Final Exam - Florida Life and Health Questions And Answers

Final Exam - Florida Life and Health
Questions And Answers
Av66vyear-
oldvisvcoveredvundervavgroupvhealthvplanvwhilevemployedvwithvavbusinessvthatvhasv40vempl
oyees.vIfvshevinjuresvherselfvwhilevwalkingvinvthevpark,vwhatvcoveragevwouldvbevconsidered
vprimary?v-vCORRECTvvANSWER-Hervgroupvhealthvplan.




Ifvthevemployervhasvmorevthanv20vemployees,vthevgroupvhealthvplanvgenerallyvpaysvfirst.

AvDisabilityvIncomevpolicyownervrecentlyvsubmittedvavclaimvforvavchronicvneckvproblemvtha
tvhasvnowvresultedvinvtotalvdisability.vThevoriginalvneckvinjuryvoccurredvbeforevthevapplicatio
nvwasvtakenv5vyearsvprior.vThevneckvinjuryvwasvnevervdisclosedvtovthevinsurervatvthevtimevofv
application.vHowvwillvthevinsurervhandlevthisvclaim?v-vCORRECTvvANSWER-
Claimvwillvbevpaidvandvcoveragevwillvremainvinvforce.

Aftervavpolicyvhasvbeenvinvforcevforv2v(sometimesv3)vyears,vitventersvthevincontestablevperio
d,vinvwhichvthevinsurervmayvnotvdenyvavclaimvbasedvonvinformationvnotvdisclosedvatvthevtime
vofvapplication.




AvHospital/SurgicalvExpensevpolicyvwasvpurchasedvforvavfamilyvofvfourvinvMarchvofv2013.vT
hevpolicyvwasvissuedvwithvav$500vdeductiblevandvavlimitvofvfourvdeductiblesvpervcalendarvye
ar.vTwovclaimsvwerevpaidvinvSeptemberv2013,veachvincurringvmedicalvexpensesvinvexcessv
ofvthevdeductible.vTwovadditionalvclaimsvwerevfiledvinv2014,veachvinvexcessvofvthevdeductibl
evamountvasvwell.vWhatvwouldvbevthisvfamily'svout-of-pocketvmedicalvexpensesvforv2013?v-
vCORRECTvvANSWER-1,000.




Invthisvsituation,vthevinsured'svmaximumvout-of-
pocketvexpensesvforv2013vwouldvbev$1,000.

Avlifevinsurancevpolicyvthatvprovidesvavpolicyownervwithvcashvvaluevalongvwithvavlevelvfacev
amountvisvcalledv-vCORRECTvvANSWER-Wholevlife-
Wholevlifevprovidesvthevinsuredvwithvavcashvvaluevasvwellvasvavlevelvfacevamount.

Avlifevinsurancevpolicyownervmayvsellvtheirvpolicyvtova(n)v_____vinvordervtovreceivevavpercen
tagevofvthevpolicy'svfacevvalue.v-vCORRECTvvANSWER-viaticalvsettlementvprovider.

,Tovreceivevavpercentagevofvthevpolicyvfacevvalue,vanvownervofvavlifevpolicyvmayvsellvthevpolic
yvtovavviaticalvsettlementvprovider.

AvlifevpolicyvloanvinvFloridavcannotvchargevavfixedvratevofvinterestvhighervthanv-
vCORRECTvvANSWER-

Thevmaximumvfixedvinterestvratevpermittedvonvavlifevpolicyvloanvisv10%.

Avmutualvinsurancevcompanyvandvavstockvinsurancevcompanyvhavevonevmainvdifferencevb
etweenvthem.vWhatvisvthisvmajorvcontrast?v-vCORRECTvvANSWER-
Stockvcompanyvisvownedvbyvitsvshareholders.vMutualvcompanyvisvownedvbyvitsvpolicyholde
rs.

Avpolicyowner'svrightsvarevlimitedvundervwhichvbeneficiaryvdesignation?v-
vCORRECTvvANSWER-Irrevocable.




Anvirrevocablevbeneficiaryvdesignationvrequiresvthevconsentvandvsignaturevofvthatvnamedv
v

beneficiaryvbeforevavchangevofvbeneficiaryvoccurs.

AvprepaidvapplicationvforvindividualvDisabilityvIncomevinsurancevwasvrecentlyvsubmittedvtov
anvinsurer.vWhenvthevinsurervreceivedvthevMedicalvInformationvBureauv(MIB)vreport,vthevre
portvshowedvthatvthevapplicantvhadvsufferedvavstrokev18vmonthsvago,vsomethingvthatvwasvn
otvdisclosedvonvthevapplication.vWhichvofvthevfollowingvactionsvwouldvthevinsurancevcompa
nyvNOTvtake?v-vCORRECTvvANSWER-
SendvavnoticevtovthevMIBvthatvthevapplicantvwasvdeclined.

ThevMIBvdoesvnotvneedvtovbevnotifiedvthatvcoveragevwasvdenied.
Submit

Avprospectivevinsuredvcompletesvandvsignsvanvapplicationvforvhealthvinsurancevbutvintentio
nallyvconcealsvinformationvaboutvavpre-
existingvheartvcondition.vThevcompanyvissuesvthevpolicy.vTwovmonthsvlater,vthevinsuredvsuf
fersvavheartvattackvandvsubmitsvavclaim.vWhilevprocessingvthevclaim,vthevcompanyvdiscover
svthevpre-existingvcondition.vInvthisvsituation,vthevcompanyvwillv-vCORRECTvvANSWER-
continuevcoveragevbutvexcludevthevheartvcondition.

Ifvthevinsuredvdidvnotvcitevthevconditionvonvthevapplicationvandvthevinsurervdidvnotvexcludevt
v

hevconditon,vthevpre-
existingvconditionvprovisionvstillvapplies.vExclusionsvarevsubjectvtovthev"timevlimitvonvcertainv
defenses"vprovision,vhowever.

AvReturnvofvPremiumvlifevinsurancevpolicyvisv-vCORRECTvvANSWER-
WholevlifevandvIncreasingvterm.
v

AvReturnvofvPremiumvlifevinsurancevpolicyvisvwholevlifevinsurancevwithvavdeathvbenefitvriderv
ofvincreasingvtermvinsurancevequalvtovthevamountvofvpremiumsvpaid.vIfvthevinsuredvdiesvwit
hinvthevperiodvofvterm,vthevbeneficiaryvwillvreceivevfacevamountvplusvthevvaluevofvallvpaidvpr
emiums.

, Avstatementvmadevbyvanvinsuredvinvanvinsurancevapplicationvthatvmustvbevtruevtovthevbestvo
fvone'svknowledgevandvwhichvbecomesvavpartvofvthevcontractvisvknownvasv-
vCORRECTvvANSWER-

Avrepresentationvisvavstatementvmadevbyvanvinsuredvinvanvinsurancevapplicationvthatvmustv
bevtruevtovthevbestvofvone'svknowledgevandvwhichvbecomesvavpartvofvthevcontract.

Avstockvlifevinsurancevcompanyvthatvissuesvbothvparticipatingvandvnonparticipatingvpolicies
visvdoingvbusinessvonv-vCORRECTvvANSWER-avmixedvplan.




Whenvavstockvlifevinsurancevcompanyvissuesvbothvparticipatingvandvnonparticipatingvpolici
es,vthevcompanyvisvdoingvbusinessvonvavmixedvplan.

Avtermvlifevinsurancevpolicyvmaturesv-vCORRECTvvANSWER-
uponvthevinsured'svdeathvduringvthevtermvofvthevpolicy.

Termvlifevpoliciesvcanvonlyvmaturev(payvoutvthevfacevamount)vifvdeathvoccursvduringvthevter
mvofvthevpolicy.

AccordingvtovFloridavlaw,vwhenvmustvanvagentvdelivervthevOutlinevofvCoveragevtovavMedica
revSupplementvapplicant?v-vCORRECTvvANSWER-Atvthevtimevofvapplication.

FloridavinsurancevlawvrequiresvthatvifvavMedicarevSupplementvpolicyvisvsold,vthevagentvmus
tvdelivervanvOutlinevofvCoveragevtovthevapplicantvnovlatervthanvwhenvthevapplicationvisvtaken
.

AccordingvtovFloridavlaw,vwhichvofvthevfollowingvinformationvdoesvNOTvneedvtovbevobtained
vbyvanvagentvrecommendingvanvannuityvpurchase?v-vCORRECTvvANSWER-Maritalvstatus.




Floridavlawvrequiresvanvagentvwhovisvrecommendingvthevpurchasevofvanvannuityvtovavperso
nvtovobtainvinformationvregardingvallvofvthesevEXCEPTvthevperson'svmaritalvstatus.

AccordingvtovFloridavlaw,vwhichvofvthevfollowingvstatementsvaccuratelyvdescribesvanvadmitt
edvmailvordervinsurancevcompany?v-vCORRECTvvANSWER-
Itvmayvsolicitvinsurancevbusinessvbyvmailvwithoutvthevassistancevofvavlicensedvagent

AccordingvtovFlorida'svrulesvonvdisclosure,vavlifevinsurancevapplicantvisvexpectedvtovbevprov
idedvwithv-vCORRECTvvANSWER-avBuyer'svGuidevandvPolicyvSummary

Agentsvthatvhavevbeenvlicensedvforvlessvthanvsixvyearsvmustvcompletev__vhoursvofvcontinui
ngveducationveveryvtwovyears.v-vCORRECTvvANSWER-
Floridavagentsvlicensedvlessvthanvsixvyearsvarevrequiredvtovcompletev24vhoursvofvcontinuin
gveducation.

AllvofvthesevarevconsideredvsourcesvofvunderwritingvinformationvaboutvanvapplicantvEXCEP
Tv-vCORRECTvvANSWER-RatingvServices.