ACCURATE SOLUTIONS
Under what circumstance does an accident and health insurer have the
right to request an autopsy?
1. When the claim exceeds an amount specified in the policy
2. When 2 days have passed after death
3. When not prohibited by state law
4. When consent is given by the beneficiary - Precise Answer ✔✔3.
When not prohibited by state law
Which of the following accurately describes the "time limit on certain
defenses"?
1. After a stated period of time, claims cannot be denied due to material
misrepresentation on the application
2. All claims can be disputed after two years
3. An insured cannot file a lawsuit within 90 days of the claim being
filed
,4. The right to return an accident and health policy must be within 10
days of policy delivery - Precise Answer ✔✔1. After a stated period of
time, claims cannot be denied due to material misrepresentation on the
application
Patrick purchased a long-term care policy. He has a health condition for
which medical treatment was recommended by a physician within 6
months prior to the policy's effective date. This condition is called a(n)
1. antecedent condition
2. pre-existing condition
3. hazardous condition
4. grandfathered condition - Precise Answer ✔✔2. pre-existing
condition
Which of the following describes coverage for the Medicare Part B
coinsurance?
1. Only a Long-term care policy will cover Medicare Part B coinsurance
2. A Medicare Supplement optional benefit
,3. A Medicare Supplement core benefit
4. Medicare Part B does not require a coinsurance so no additional
coverage is needed - Precise Answer ✔✔3. A Medicare Supplement
core benefit
Larry has a Major Medical Expense policy for his family with a $1,000
per family/per year deductible and an 80/20 coinsurance provision. If
Larry's family files four claims of $400, $800, $100, and $700 in one
year, how much will the insurance company pay?
1. $500
2. $800
3. $1,000
4. $1,200 - Precise Answer ✔✔2. $800
(($400 + $800 + $100 + $700 = $2,000. The insurance company pays
80% of $1,000 (outstanding balance after deductible is paid), or $800.))
Long-term care policies issued in New York must provide benefits for at
least
1. 6 months
, 2. 12 months
3. 18 months
4. 24 months - Precise Answer ✔✔2. 12 months
Which of the following types of insurers limits the exposures it writes to
those of its owners?
1. Restricted insurer
2. Limited insurer
3. Confined insurer
4. Captive insurer - Precise Answer ✔✔4. Captive insurer
Notice of information practices must be given to a policyholder at least
1. every year
2. every two years