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1. Jean misstated her age on her health insurance application. According to the
optional provisions of Uniform Policy Provisions Law, what is the insurer's
duty? - ANSWER to adjust any benefits to what the premium paid would
have purchased at the correct age
2. Which of the following is an effective means of controlling over insurance
in health coverage under optional provisions of Uniform Policy Provisions
Law? - ANSWER establishing maximum amounts payable to any one
insured for certain coverages
3. Premium amounts that cover the time for which protection has not yet been
provided, are called - ANSWER unearned premiums
4. Under the Misstatement of Age Provision, if an insured has misstated his or
her age on the application, the company has the right to - ANSWER adjust
the benefits payable.
5. Which statement describes the purpose of the Uniform Provisions Law? -
ANSWER to provide each state with a law that will permit the use of
uniform standard provisions, resulting in some standardization of policy
forms.
,6. Optional Provisions 3, 4, 5, and 6, Other Insurance in This Insurer,
Insurance, With Other Insurers, Relation of Earnings of Insurance,
respectively, has which common purpose? - ANSWER to avoid the insured
from becoming over-insured
7. The Misstatement of Age provision gives the insurance company the right to
- ANSWER adjust benefits payable
8. All of the following are required A&H Policy Provisions: - ANSWER -
time limit on certain defenses: incontestability
- change of beneficiary
- reinstatement
9. This portion of a premium which has paid for the protection given under the
policy during the "now expired" portion of the policy term is referred to as: -
ANSWER earned premium
10.Which of the following is an applicant's written request to an insurer asking
the company to issue a policy or contract of insurance on the basis of
information provided in the application? - ANSWER application
11.Which of the following best describes the importance of an insurance
application? - ANSWER - statements made in the application become the
basis for issuing the policy.
- the application helps to identify the applicant more fully.
12.Any changes made on an insurance application: - ANSWER must be
initialed by the applicant
,13.A misrepresentation to an insurance company with the intent to deceive and
to gain advantage is: - ANSWER fraud
14.What type of misrepresentation is a critical factor in an insurance company's
decision to issue or not issue a policy? - ANSWER material
misrepresentation
15.When an agent does not put the interest of his clients above those of his
own, which of the following is likely to be a errors and omissions liability? -
ANSWER - failure to obtain the correct coverage for a client
- failure to obtain adequate coverage for a client
- failure to maintain adequate coverage for a client
16.Russ has two identical health insurance policies from different insurers. He
has an operation costing $10,000 and both policies would cover it. Under the
optional provisions of Uniform Policy Provisions Law, how will the
provider be paid ? - ANSWER the companies will pay their proportionate
shares.
17.Tad suffers a disability and is covered under both the accident and disability
coverages of a single policy. Under the optional provisions of Uniform
Policy Provisions Law, will Tad receive benefits? - ANSWER yes, he will
receive benefits but not to exceed the monthly earning at the time of
disability or the average monthly earnings for two years immediately
preceding the disability.
18.Remaining disabled as a means of continuing to collect insurance is termed:
- ANSWER malingering
, 19.Tuck's insurer cancels his health insurance policy. The company returns part
of his last premium calling it "unearned," and the company keeps a part of
the premium calling it "earned." This called a: - ANSWER pro rata return
20.Ramona cancels her health insurance policy. The company retains a portion
of her last premium paid above the earned premium and returns the
remainder to Ramona. This is called a(n): - ANSWER short rate return
21.Under the optional provisions of Uniform Policy Provisions Law, if an
insurance policy is in conflict with a state statute, which one prevails? -
ANSWER the statute
22.In an attempt to rob a pawn shop, Victor is accidentally shot in the back by
his partner in crime and is permanently paralyzed. Under the optional
provisions of Uniform Policy Provisions Law, will his health or disability
income coverage pay benefits? - ANSWER no because he was in the act of
committing a felony
23.Aaron has been a successful bank robber by profession. While robbing a
large bank, he is shot with a shotgun in both legs by bystander. Under the
optional provisions of Uniform Policy Provisions Law, will his health or
disability income coverage pay benefits? - ANSWER no because a
contributing cause of the loss was the insured's being engaged in an illegal
profession
24.Connie suffers an accidental heroin overdose, and she is in a coma for two
months. Under the optional provisions of Uniform Policy Provisions Law,
will her health insurance pay benefits for coverage for treatment? -
ANSWER no because she was under the influence of a narcotic not
administered on the advice of a physician