Insurance MCQ

The Time Limit on Certain Defenses (Incontestable) period is _____ years under individual health and disability contracts. A. 7 B. 3 C. 5 D. 2 Answer: D.

The Unpaid Premiums Optional Uniform Provision allows an insurer to: A. Cancel the policy during the grace period B. Reduce the amount of a claim payment by the premium due C. Charge the insured a credit charge if premiums are not paid D. Charge interest on past due premiums Answer: B.

Which provision in a health insurance policy allows a claim to be denied due to the insured being intoxicated or under the influence of narcotics? A. Conformity with State Statutes B. Legal Actions C. Illegal Act D. Intoxicant and Narcotics Answer: D.

All of the following are Optional Uniform Provisions, except: A. Legal Actions B. Illegal Occupation C. Change of Occupation D. Misstatement of Age Answer: A.

Anna has a contract that includes the Non-Emergency Hospital Preauthorization Admissions Provision. For a scheduled hospital stay, she must first get preauthorization through her insurer. If she does not, the insurer may: A. Cancel her contract D. Reduce her normal benefits C. Check her out of the hospital D. Pay the benefit, but send her a bill for additional premium Answer: B.

If Mr. Stanley is injured while attempting to escape from the police after committing a bank robbery, his A & H coverage will probably pay: A. Full claim, less the deductible B. Amount scheduled C. Nothing D. One half of normal benefit Answer: C.

Every Health and Disability Income Policy must express the conditions and provisions for _______. A. Policy corrections B. Refunds of premium at maturity C. Conditional coverage D. Continuation of the contract Answer: D.

Does the insured have the right to change the beneficiary designation of a health insurance policy? A. No, the beneficiary designation in health policies is always irrevocable B. Yes, the beneficiary designation is always revocable in health policies C. Yes, unless the beneficiary is designated as irrevocable D. No, only the insurer has that right in health policies Answer: C.

Examples of preventive care include all of the following, except: A. Immunizations B. Well child visits C. Mammography screenings D. restricting travel to within 5 miles of home Answer: D.

C has duplicate coverage with companies X and Y ($2,000 with X and $3,000 with Y). If C suffers a loss of $1,000, based on the insurance with other insurers provision, how much will company X have to pay out as a claim? A. $1,000 B. $400 C. Zero D. $600 Answer: B.

Precertification, Mandatory Second Surgical Opinion, and Concurrent Review are provisions in health insurance policies known as: A. Managed Care Provisions B. Extra-Legal Actions Provisions C. Miscellaneous Provisions D. Oversight Provisions Answer: A.

Notice of claim is required within _____ days of loss. A. 10 B. 20 C. 90 D. 15 Answer: B.

All of the following are examples of cost containment and managed health care, except: A. Mandatory second surgical opinion B. Experimental drug treatment C. Concurrent review D. Pre-certification Answer: B.

Which statement is inaccurate regarding the Change of Occupation Provision? A. The insured must notify the insurer of a change of occupation, or the policy will be cancelled B. If the insured works at two occupations, rates for the most hazardous occupation will be charged C. If the insured changes to a less hazardous occupation, he/she may apply for a rate reduction D. If the insured changes to a more hazardous occupation, benefits will be reduced to the amount which the premiums paid would purchase at the more hazardous occupation Answer: A.

An insured should receive necessary claim forms within _____ days after notice of claim. A. 10 B. 20 C. 5 D. 15 Answer: D.

In which ONE of the following situations would an insurance company most likely use an impairment rider? A. G is looking to obtain a health insurance policy, but is concerned about a current heart condition B. T, age 70, wants to buy an individual disability income policy but is retired and receiving home health care C. F has cancer and is looking to buy a cancer only policy to help with the cost of treatment D. S is looking to buy a disability income policy, but is unemployed Answer: A.

Which of the following is not an example of a cost containment measure? A. Replacement B. Pre-certification for cancer therapy C. Utilization review D. Mandatory second option Answer: A.

How may the premium in a guaranteed renewable policy be increased? A. It may be increased for all similarly situated insureds based on age B. It may be increased according to the increased risk of the insured's health status C. It may be increased only in relation to the number of claims paid in the past year D. It may not be increased at all Answer: A.

Rank the following renewability provisions in order from least favorable to most favorable in terms of benefit to an insured: A. Cancellable, conditionally renewable, guaranteed renewable B. Guaranteed renewable, noncancellable, cancellable C. Guaranteed renewable, optionally renewable, conditionally renewable D. Noncancellable, guaranteed renewable, optionally renewable Answer: A.

What is the purpose of a probationary period in a disability income policy? A. It allows the employer to fire the employee up to 90 days after being hired without liability for any disability which may have occurred B. It allows the insurance company to avoid illness claims made in the first 10-30 days of the policy C. It allows the insurance company to avoid any claims due to accidental causes in the first few days of the policy D. It allows the insurance company to avoid all claims made in the first 10-30 days of the policy Answer: B.