Which document is sent by private insurance carriers to detail amounts paid or denied on an insurance claim?

a. Coverage outline

b. Remittance advice

c. explanation of benefits

d. summary notice

Answer: c. explanation of benefits

Health Insurance and Claims Submissions

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An insured's building has an actual cash value of $200,000, and he has insured the property for $120,000 with an 80% coinsurance clause. A $40,000 loss occurs. How much will the policy pay?

An insured's building has an actual cash value of $200,000, and he has insured the property for $120,000 with an 80% coinsurance clause. A $40,000 loss occurs. How much will the policy pay? a) $0 b) $30,000 c) $32,000 d) $40,000 Answer: B

Jim has been arrested for drunk driving. In order to be allowed out of jail before his court date, Jim will most likely need:

Jim has been arrested for drunk driving. In order to be allowed out of jail before his court date, Jim will most likely need: Answer: A bail bond Jim will most likely need to post bail to be allowed out of jail before his court date. Bail is a set amount of money an arrested individual must pay the court to guarantee they will appear for their scheduled hearings and trial dates. By posting bail, Jim can secure his release from jail pending his court appearances. There are several options for posting bail: Cash Bail : Jim or someone on his behalf can pay the total bail amount in cash directly to the court. Once the case is resolved, the bail money is returned minus any fees or fines imposed by the court. Bail Bond : If Jim or his family cannot afford to pay the full bail amount, they may use a bail bond service. A bail bondsman typically charges a non-refundable fee, usually a percentage of the total bail amount, in exchange for posting the full bail amount on Jim's behalf. Th...

James is the insured on a life insurance policy where his age was misstated on the application. Which of the following is CORRECT regarding the death benefit amount?

James is the insured on a life insurance policy where his age was misstated on the application. Which of the following is CORRECT regarding the death benefit amount? a) The original face amount will be paid to the beneficiary b) The policy will be voided with no death benefits paid c) The death benefit paid will be what the premium would have purchased at the correct age d) The amount of premiums paid will be returned with interest Answer: c) The death benefit paid will be what the premium would have purchased at the correct age

All of the following are general requirements of a qualified plan EXCEPT
Which of the following terms best describe the coverage provided by term policies, as compared to any other form of protection?
All of the following are considered limited lines of authority EXCEPT
What is the other term for the cash payment settlement option?
The pro rata liability clause is designed to protect the principle of
What does the Group Life underwriting risk selection process help protect insurance companies from?
All of the following are factors that an underwriter could use to select and classify risk EXCEPT
All of these statements concerning whole life insurance are false EXCEPT
All of the following statements concerning the use of life insurance as an Executive Bonus are correct EXCEPT
All of the following could own group life insurance EXCEPT
Fixed annuities provide each of the following EXCEPT
What is the purpose of establishing the target premium for a universal life policy?
A domestic insurer issuing variable contracts must establish one or more
All of the following statements concerning the use of life insurance as an Executive Bonus are correct EXCEPT
All of these statements about the Waiver of Premium provision are correct EXCEPT
Which of the following best defines target premium in a universal life policy?
What does the word "level" in Level Term describe?
A beneficiary change can occur
No existing agent's license will be revoked until
Which of the following statements about aleatory contracts is NOT true?
A type of group that has a constitution and bylaws and has been organized for purposes other than obtaining insurance is called a(n)
The minimum interest rate on an equity indexed annuity is often based on
Under an extended term nonforfeiture option, the policy cash value is converted to
Which type of life insurance policy generates immediate cash value?
What rule is used to determine the importance of a representation?
Which of the following is NOT the purpose of HIPAA?
The pro rata liability clause is designed to protect the principle of
The two major actions required for a policyholder to comply with the Reinstatement Clause are
Life insurance policies will normally pay for losses arising from
Which of the following statements regarding the taxation of Modified Endowment Contracts is FALSE
Ambiguities in an insurance policy are always resolved in favor of the
In an insurance contract, the applicant's "consideration" is the
Agents may be found guilty of defamation if they make a false statement that is intended to?
How many pair of glasses in a 12-month period will a vision expense insurance plan cover?
The voluntary relinquishment of a legal right is called
What documentation grants express authority to an agent?
An error was made on Mary's life insurance application. Which of the following areas are errors commonly made on applications for which the incontestable clause does NOT apply?
All of the following statements are true regarding installments for a fixed amount EXCEPT
Fraternal Benefit Society has each of the following characteristics EXCEPT
Which contract element is insurable interest a component of?
Which nonforfeiture option provides coverage for the longest period of time?
Agents who persuade insureds to cancel a policy in favor of another one when it might not be in the insured's best interest are guilty of:
A securities license is required for a life insurance producer to sell
Which of the following statements about accumulated interest earned on dividends from an insurance policy is TRUE?
All of the following statements are correct regarding Credit Life Insurace EXCEPT:
All of the following are true regarding a decreasing term policy EXCEPT
Purchasing a life insurance policy in order to avoid the forced sale of assets upon death is called
Health insurance will typically cover which of the following perils?
Simon has purchased a fixed immediate annuity. His payment amount will be dependent upon principal, interest, and the contract's
Insurable interest does NOT occur in which of the following relationships?
Which of these is a method of determining the level of funds required for ongoing support in the event of the breadwinner's death?
The authority granted to a licensed producer is provided via the
All of the following are examples of a Business Continuation Plan EXCEPT
Which of these would be the best example of a limited pay life insurance policy?
All of the following entities regulate variable life policies EXCEPT
The pro rata liability clause is designed to protect the principle of
When the principal gives the agent authority in writing, it's referred to as
What is the benefit of choosing extended term as a nonforfeiture option?
All of the following are TRUE regarding the convertibility option under a term life insurance policy EXCEPT
All of the following statements concerning dividends are true EXCEPT:
All of the following are true regarding rebates EXCEPT
Which of the following is NOT a characteristic of an insurable risk?
All of the following are elements of an insurance policy EXCEPT
What would be an expense factor in an insurance program?
All of the following are true of key person insurance EXCEPT
Which of the following statements concerning a Simplified Employee Pension plan (SEP) is INCORRECT?
All of the following statements are true regarding tax-qualified annuities EXCEPT
Which of the following is true regarding a market value adjusted annuity?
Which of the following statements is NOT true regarding a personal umbrella liability policy?
Items stipulated in the contract that the insurer will not provide coverage for are found in the
All of the following would be different between qualified and nonqualified retirement plans EXCEPT
The paid-up addition option uses the dividend
A Universal Life insurance policy has two types of interest rates that are called
Which of the following statements about group life is correct?
The paid-up addition option uses the dividend
Another name for a substandard risk classification is
Circulating deceptive sales material to the public is what type of Unfair Trade Practice?
A tornado that destroys property would be an example of which of the following?
The requirement that agents not commingle insurance monies with their own funds is known as
Who is responsible for assembling the policy forms for insureds?
Life income joint and survivor settlement option guarantees
What is the other term for the cash payment settlement option?
Which of the following is NOT true regarding the accumulation period of an annuity?
Which of the following is NOT true regarding a Certificate of Authority?
Which of the following is NOT an example of utilization review?
The requirement that agents not commingle insurance monies with their own funds is known as
An individual purchased a $100,000 Joint Life policy on himself and wife. Eight years later, he died in an automobile accident. How much will his wife receive from the policy?
What is the purpose of establishing the target premium for a universal life policy?
What is the other term for the cash payment settlement option?
Circulating deceptive sales material to the public is what type of Unfair Trade Practice?
Insurance represents the process of risk
All of these are valid options for an Adjustable Life Policy EXCEPT
What is the purpose of establishing the target premium for a universal life policy?
Which of the following is NOT true regarding the accumulation period of an annuity?
Group health plans may deny participation based upon the
In insurance, an offer is usually made when
Which of the following is true regarding a market value adjusted annuity?
What is the other term for the cash payment settlement option?
What documentation grants express authority to an agent?

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