Louisiana Life and Health Insurance
Exam Questions with Complete
Solutions (A+ Rated, 100% Pass)
All of the following are correct about the required provisions of a health insurance policy
EXCEPT
A. The entire contract clause means the signed application, policy, endorsements, and
attachments constitute the entire contract.
B. A reinstated policy provides immediate coverage for an illness.
C. Policies become incontestable after being in force for 3 years.
D. A grace period of 31 days is found in an annual pay policy. - Answer-B. A reinstated
policy provides immediate coverage for an illness.
Accidental injury is covered immediately, but to protect the insurer against adverse
selection, losses resulting from sickness are covered only if the sickness occurs at least
10 days after the reinstatement date.
An insured pays a monthly premium of $100 for health insurance. What would be the
duration of the grace period under the policy?
A. 15 days
B. 30 days
C. 60 days
D. 7 days - Answer-B. 30 days
The grace period is 30 days for all health insurance policies in Louisiana.
Question 11 of 15
An applicant for an individual health policy failed to complete the application properly.
Before being able to complete the application and pay the initial premium, she is
confined to a hospital. This will not be covered by insurance because she has not met
the conditions specified in the
A. Insuring Clause.
B. Pre-existing Conditions Clause.
,C. Eligibility Clause.
D. Consideration Clause. - Answer-D. Consideration Clause.
The consideration clause specifies that both parties to the contract must give some
valuable consideration. The payment of the premium is the consideration given by the
applicant. Because the applicant had not paid an initial premium, she is not covered by
insurance.
Question 12 of 15
Under the mandatory uniform provision Notice of Claim, the first notice of injury or
sickness covered under an accident and health policy must contain
A. An estimate of the total amount of medical and hospital expense for the loss.
B. A complete physician's statement.
C. A statement that is sufficiently clear to identify the insured and the nature of the
claim.
D. A statement from the insured's employer showing that the insured was unable to
work. - Answer-C. A statement that is sufficiently clear to identify the insured and the
nature of the claim.
The Insurance Code requires that each policy must include, "Written notice of claim
must be given to the insurer within 20 days after the occurrence or commencement of
any loss covered by the policy, or as soon thereafter as is reasonably possible".
Question 13 of 15
The expense for an autopsy covered under the physical exam and autopsy provision is
paid by
A. The estate of the insured.
B. The insurer.
C. The state's autopsy fund.
D. The limits of coverage under the health insurance policy. - Answer-B. The insurer
Where not forbidden by state law, the insurer, at its own expense, may cause an
autopsy to be performed on a deceased insured.
An insured notifies the insurance company that he has become disabled. What
provision states that claims must be paid immediately upon written proof of loss?
,A. Time of Payment of Claims
B. Incontestability
C. Physical Exam and Autopsy
D. Legal Actions - Answer-A. Time of Payment of Claims
The Time of Payment of Claims provision specifies that claims are to be paid
immediately upon written proof of loss.
Which renewability provision allows an insurer to terminate a policy for any reason, and
to increase the premiums for any class of insureds?
A. Conditionally renewable
B. Cancellable
C. Guaranteed renewable
D. Optionally renewable - Answer-D. Optionally renewable
The renewability provision in an optionally renewable policy gives the insurer the option
to terminate the policy for any reason on the date specified in the contract (usually a
renewal date). Furthermore, this provision allows the insurer to increase the premium
for any class of optionally renewable insureds.
When an insurer issues an individual health insurance policy that is guaranteed
renewable, the insurer agrees
A. To charge a lower premium every year the policy is renewed.
B.Not to change the premium rate for any reason.
C. To renew the policy indefinitely.
D. To renew the policy until the insured has reached age 65. - Answer-D. To renew the
policy until the insured has reached age 65.
The guaranteed renewable provision is similar to the noncancellable provision, with the
exception that the insurer can increase the policy premium on the policy anniversary
date. As with the noncancellable policy, coverage is generally not renewable beyond the
insured's age 65.
, Which provision concerns the insured's duty to provide the insurer with reasonable
notice in the event of a loss?
A. Notice of Claim
B. Loss Notification
C. Claims Initiation
D. Consideration - Answer-A. Notice of Claim
The Notice of Claim Provision spells out the insured's duty to provide the insurer with
reasonable notice in the event of a loss.
In an optionally renewable policy, the insurer has which of the following options?
A. Alter the due date so the policy can be cancelled sooner
B. Shorten the notice that the insured receives
C. Increase premiums
D. Increase the grace period - Answer-C. Increase premiums
Optionally renewable policies allow the insurer to cancel a policy for any reason
whatsoever. Policies can only be cancelled by class on the policy anniversary or
premium due date (renewal date). If the insurer elects to renew coverage, it can also
increase the policy premium.
A health insurance policy clause that prevents an insurance company from denying
payment of a claim after a specified period of time is known as the
A. Insuring clause.
B. Time Limit on Certain Defenses clause.
C. Misstatement of Age clause.
D. Reinstatement clause. - Answer-B. Time Limit on Certain Defenses clause.
The Time Limit on Certain Defenses provision guarantees that a misstatement made in
the application, unless it is fraudulent, cannot be contested after the first 3 years of the
policy.
Exam Questions with Complete
Solutions (A+ Rated, 100% Pass)
All of the following are correct about the required provisions of a health insurance policy
EXCEPT
A. The entire contract clause means the signed application, policy, endorsements, and
attachments constitute the entire contract.
B. A reinstated policy provides immediate coverage for an illness.
C. Policies become incontestable after being in force for 3 years.
D. A grace period of 31 days is found in an annual pay policy. - Answer-B. A reinstated
policy provides immediate coverage for an illness.
Accidental injury is covered immediately, but to protect the insurer against adverse
selection, losses resulting from sickness are covered only if the sickness occurs at least
10 days after the reinstatement date.
An insured pays a monthly premium of $100 for health insurance. What would be the
duration of the grace period under the policy?
A. 15 days
B. 30 days
C. 60 days
D. 7 days - Answer-B. 30 days
The grace period is 30 days for all health insurance policies in Louisiana.
Question 11 of 15
An applicant for an individual health policy failed to complete the application properly.
Before being able to complete the application and pay the initial premium, she is
confined to a hospital. This will not be covered by insurance because she has not met
the conditions specified in the
A. Insuring Clause.
B. Pre-existing Conditions Clause.
,C. Eligibility Clause.
D. Consideration Clause. - Answer-D. Consideration Clause.
The consideration clause specifies that both parties to the contract must give some
valuable consideration. The payment of the premium is the consideration given by the
applicant. Because the applicant had not paid an initial premium, she is not covered by
insurance.
Question 12 of 15
Under the mandatory uniform provision Notice of Claim, the first notice of injury or
sickness covered under an accident and health policy must contain
A. An estimate of the total amount of medical and hospital expense for the loss.
B. A complete physician's statement.
C. A statement that is sufficiently clear to identify the insured and the nature of the
claim.
D. A statement from the insured's employer showing that the insured was unable to
work. - Answer-C. A statement that is sufficiently clear to identify the insured and the
nature of the claim.
The Insurance Code requires that each policy must include, "Written notice of claim
must be given to the insurer within 20 days after the occurrence or commencement of
any loss covered by the policy, or as soon thereafter as is reasonably possible".
Question 13 of 15
The expense for an autopsy covered under the physical exam and autopsy provision is
paid by
A. The estate of the insured.
B. The insurer.
C. The state's autopsy fund.
D. The limits of coverage under the health insurance policy. - Answer-B. The insurer
Where not forbidden by state law, the insurer, at its own expense, may cause an
autopsy to be performed on a deceased insured.
An insured notifies the insurance company that he has become disabled. What
provision states that claims must be paid immediately upon written proof of loss?
,A. Time of Payment of Claims
B. Incontestability
C. Physical Exam and Autopsy
D. Legal Actions - Answer-A. Time of Payment of Claims
The Time of Payment of Claims provision specifies that claims are to be paid
immediately upon written proof of loss.
Which renewability provision allows an insurer to terminate a policy for any reason, and
to increase the premiums for any class of insureds?
A. Conditionally renewable
B. Cancellable
C. Guaranteed renewable
D. Optionally renewable - Answer-D. Optionally renewable
The renewability provision in an optionally renewable policy gives the insurer the option
to terminate the policy for any reason on the date specified in the contract (usually a
renewal date). Furthermore, this provision allows the insurer to increase the premium
for any class of optionally renewable insureds.
When an insurer issues an individual health insurance policy that is guaranteed
renewable, the insurer agrees
A. To charge a lower premium every year the policy is renewed.
B.Not to change the premium rate for any reason.
C. To renew the policy indefinitely.
D. To renew the policy until the insured has reached age 65. - Answer-D. To renew the
policy until the insured has reached age 65.
The guaranteed renewable provision is similar to the noncancellable provision, with the
exception that the insurer can increase the policy premium on the policy anniversary
date. As with the noncancellable policy, coverage is generally not renewable beyond the
insured's age 65.
, Which provision concerns the insured's duty to provide the insurer with reasonable
notice in the event of a loss?
A. Notice of Claim
B. Loss Notification
C. Claims Initiation
D. Consideration - Answer-A. Notice of Claim
The Notice of Claim Provision spells out the insured's duty to provide the insurer with
reasonable notice in the event of a loss.
In an optionally renewable policy, the insurer has which of the following options?
A. Alter the due date so the policy can be cancelled sooner
B. Shorten the notice that the insured receives
C. Increase premiums
D. Increase the grace period - Answer-C. Increase premiums
Optionally renewable policies allow the insurer to cancel a policy for any reason
whatsoever. Policies can only be cancelled by class on the policy anniversary or
premium due date (renewal date). If the insurer elects to renew coverage, it can also
increase the policy premium.
A health insurance policy clause that prevents an insurance company from denying
payment of a claim after a specified period of time is known as the
A. Insuring clause.
B. Time Limit on Certain Defenses clause.
C. Misstatement of Age clause.
D. Reinstatement clause. - Answer-B. Time Limit on Certain Defenses clause.
The Time Limit on Certain Defenses provision guarantees that a misstatement made in
the application, unless it is fraudulent, cannot be contested after the first 3 years of the
policy.
