Insurance MCQ

An agent who knowing misrepresents material information for the purpose of inducing an insured to lapse, forfeit, change or surrender a life insurance policy or annuity has committed an illegal practice known as a). Misrepresentation b). Twisting c). Fraud d). Concealment Answer: b). Twisting

All of the following are features of a health insurance plan purchased on the health insurance marketplace EXCEPT a). Coverage for emergency services b). Coverage for pre-existing conditions c). Dollar limits on essential benefits d). Guaranteed renewability Answer: c). Dollar limits on essential benefits

An employee that becomes ineligible for group coverage because of termination of employment or change in status, must exercise extension of benefits under COBRA a). Within 10 days b). Within 60 days c). Within 30 days d). Before termination is complete Answer: b). Within 60 days

Following a covered loss, the Time Payment of Claims Provision requires that an insurance company pay disability income benefits no less frequently than a). Semi-annually b). Annually c). Weekly d). Monthly Answer: d). Monthly

All of the following could qualify as a group for the purpose of purchasing group health insurance EXCEPT a). Single employer with 14 employees b. An association of 35 people c). Labor union d). Multiple employer trust Answer: b. An association of 35 people

HMO's are known as what type of plans? a). Health saving b). Consumer driven c). Reimbursement d). Service Answer: d). Service

The commissioner has refused to issue a candidate's license for failure to fully meet the licensing requirements. If the candidate believes the Commissioner's decision is in error, she make a written demand for a review to determine the reasonableness of the Commissioner's action within how many days of the service of the notification? a). 10 days b). 30 days c). 45 days d). 60 days Answer: b). 30 days

All of the following would be classified as "limited insurance coverage" EXCEPT a). Supplement Social Security coverage b). Travel insurance policy c). Dread disease policy d). Accidental death and dismemberment policy Answer: a). Supplement Social Security coverage

With the respect to the entire contract clause in health policies, who has the authority to make changes to an existing policy? a). Solely the producer b). Solely the policyowner c). Changes cannot be made on the policy d). Only an executive officer of the company Answer: d). Only an executive officer of the company

An insured is anxious to get treatment for a health condition, and is convinced that a specialist is needed to cure the condition. If the insured has a PPO plan, which of the following is true? a). The insured visit a specialist in-network without consulting a primary care physician, but the out-of-pocket cost will be greater without the primary care physician's referral b). The insured will have to pay all costs for the specialist out-of-pocket if a primary care physician referral is not obtained c). The insured can select any specialist, but non-network specialist will have higher out-of-pocket costs d). The insured must visit a primary care physician who will provide a referral to a specialist if the condition require one. Answer: c). The insured can select any specialist, but non-network specialist will have higher out-of-pocket costs

A man is an attorney when he applies for a health policy. He decides to become a professional bungee jumper. He files a claim. What should happen? a). His coverage will be dropped b). The man's workers comp will pay the claim in full c). The insurance company will not pay the claim d). The insurance company will pay the claim according to the benefits available if the correct premium has been paid Answer: d). The insurance company will pay the claim according to the benefits available if the correct premium has been paid

During policy solicitation, an insurer exaggerates the financial condition of one of it's competitors, and makes it sound worse than it is. This is an example of an unfair trade practice of? a). Defamation b). Twisting c). False advertising d). Misrepresentation Answer: a). Defamation

Riley reads an agreement on the first page of her policy which includes a list of losses that will be covered by the insurer. What is the name of this agreement? a). Consideration Clause b). Insuring Clause c). Coverage Provisions d). Statement of Loss Coverage Answer: b). Insuring Clause

Which of the following best describes a presumptive disability? a). One that is severe enough that the insured automatically qualities for full disability benefits b). One that requires the insured to submit to physical exams periodically c). One that a doctor predicts may reoccur in the future d). One that the insured will fully recover from in the future Answer: a). One that is severe enough that the insured automatically qualities for full disability benefits

A dentist is off work for 4 months due to a disability. His dental assistant's salary would be covered by? a). Business Overhead Insurance b). Disability Income c). Key Employee Disability d). Partnership Disability Answer: a). Business Overhead Insurance

Who would be the insured in business disability insurance? a). All employees b). The insurer c). The employer d). Key employees Answer: d). Key employees

Under the mandatory uniform provision "Notice of Claim" written notice of a claim must be submitted to the insurer within what time parameters? a). Within 10 days b). Within 20 days c). Within 30 days d). Within 60 days Answer: b). Within 20 days

Insured have the right to do which of the following if they have not received the proper claim forms within 15 days of their notice to the insurer of a covered loss under a major medical policy? a). Speak with a claims adjuster or another representative from the insurance company b). Submit the description in their own words on a plain sheet of paper. c). Be reimbursed any copayment or deductible on the claim d). Demand full payment immediately for the claim Answer: b). Submit the description in their own words on a plain sheet of paper.

A husband and wife are insured under group health insurance plans at their own places of employment, and as dependents under their spouse's coverage. If one of them incurs hospital expenses, how will those expenses likely be paid? a)Neither plan would pay. b)Each plan will pay in equal shares. c)The insured will have to select a plan from which to collect benefits. d)The benefits will be coordinated. Answer: d)The benefits will be coordinated.

The relation of earnings to insurance provision allows the insurance company to limit the insured's benefits to his/her average income over the last a)6 months. b)12 months. c)18 months. d)24 months. Answer: d)24 months.