Accident and Health Insurance
Agent/Broker Practice Exam with
complete solutions.
Accident and Health Insurance
Agent/Broker Practice Exam with
complete solutions.
Sally is considering her Medicare options. She understands that to enroll in Medicare
Part B, she will have to pay a monthly premium. Since she is healthy, she is considering
delaying her enrollment until later. Will she be able to enroll at a later date?
1.Yes, she can enroll at anytime in the future
2.Yes, however; she would have a permanent premium penalty when she does enroll
3.No, this is a take or leave it situation
4.Yes, but she would have to show evidence of good health. - Answer = Yes, however;
she would have a permanent premium penalty when she does enroll
Under Medicare Part A, a spell of illness begins again and is subject to a new
deductible for another admission when:
1.The patient has been discharged from a prior stay and 45 days have elapsed
2.The patient has been discharged from a prior stay and 30 days have elapsed
3.The patient has been discharged from a prior stay and 60 days have elapsed
4.The patient has been discharged from a prior stay and 90 days have elapsed -
Answer = The patient has been discharged from a prior stay and 60 days have elapsed
What type of insurer retains risk?
1.Government insurance.
2.Reinsurers.
3.Self insurers.
4.Assessment insurers. - Answer = Self insurers.
A variety of types of care are provided under a long-term care policy. All of the following
are types of care generally provided EXCEPT:
1.Home health care
2.Intensive care
3.Custodial care
4.Skilled care - Answer = Intensive care
,Accident and Health Insurance
Agent/Broker Practice Exam with
complete solutions.
Melvin has a long-term care policy with a 30-day elimination period. The policy has a
daily benefit of $100/day. The policy has a 3-year benefit period. If Melvin is confined to
a nursing home for 9 months, how much in benefits will his policy pay?
1.$27,000
2.$18,000
3.$24,000
4.$17,000 - Answer = $24,000
Martin and his friends were at a local tavern celebrating his birthday. Martin left the bar
to drive home, but unfortunately, he was involved in a fatal accident, killing himself and
two other individuals. An autopsy reveals that Martin was well above the legal limit on
his blood alcohol test. Martin's family will receive the following from his Accidental Death
and Dismemberment policy:
1.His family will receive reduced benefits since other deaths were involved.
2.His family will receive the principal sum since this was death
3.His family will receive no benefits, since he was in the act of committing a felony
4.His family will receive no benefits since there was no dismemberment involved. -
Answer = His family will receive no benefits, since he was in the act of committing a
felony
An exclusion that always appears in a health policy is:
1.No coverage for drug or alcohol related illness
2.Hernia from an accident
3.Travel outside of the USA
4.Injury in the act of committing a felony - Answer = Injury in the act of committing a
felony
Bruce owns a plan that pays $100 daily benefit for a hospital stay with no deductible.
This kind of policy is known as a (an):
1.Major medical plan
2.Basic plan
3.Indemnity plan
4.Reimbursement plan - Answer = Indemnity plan
Under what conditions is the death benefit (principal sum) payable under an Accidental
Death and Dismemberment (AD&D) policy?
1.The insured dies from a grave illness
,Accident and Health Insurance
Agent/Broker Practice Exam with
complete solutions.
2.The insured dies from natural causes
3.The insured dies from an accident
4.All of the above - Answer = The insured dies from an accident
An insurance agent told a member of his church who had recently experienced several
personal and financial losses that he could see that she got a more favorable rate on
her insurance policies than her health and general circumstances would warrant. The
woman had been his kindergarten teacher and was a pillar in the community's life. He
wanted to help her. Which of the following is FALSE?
1.The agent was breaking the law.
2.The agent is compassionate.
3.The agent was engaging in unfair discrimination.
4.The agent was engaging in twisting. - Answer = The agent was engaging in twisting.
Which of the following is NOT considered to be an unfair claims settlement practice?
1.Knowingly misrepresenting policy provisions.
2.Replacing one insurance policy with another.
3.Failing to promptly acknowledge pertinent communications.
4.Refusing to pay claimants without conducting a reasonable investigation. - Answer =
Replacing one insurance policy with another.
The practice of using misrepresentation to induce a policyholder to replace a policy
issued by the insurer the producer represents is called:
1.twisting.
2.churning.
3.intimidation.
4.misrepresentation. - Answer = churning.
All of the following acts are considered unfair trade practices EXCEPT:
1.replacement.
2.misrepresentation
3.coercion.
4.rebating. - Answer = replacement.
What gives the insurance company the right to assume rights of the insured in order to
sue a responsible third party when damages are inflicted on the insured?
1.Warranties
, Accident and Health Insurance
Agent/Broker Practice Exam with
complete solutions.
2.Subrogation
3.Concealment
4.Utmost good faith - Answer = Subrogation
Insurance contracts sometimes contain ambiguities. Which of the following has not
been taken to court for further interpretation?
1.Reasonable expectations
2.Subrogation
3.Ambiguities in a contract of adhesion
4.Utmost good faith - Answer = Subrogation
There are various optional provision for health policies. Which of the following is not an
optional provision?
1.Intoxicants and narcotics
2.Conformity with state statutes
3.Reinstatement
4.Illegal occupation - Answer = Reinstatement
Tony (the insured) cancelled his health policy by submitting a written notice to the
insurer. How are unearned premiums handled?
1.Returned to the insured using a pro-rata basis
2.They are returned to the agent
3.The insurer gets to keep them
4.Returned to the insured using a short-rate basis - Answer = Returned to the insured
using a short-rate basis
The Patient Protection and Affordable Care Act allows states to combine their SHOP
exchange with -
1.Commercial insurance companies
2.Their Medicaid recipients
3.Their exchange for individual consumers
4.All of the above - Answer = Their exchange for individual consumers
o elect continuation of coverage, the insured must request continuation during the
election period (45 days after the date of the _____). Employers must provide the
proper forms for election within 14 days of receipt of request of election.
1.Arraignment, annulment, or release on bond
Agent/Broker Practice Exam with
complete solutions.
Accident and Health Insurance
Agent/Broker Practice Exam with
complete solutions.
Sally is considering her Medicare options. She understands that to enroll in Medicare
Part B, she will have to pay a monthly premium. Since she is healthy, she is considering
delaying her enrollment until later. Will she be able to enroll at a later date?
1.Yes, she can enroll at anytime in the future
2.Yes, however; she would have a permanent premium penalty when she does enroll
3.No, this is a take or leave it situation
4.Yes, but she would have to show evidence of good health. - Answer = Yes, however;
she would have a permanent premium penalty when she does enroll
Under Medicare Part A, a spell of illness begins again and is subject to a new
deductible for another admission when:
1.The patient has been discharged from a prior stay and 45 days have elapsed
2.The patient has been discharged from a prior stay and 30 days have elapsed
3.The patient has been discharged from a prior stay and 60 days have elapsed
4.The patient has been discharged from a prior stay and 90 days have elapsed -
Answer = The patient has been discharged from a prior stay and 60 days have elapsed
What type of insurer retains risk?
1.Government insurance.
2.Reinsurers.
3.Self insurers.
4.Assessment insurers. - Answer = Self insurers.
A variety of types of care are provided under a long-term care policy. All of the following
are types of care generally provided EXCEPT:
1.Home health care
2.Intensive care
3.Custodial care
4.Skilled care - Answer = Intensive care
,Accident and Health Insurance
Agent/Broker Practice Exam with
complete solutions.
Melvin has a long-term care policy with a 30-day elimination period. The policy has a
daily benefit of $100/day. The policy has a 3-year benefit period. If Melvin is confined to
a nursing home for 9 months, how much in benefits will his policy pay?
1.$27,000
2.$18,000
3.$24,000
4.$17,000 - Answer = $24,000
Martin and his friends were at a local tavern celebrating his birthday. Martin left the bar
to drive home, but unfortunately, he was involved in a fatal accident, killing himself and
two other individuals. An autopsy reveals that Martin was well above the legal limit on
his blood alcohol test. Martin's family will receive the following from his Accidental Death
and Dismemberment policy:
1.His family will receive reduced benefits since other deaths were involved.
2.His family will receive the principal sum since this was death
3.His family will receive no benefits, since he was in the act of committing a felony
4.His family will receive no benefits since there was no dismemberment involved. -
Answer = His family will receive no benefits, since he was in the act of committing a
felony
An exclusion that always appears in a health policy is:
1.No coverage for drug or alcohol related illness
2.Hernia from an accident
3.Travel outside of the USA
4.Injury in the act of committing a felony - Answer = Injury in the act of committing a
felony
Bruce owns a plan that pays $100 daily benefit for a hospital stay with no deductible.
This kind of policy is known as a (an):
1.Major medical plan
2.Basic plan
3.Indemnity plan
4.Reimbursement plan - Answer = Indemnity plan
Under what conditions is the death benefit (principal sum) payable under an Accidental
Death and Dismemberment (AD&D) policy?
1.The insured dies from a grave illness
,Accident and Health Insurance
Agent/Broker Practice Exam with
complete solutions.
2.The insured dies from natural causes
3.The insured dies from an accident
4.All of the above - Answer = The insured dies from an accident
An insurance agent told a member of his church who had recently experienced several
personal and financial losses that he could see that she got a more favorable rate on
her insurance policies than her health and general circumstances would warrant. The
woman had been his kindergarten teacher and was a pillar in the community's life. He
wanted to help her. Which of the following is FALSE?
1.The agent was breaking the law.
2.The agent is compassionate.
3.The agent was engaging in unfair discrimination.
4.The agent was engaging in twisting. - Answer = The agent was engaging in twisting.
Which of the following is NOT considered to be an unfair claims settlement practice?
1.Knowingly misrepresenting policy provisions.
2.Replacing one insurance policy with another.
3.Failing to promptly acknowledge pertinent communications.
4.Refusing to pay claimants without conducting a reasonable investigation. - Answer =
Replacing one insurance policy with another.
The practice of using misrepresentation to induce a policyholder to replace a policy
issued by the insurer the producer represents is called:
1.twisting.
2.churning.
3.intimidation.
4.misrepresentation. - Answer = churning.
All of the following acts are considered unfair trade practices EXCEPT:
1.replacement.
2.misrepresentation
3.coercion.
4.rebating. - Answer = replacement.
What gives the insurance company the right to assume rights of the insured in order to
sue a responsible third party when damages are inflicted on the insured?
1.Warranties
, Accident and Health Insurance
Agent/Broker Practice Exam with
complete solutions.
2.Subrogation
3.Concealment
4.Utmost good faith - Answer = Subrogation
Insurance contracts sometimes contain ambiguities. Which of the following has not
been taken to court for further interpretation?
1.Reasonable expectations
2.Subrogation
3.Ambiguities in a contract of adhesion
4.Utmost good faith - Answer = Subrogation
There are various optional provision for health policies. Which of the following is not an
optional provision?
1.Intoxicants and narcotics
2.Conformity with state statutes
3.Reinstatement
4.Illegal occupation - Answer = Reinstatement
Tony (the insured) cancelled his health policy by submitting a written notice to the
insurer. How are unearned premiums handled?
1.Returned to the insured using a pro-rata basis
2.They are returned to the agent
3.The insurer gets to keep them
4.Returned to the insured using a short-rate basis - Answer = Returned to the insured
using a short-rate basis
The Patient Protection and Affordable Care Act allows states to combine their SHOP
exchange with -
1.Commercial insurance companies
2.Their Medicaid recipients
3.Their exchange for individual consumers
4.All of the above - Answer = Their exchange for individual consumers
o elect continuation of coverage, the insured must request continuation during the
election period (45 days after the date of the _____). Employers must provide the
proper forms for election within 14 days of receipt of request of election.
1.Arraignment, annulment, or release on bond
