Life and Health Insurance Final Exam Flashcards
An insurer is NOT required to provide information on fraudulent claims if requested by
An insured
L, aged 50, and L’s spouse, 48 have one natural child and one adopted child. They purchase a Family Policy that covers L’s spouse to age 65. A death benefit will NOT be paid in which of the following circumstances.
L’s spouse dies at age 66
An insurance applicant MUST be informed of an investigation regarding his/her reputation and character according to the
Fair Credit Reporting Act
Which statement regarding the Change of Beneficiary provision is True
The policyowner can change the beneficiary
Which of the following BEST describes a short-term medical expense policy?
Nonrenewable
F needs life insurance that provides coverage for only a limited amount of time with a death benefit that changes regularly according to a schedule. What kind of policy is needed?
Decreasing Term Policy
All of the following statements about Major Medical benefits are true, EXCEPT
Benefits have no maximum limit
An insurance company receives E’s application for an individual health policy. E did not complete all of the medical history questions because she could not remember the exact dates. E signed the policy and submitted it to the insurance company anyway. A few weeks later, E suffers a heart attack and is hospitalized without completing the medical history questions and paying the initial premium. E is not insured, Which of the following clauses details the conditions that E did not meet?
Consideration Clause
Life insurance coverage will frequently contain an Accelerated Benefits rider attached to the policy. What would be considered a “qualifying event” under these riders?
A Medical condition resulting in a significantly-shortened lifespan
Which of the following requires insurers to disclose when an applicant’s consumer or credit history is being investigated.
1970 - Fair Credit Reporting Act
The reason for backdating a policy is
To obtain a premium rate based on an earlier age
Under the Patient Protection and Affordable Care Act (PPACA) consumers have access to health coverage that is
Guaranteed available and renewable
An example of unfair discrimination would be
Offering different terms of coverage for different policyowners having the same risk classification
A hearing must be held before a producer’s license can be suspended or revoked. Prior to the hearing, the Insurance Commissioner is required to
Give written notice to the producer
T files a claim on his Accident and Health policy after being treated for an illness. The insurance company believes that T misrepresented his actual health on the initial insurance application and is, therefore, disputing the claim’s validity. The provision that limits the time period during which that company may dispute a claims validity is called
Time Limit on Certain Defenses
An example of rebating would be
Offering a client something of value not stated in the contract in exchange for their business
An example of an Unfair Claims Settlement Practice is
Turning down a claim without providing the basis of denial
J is a subscriber to a plan which contracts with doctors and hospitals to provide medical benefits at a predetermined price. What type of plan does J belong to?
Health Maintenance Organization (HMO)
N is covered by a Term Life policy and does not make the required premium payment which was due August 1. N dies September 15. What action will the insurer take?
Claim will be denied
An incomplete life insurance application submitted to an insurer will result in which of these actions?
Application will be returned to the writing agent
Which of these statements in INCORRECT regarding the federal income tax treatment of life insurance?
Entire cash surrender value is taxable.
Which type of life policy contains a monthly mortality charge as well as self-directed investment choices?
Variable Universal Life
D is the policyowner and insured for a $50,000 life insurance policy. The beneficiary is D’s wife. D and his wife divorce and D remarries, transferring ownership of his policy to his new wife. If D dies without making any further changes, to whom will the policy proceeds be paid to?
Ex-Wife
A policy owner is allowed to pay premiums more than once a year under which provision?
Mode of Premium
