WEBCE PRACTICE ACTUAL EXAM PAPER
2026 QUESTIONS WITH ANSWERS
GRADED A+
◍ Frank is a PPO member and just received information from his insurer
which lists all of the covered services and benefits under his plan. As a PPO
member, Frank is also entitled to all of the following information EXCEPTa
current list of preferred providers each year.an explanation of his financial
responsibility for paying premiums, deductibles and copayments.an
explanation of his legal remedies if he disagrees with the insurer's decision,
including his right to arbitration and mediation.a description of emergency
care services provided..
Answer: an explanation of his legal remedies if he disagrees with the
insurer's decision, including his right to arbitration and mediationAs a PPO
member, Frank must receive a current list of preferred providers at least
annually.
◍ Gracie has a Medicare Advantage policy and needs emergency care while
traveling. However, there are no network providers nearby. What should she
do?delay treatment until she locates a provider within the networksee any
suitable provider even if outside the networkseek a provider in another
networksubmit her expenses to her insurer for reimbursement.
Answer: see any suitable provider even if outside the networkA Medicare
Advantage policy or certificate will cover emergency services that are not
available through network providers.
◍ Felicia cannot understand some of the phrasing in her homeowners policy.
She therefore presents her insurance agent with her request for a series of
suggested modifications that would, in her opinion, make the policy clearer.
The agent informs her that the wording of this standard policy cannot be
, changed. Felicia's policy is a(n) a. ambivalent contract. b. contract of
adhesion. c. manuscript policy. d. uniform policy..
Answer: contract of adhesion. --A contract of adhesion is a standard-form
contract prepared by one party (the insurance company, in this case) in
terms that the other party is not permitted to negotiate or modify.
◍ When applying an allowable maximum dollar amount for certain types of
property, adjuster Don is a. evaluating the facts and information gained from
the investigation process. b. evaluating the resulting damages claimed to
policy coverages, conditions, exclusions, and limitations. c. establishing a
documented value for claims resolution. d. trying to save his company some
money..
Answer: evaluating the facts and information gained from the investigation
process.This answer is incorrect. The correct answer is "B. evaluating the
resulting damages claimed to policy coverages, conditions, exclusions, and
limitations." Adjuster Don reviewed the section of the policy about special
limits on certain types of personal property. Those are the limits that he
applied in accordance with the policy wording.
◍ Proper claim file documentation requires all the following, except: a.
retention of all written communications that are materially related to the
claim. b. notation of date received, date processed, or date mailed for each
relevant document. c. enough information to permit reconstruction of the
insurer's claims adjusting activities. d. prior approval by the National
Association of Insurance Commissioners (NAIC)..
Answer: prior approval by the National Association of Insurance
Commissioners (NAIC).That's correct! Documentation does not require
prior approval of the National Association of Insurance Commissioners. It
also includes transactions, notes, work papers, claim forms, bills,
explanation of benefits forms, etc.
◍ Adjuster Donna writes the following coverage denial letter to the insured:
"Dear Ms. Jones, Our investigation into the above captioned loss is
complete. Due to exclusion B 6, on page 17 of your auto policy, we are
, unable to make any payment to you. Thank you for selecting ABC Insurance
to insure your home and auto. Sincerely, Donna, Adjuster, ABC Insurance."
This was not a proper coverage denial letter. A proper coverage denial letter
will do all the following, except: a. Give a summary of the coverage facts. b.
Quote the specific policy provisions. c. Connect the facts to the policy
provisions quoted. d. Avoid specifically saying that the claim is not
covered..
Answer: Avoid specifically saying that the claim is not covered.That's
correct! The insured deserves a full and understandable explanation of the
decision, and the regulations require it.
◍ To involve the insured in a products liability claim, adjuster Dixon asked the
insured to send him a picture of the user's instructions. Two days later, a
courier delivers a set of ten loose-leaf manuals, each of which deals with a
different application of the product. Dixon has doubts as to what he should
do with all these documents, some of which might not even relate to the
case. What is the best course of action? a. Select a few relevant manuals and
discard the rest to keep the file manageable. b. When in doubt, leave it in;
keep all manuals in the file or at a location referred to in the file. c. When in
doubt, leave it out; choose the most relevant instruction manual (which is all
he asked for) and discard the rest. d. Write a note on the first page of each
manual to indicate its relevance to the case..
Answer: Write a note on the first page of each manual to indicate its
relevance to the case.This answer is incorrect. The correct answer is "B.
When in doubt, leave it in; keep all manuals in the file or at a location
referred to in the file." When in doubt about whether to retain a document,
the safest course of action is to leave it in the file or in an otherwise
accessible location.
◍ Tim and Alma Smith have a homeowners policy that covers property losses
occurring during the policy period. When Tim and Alma Smith report the
breaking and entering damage and theft of personal property to their
homeowners insurer, the first notice of loss form will list the term of their
policy, the date of the loss, and the date of report to the insurer. The person
, taking the loss will then check to see whether a. the date of the report is
before the last day of their policy term. b. the date of loss is before the last
day of their policy term. c. the date of loss is between the first day and the
last day of the policy term. d. the date of the report is between the first day
and the last day of the policy term..
Answer: the date of loss is between the first day and the last day of the
policy term.That's correct! For coverage to apply, the date of the loss must
fall within the beginning and ending date of the policy period.
◍ As regards the resolution process, new adjusters often ask experienced
adjusters which party should put forth its proposed resolution amount
first-the adjuster with an offer or the insured/claimant with a demand. What
will the experienced adjuster advise? a. It depends upon the individual claim
file. b. It is the insured/claimant's obligation since claimants want the
money. c. The adjuster is required by the claims settlement regulations to go
first. d. It is the adjuster's obligation since the insurer has the money..
Answer: It depends upon the individual claim file.That's correct!
Experienced claims professionals allow the individual variables of each
specific file to determine who discusses resolution amount first.
◍ end of course.
Answer: //
◍ Which of the following would be likely to offer credit life insurance?an
annuity companya reinsurera multiple employer trust (MET)a loan
company.
Answer: a loan company
◍ A cancellable, nonrenewable health insurance policy that provides coverage
for a specified short-term period only is called a:nonrenewable health
insurance policytemporary health insurance policyterm health insurance
policylife event health insurance policy.
Answer: term health insurance policy
◍ chap 8.
Answer: //
2026 QUESTIONS WITH ANSWERS
GRADED A+
◍ Frank is a PPO member and just received information from his insurer
which lists all of the covered services and benefits under his plan. As a PPO
member, Frank is also entitled to all of the following information EXCEPTa
current list of preferred providers each year.an explanation of his financial
responsibility for paying premiums, deductibles and copayments.an
explanation of his legal remedies if he disagrees with the insurer's decision,
including his right to arbitration and mediation.a description of emergency
care services provided..
Answer: an explanation of his legal remedies if he disagrees with the
insurer's decision, including his right to arbitration and mediationAs a PPO
member, Frank must receive a current list of preferred providers at least
annually.
◍ Gracie has a Medicare Advantage policy and needs emergency care while
traveling. However, there are no network providers nearby. What should she
do?delay treatment until she locates a provider within the networksee any
suitable provider even if outside the networkseek a provider in another
networksubmit her expenses to her insurer for reimbursement.
Answer: see any suitable provider even if outside the networkA Medicare
Advantage policy or certificate will cover emergency services that are not
available through network providers.
◍ Felicia cannot understand some of the phrasing in her homeowners policy.
She therefore presents her insurance agent with her request for a series of
suggested modifications that would, in her opinion, make the policy clearer.
The agent informs her that the wording of this standard policy cannot be
, changed. Felicia's policy is a(n) a. ambivalent contract. b. contract of
adhesion. c. manuscript policy. d. uniform policy..
Answer: contract of adhesion. --A contract of adhesion is a standard-form
contract prepared by one party (the insurance company, in this case) in
terms that the other party is not permitted to negotiate or modify.
◍ When applying an allowable maximum dollar amount for certain types of
property, adjuster Don is a. evaluating the facts and information gained from
the investigation process. b. evaluating the resulting damages claimed to
policy coverages, conditions, exclusions, and limitations. c. establishing a
documented value for claims resolution. d. trying to save his company some
money..
Answer: evaluating the facts and information gained from the investigation
process.This answer is incorrect. The correct answer is "B. evaluating the
resulting damages claimed to policy coverages, conditions, exclusions, and
limitations." Adjuster Don reviewed the section of the policy about special
limits on certain types of personal property. Those are the limits that he
applied in accordance with the policy wording.
◍ Proper claim file documentation requires all the following, except: a.
retention of all written communications that are materially related to the
claim. b. notation of date received, date processed, or date mailed for each
relevant document. c. enough information to permit reconstruction of the
insurer's claims adjusting activities. d. prior approval by the National
Association of Insurance Commissioners (NAIC)..
Answer: prior approval by the National Association of Insurance
Commissioners (NAIC).That's correct! Documentation does not require
prior approval of the National Association of Insurance Commissioners. It
also includes transactions, notes, work papers, claim forms, bills,
explanation of benefits forms, etc.
◍ Adjuster Donna writes the following coverage denial letter to the insured:
"Dear Ms. Jones, Our investigation into the above captioned loss is
complete. Due to exclusion B 6, on page 17 of your auto policy, we are
, unable to make any payment to you. Thank you for selecting ABC Insurance
to insure your home and auto. Sincerely, Donna, Adjuster, ABC Insurance."
This was not a proper coverage denial letter. A proper coverage denial letter
will do all the following, except: a. Give a summary of the coverage facts. b.
Quote the specific policy provisions. c. Connect the facts to the policy
provisions quoted. d. Avoid specifically saying that the claim is not
covered..
Answer: Avoid specifically saying that the claim is not covered.That's
correct! The insured deserves a full and understandable explanation of the
decision, and the regulations require it.
◍ To involve the insured in a products liability claim, adjuster Dixon asked the
insured to send him a picture of the user's instructions. Two days later, a
courier delivers a set of ten loose-leaf manuals, each of which deals with a
different application of the product. Dixon has doubts as to what he should
do with all these documents, some of which might not even relate to the
case. What is the best course of action? a. Select a few relevant manuals and
discard the rest to keep the file manageable. b. When in doubt, leave it in;
keep all manuals in the file or at a location referred to in the file. c. When in
doubt, leave it out; choose the most relevant instruction manual (which is all
he asked for) and discard the rest. d. Write a note on the first page of each
manual to indicate its relevance to the case..
Answer: Write a note on the first page of each manual to indicate its
relevance to the case.This answer is incorrect. The correct answer is "B.
When in doubt, leave it in; keep all manuals in the file or at a location
referred to in the file." When in doubt about whether to retain a document,
the safest course of action is to leave it in the file or in an otherwise
accessible location.
◍ Tim and Alma Smith have a homeowners policy that covers property losses
occurring during the policy period. When Tim and Alma Smith report the
breaking and entering damage and theft of personal property to their
homeowners insurer, the first notice of loss form will list the term of their
policy, the date of the loss, and the date of report to the insurer. The person
, taking the loss will then check to see whether a. the date of the report is
before the last day of their policy term. b. the date of loss is before the last
day of their policy term. c. the date of loss is between the first day and the
last day of the policy term. d. the date of the report is between the first day
and the last day of the policy term..
Answer: the date of loss is between the first day and the last day of the
policy term.That's correct! For coverage to apply, the date of the loss must
fall within the beginning and ending date of the policy period.
◍ As regards the resolution process, new adjusters often ask experienced
adjusters which party should put forth its proposed resolution amount
first-the adjuster with an offer or the insured/claimant with a demand. What
will the experienced adjuster advise? a. It depends upon the individual claim
file. b. It is the insured/claimant's obligation since claimants want the
money. c. The adjuster is required by the claims settlement regulations to go
first. d. It is the adjuster's obligation since the insurer has the money..
Answer: It depends upon the individual claim file.That's correct!
Experienced claims professionals allow the individual variables of each
specific file to determine who discusses resolution amount first.
◍ end of course.
Answer: //
◍ Which of the following would be likely to offer credit life insurance?an
annuity companya reinsurera multiple employer trust (MET)a loan
company.
Answer: a loan company
◍ A cancellable, nonrenewable health insurance policy that provides coverage
for a specified short-term period only is called a:nonrenewable health
insurance policytemporary health insurance policyterm health insurance
policylife event health insurance policy.
Answer: term health insurance policy
◍ chap 8.
Answer: //
