
(C) the inability of the employee to engage in any occupation for which he or she is qualified by training, education, or experience
(D) the inability of the employee to engage in his or her own occupation for 24 months and any occupation for which he or she is qualified thereafter
The answer is (B). (A) is incorrect because it is the most liberal definition for the employee, since the inability to perform one major duty would constitute disability. (C) is incorrect because it is more liberal for the employee than (B) but not as liberal as (A) because the employee could perform several different occupations based on qualifications even if he or she could not perform one of the major duties of his or her own occupation. (D) is incorrect because it is very liberal for a period of 24 months before becoming less so but still more liberal than (B).
Lynn owns the commercial building that houses her business. The property insurance policy covering the building has an 80 percent coinsurance clause. If the replacement cost of the building is $500,000 and Lynn has it insured for $300,000 on a replacement cost basis, how much would the insurance company pay (ignoring any deductible) if the building were to suffer fire damage with a replacement cost of $100,000? (A) $60,000 (B) $75,000 (C) $80,000 (D) $100,000
The answer is (B).
If the amount of insurance is less than 80 percent of replacement cost, the insurer will pay the portion of the cost to repair or replace the damage that the limit of insurance bears to 80 percent of the replacement cost at the time of loss. This is explained by the following formula:
$500,000 *.8 = $400,000
$300,000 / $400,000 = 0.75
$100,000 * 0.75 = $75,000
A state requires prior approval of proposed rate changes only if they exceed 5 percent of existing rates. No prior approval is needed for proposed rate changes at 5 percent or less. This is an example of (A) a use-and-file law (B) a file-and-use law (C) a flex-rating law (D) open competition
The answer is (C). (A) is incorrect because with a use-and-file law, rates are filed within a specified time after they are first used, and they may be disapproved. (B) is incorrect because a file-and-use law permits immediate use of filed rates without affirmative approval, although the commissioner may disapprove rates within a certain time period. (D) is incorrect because open competition relies on competition, rather than regulation, to set rates.
An insurance company that has not gained approval to place insurance business from a department of insurance in the jurisdiction where it or a producer wants to sell insurance is known as a(n) (A) unlicensed company (B) unregistered party (C) unapproved firm (D) unauthorized entity
The answer is (D). An entity that has not gained approval to place insurance business from a department of insurance in the jurisdiction where it or a producer wants to sell insurance is referred to an unauthorized entity.
Insurance as a technique for treating risks is most suitable when used for risks that involve
A) a low loss frequency and high loss severity
(B) a high loss frequency and low loss severity
(C) both a low loss frequency and low loss severity
(D) both a high loss frequency and high loss severity
The answer is (A). (B) is incorrect because retention is most suitable for risks with high loss frequency and low loss severity. (C) is incorrect because retention is most suitable for risks with low loss frequency and low loss severity. (D) is incorrect because avoidance is most suitable for risks with high loss frequency and high loss severity.
Which of the following homeowners forms is designed for the owners of condominium units?
(A) HO-2
(B) HO-4
(C) HO-6
(D) HO-8
The answer is (C). (A) is incorrect because HO-2 is designed for owner-occupants of dwellings. (B) is incorrect because HO-4 is designed for tenants of residential property. (D) is incorrect because HO-8 is designed for owner-occupants of dwellings.
Which of the following types of life insurance allows the policyowner to increase or decrease premium payments to virtually any amount desired as long as there is sufficient cash value to cover mortality costs and expenses?
(A) current assumption whole life insurance
(B) variable life insurance
(C) universal life insurance
(D) ordinary life insurance
The answer is (C). (A), (B), and (D) are incorrect because current assumption whole life, variable life, and ordinary life have fixed premiums. Truly flexible premiums are a distinctive feature of universal life insurance.
Robert sued Heather for injuries received in an auto accident. Based on the facts presented, the jury determined that Robert was 20 percent at fault and Heather was 80 percent at fault. Under a comparative negligence law, the jury award to Robert would be (A) nothing (B) 20 percent of his actual damages (C) 80 percent of his actual damages (D) 100 percent of his actual damages
The answer is (C). Under a comparative negligence law, Robert would have his judgment reduced by 20 percent, which is the degree of his fault.
Sarah lives with her mother and stepfather. She is an eligible dependent for medical expense coverage under both of their medical expense plans as well as
under the plan of her father. There is no court decree that establishes responsibility for Sarah’s medical expenses. Which of the following statements describes the priority of benefits if all three plans contain the usual coordination-of-benefit (COB) provisions?
(A) The mother’s plan is primary, and neither the father’s plan nor the stepfather’s
plan pays anything.
(B) The mother’s plan is primary, the stepfather’s plan is secondary, and the
father’s plan pays last.
(C) The father’s plan is primary, the mother’s plan is secondary, and the
stepfather’s plan pays last.
(D) The mother’s plan and father’s plan each pay 50 percent of the expenses.
The answer is (B). Under the usual COB provision, the plan of the parent with custody is primary, the plan of the stepparent who is the spouse of the parent with custody is secondary, and the plan of the parent without custody is tertiary.
Which of the following statements defining ethics is (are) correct?
I. Ethics is both a field of study and a skill. II. Ethics is a branch of philosophy that investigates, among other things, how we should behave.
(A) I only
(B) II only
(C) Both I and II
(D) Neither I nor II
The answer is (C). Both I and II are correct.
Which of the following statements concerning state high-risk pools for individual medical expense coverage is (are) correct?
I. As a result of state subsidies, premiums tend to be much lower than in the regular marketplace. II. Benefits for preexisting conditions are often subject to a waiting period.
(A) I only
(B) II only
(C) Both I and II
(D) Neither I nor II
The answer is (B). I is incorrect because ACA will require premiums to be the same based on ratings that do not take health conditions into account.
Which of the following statements concerning stakeholder theory is (are) correct?
I. Stakeholder theory was designed as a theory of management decision-making.
II. Stakeholder theory is a helpful way to consider decision-making for financial services professionals.
(A) I only
(B) II only
(C) Both I and II
(D) Neither I nor II
The answer is (C). Both I and II are correct.