Exam questions and Correct Answers
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. -
Correct 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 - Correct 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. - Correct 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. - Correct 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. -
Correct 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