NY SERIES 17-52 EVALUATION EXAM 2025 QUESTIONS
WITH ANSWERS RATED A+
✔✔Evan's Major Medical policy is reinstated on February 1. When he suffers a heart
attack on February 6th, he files a claim. How should the company handle the claim? -
✔✔The claim is denied due to a 10-day probationary period.
✔✔What is a moral hazard? - ✔✔consumer attitude or behavior that leads to a higher
utilization of health care services when the services are covered by insurance
✔✔Which of the following is an example of a moral hazard? - ✔✔Filing a false
insurance claim
✔✔Upon the issuance of a conditional receipt for a renewal when the premium is paid
AFTER the time granted by the insurer, what is the maximum amount of time for
reinstatement of the policy? - ✔✔45 days
✔✔A Basic Hospital Policy pays expenses for - ✔✔hospital room and board
✔✔homogeneous - ✔✔of a similar kind
✔✔hetergeneous - ✔✔different; dissimilar
✔✔In order to make an accurate determination of the relative risk of an applicant for a
health policy, an underwriter would need to be able to examine a - ✔✔large number of
homogeneous risks.
✔✔Which benefit exists solely to encourage a disabled policy owner to attempt to return
to work? - ✔✔Recurrent Disability
✔✔Dental coverage plans which list all covered dental procedures and the price the
coverage will pay for each procedure are known as what type of plan? - ✔✔Scheduled
✔✔Dr. Martin purchases a $20,000 per month Own Occupation Disability Income
policy, and Dr. Foster buys an identical policy. Dr. Martin loses his right hand in a
boating accident at age 35 and is paid $240,000 per year for the rest of his life. Dr.
Foster pays his premium until age 65 and never files a disability claim. This clearly
demonstrates that insurance policies are what kind of contracts? - ✔✔Aleatory
Contracts
✔✔Which comparison of a Probationary Period to an Elimination Period is TRUE? -
✔✔Disability Income policies can contain both.
, ✔✔A Health Maintenance Organization (HMO) differs from a traditional insurer in that
an HMO - ✔✔emphasizes preventive medicine
✔✔The group conversion option is allowed for all of the following EXCEPT - ✔✔during
the annual benefits enrollment period.
✔✔Ann's Major Medical policy lapsed 6 months ago. When she fills out her
reinstatement application, the company can ask for no more than how many days of -
✔✔60 days
✔✔What is the maximum amount of time the insured has to file legal action against the
insurer after written proof of loss is provided? - ✔✔3 years
✔✔Which of the following is TRUE of a point of a service plan? - ✔✔A patient's in-
network care is coordinated by a primary care physician.
✔✔All of the following are TRUE regarding incomplete applications EXCEPT - ✔✔the
incomplete application can be accepted with the missing information added later.
✔✔Which rider will protect against inflation by increasing disability income benefits
annually after the start of a disability? - ✔✔cost of living adjustment
✔✔In a disability income policy, the specified period of time after the effective date and
before coverage goes into effect is the - ✔✔probationary period.
✔✔What is the major reason that insurance regulators are often critical of dread
disease insurance policies? - ✔✔Buyers often think they are getting broader coverage
than they actually purchase.
✔✔What is a beneficiary? - ✔✔A person or group who is legally entitled to receive the
death be
✔✔Which statement about COBRA is FALSE? - ✔✔An insured person who quits their
job forfeits their rights under COBRA
✔✔Which federal law provides for the continuation of Group Medical Expense coverage
for departing employees and their dependents? - ✔✔COBRA
✔✔ If an insurance company obtains an investigative consumer report on a prospective
insured , it MUST inform the prospect that it is permitted to do so under which of the
following Federal laws ? - ✔✔The Fair Credit Reporting Act
WITH ANSWERS RATED A+
✔✔Evan's Major Medical policy is reinstated on February 1. When he suffers a heart
attack on February 6th, he files a claim. How should the company handle the claim? -
✔✔The claim is denied due to a 10-day probationary period.
✔✔What is a moral hazard? - ✔✔consumer attitude or behavior that leads to a higher
utilization of health care services when the services are covered by insurance
✔✔Which of the following is an example of a moral hazard? - ✔✔Filing a false
insurance claim
✔✔Upon the issuance of a conditional receipt for a renewal when the premium is paid
AFTER the time granted by the insurer, what is the maximum amount of time for
reinstatement of the policy? - ✔✔45 days
✔✔A Basic Hospital Policy pays expenses for - ✔✔hospital room and board
✔✔homogeneous - ✔✔of a similar kind
✔✔hetergeneous - ✔✔different; dissimilar
✔✔In order to make an accurate determination of the relative risk of an applicant for a
health policy, an underwriter would need to be able to examine a - ✔✔large number of
homogeneous risks.
✔✔Which benefit exists solely to encourage a disabled policy owner to attempt to return
to work? - ✔✔Recurrent Disability
✔✔Dental coverage plans which list all covered dental procedures and the price the
coverage will pay for each procedure are known as what type of plan? - ✔✔Scheduled
✔✔Dr. Martin purchases a $20,000 per month Own Occupation Disability Income
policy, and Dr. Foster buys an identical policy. Dr. Martin loses his right hand in a
boating accident at age 35 and is paid $240,000 per year for the rest of his life. Dr.
Foster pays his premium until age 65 and never files a disability claim. This clearly
demonstrates that insurance policies are what kind of contracts? - ✔✔Aleatory
Contracts
✔✔Which comparison of a Probationary Period to an Elimination Period is TRUE? -
✔✔Disability Income policies can contain both.
, ✔✔A Health Maintenance Organization (HMO) differs from a traditional insurer in that
an HMO - ✔✔emphasizes preventive medicine
✔✔The group conversion option is allowed for all of the following EXCEPT - ✔✔during
the annual benefits enrollment period.
✔✔Ann's Major Medical policy lapsed 6 months ago. When she fills out her
reinstatement application, the company can ask for no more than how many days of -
✔✔60 days
✔✔What is the maximum amount of time the insured has to file legal action against the
insurer after written proof of loss is provided? - ✔✔3 years
✔✔Which of the following is TRUE of a point of a service plan? - ✔✔A patient's in-
network care is coordinated by a primary care physician.
✔✔All of the following are TRUE regarding incomplete applications EXCEPT - ✔✔the
incomplete application can be accepted with the missing information added later.
✔✔Which rider will protect against inflation by increasing disability income benefits
annually after the start of a disability? - ✔✔cost of living adjustment
✔✔In a disability income policy, the specified period of time after the effective date and
before coverage goes into effect is the - ✔✔probationary period.
✔✔What is the major reason that insurance regulators are often critical of dread
disease insurance policies? - ✔✔Buyers often think they are getting broader coverage
than they actually purchase.
✔✔What is a beneficiary? - ✔✔A person or group who is legally entitled to receive the
death be
✔✔Which statement about COBRA is FALSE? - ✔✔An insured person who quits their
job forfeits their rights under COBRA
✔✔Which federal law provides for the continuation of Group Medical Expense coverage
for departing employees and their dependents? - ✔✔COBRA
✔✔ If an insurance company obtains an investigative consumer report on a prospective
insured , it MUST inform the prospect that it is permitted to do so under which of the
following Federal laws ? - ✔✔The Fair Credit Reporting Act
