Florida Health Insurance Exam
Questions with Verified Answers
Consideration - ✔✔It is the binding force in any contract. Something of value that each party
gives to the other. Insurer's is the promise to pay for losses; insured's is the premium and
statements on the application.
Representations - ✔✔statements believed to be true to the best of one's knowledge, but they
are not guaranteed to be true.
The Insured's statements on the application are _________________.
warranty - ✔✔An absolutely true statement upon which the validity of the insurance policy
depends. A guaranteed statement
Conditional contract - ✔✔Requires that certain conditions must be met by the policy owner
and the company in order for the contract to be executed, and before each party fulfills its
obligations.
unilateral contract - ✔✔only one of the parties to the contract is legally bound to do anything
contract of adhesion - ✔✔prepared by one of the parties (insurer) and accepted or rejected by
the other party (insured)
aleatory - ✔✔an exchange of unequal amounts or values
application - ✔✔the applicant's written request to the insurance company to issue a policy or
contract based upon his/her information.
,notice to the applicant - ✔✔informs applicant a credit report will be ordered concerning past
history and any other life and health insurance for which they have previously applied.
health insurance application signatures req'd - ✔✔proposed insured, the policyowner (if diff.
than insured) and the agent
changes in the application - ✔✔first and best is to start over with new application; if not
practical, draw a line through the incorrect answer and inset correct one. Applicant must inital
the correct answer.
Initial premium - ✔✔sum of money collected for a health insurance policy; coverage does not
begin until the insurer has approved the application and issued the policy
Sources of Insurability Information - ✔✔Attending Physician Report, Medical Info. and
Consumer Reports, Medical exam report and Fair Credit Reporting Act; applicant must be
advised of the sources to be used and how the info is gathered.
Attending Physicians report - ✔✔Requested by underwriter. A report or statement from the
proposed insured's own physician detailing the specifics of an accident or disease, or treatment
and prognosis.
Medical Information Bureau (MIB) - ✔✔A membership corporation owned by member
insurance companies; a non-profit which receives adverse medical info. from insur. companies
and maintains confidential medical impairment info on individuals history. An applicant cannot
be refused due to adverse information.
Medical exam report - ✔✔Conducted by physicians or paramedics at the insurance company's
expense. Usually not required with health insurance, more common with life insurance
underwriting. It is required by law that an insurer informs the applicant of all sources that will
be contacted and how the info will be gathered
, Investigative Consumer Report - ✔✔Similar to consumer reports in that they also provide
information on the consumer's character, reputation, and habits, but through investigation and
interviews with associates, friends & neighbors. Consumer must be advised in writing within 3
days
Free Look Period - ✔✔An amount of time provided to an insured in order to examine the
insurance policy. allows the insured to review the policy & return it for a refund within a certain
time
Effective Date of Coverage - ✔✔Time when policy is delivered; if the premium is not paid with
the application, the agent must obtain the premium and a statement of continued good health.
agents responsibility - ✔✔compare benefits, limitations & exclusions found in the current and
the proposed replacement policy
ensure the current policy is not cancelled before the new policy is issued
HIV exams - ✔✔require prior informed written consent from the applicant; HIV exam results
may be disclosed to underwriters, but not agents.
Basic Hospital Expense Coverage - ✔✔cover hospital room and board, and miscellaneous
hospital expenses, such as lab, x-ray charges, medicines, use of operating room/supplies, while
the insured is confined in a hospital.
miscellaneous hospital expenses - ✔✔Pays for other expenses associated with a hospital stay;
expressed either as a multiple of the room and board charge or as a flat amount
basic medical expense coverage - ✔✔provides coverage for nonsurgical services a physician
provides
Basic Surgical Expense Coverage - ✔✔• Commonly written in conjunction with hospital expense
policies
Questions with Verified Answers
Consideration - ✔✔It is the binding force in any contract. Something of value that each party
gives to the other. Insurer's is the promise to pay for losses; insured's is the premium and
statements on the application.
Representations - ✔✔statements believed to be true to the best of one's knowledge, but they
are not guaranteed to be true.
The Insured's statements on the application are _________________.
warranty - ✔✔An absolutely true statement upon which the validity of the insurance policy
depends. A guaranteed statement
Conditional contract - ✔✔Requires that certain conditions must be met by the policy owner
and the company in order for the contract to be executed, and before each party fulfills its
obligations.
unilateral contract - ✔✔only one of the parties to the contract is legally bound to do anything
contract of adhesion - ✔✔prepared by one of the parties (insurer) and accepted or rejected by
the other party (insured)
aleatory - ✔✔an exchange of unequal amounts or values
application - ✔✔the applicant's written request to the insurance company to issue a policy or
contract based upon his/her information.
,notice to the applicant - ✔✔informs applicant a credit report will be ordered concerning past
history and any other life and health insurance for which they have previously applied.
health insurance application signatures req'd - ✔✔proposed insured, the policyowner (if diff.
than insured) and the agent
changes in the application - ✔✔first and best is to start over with new application; if not
practical, draw a line through the incorrect answer and inset correct one. Applicant must inital
the correct answer.
Initial premium - ✔✔sum of money collected for a health insurance policy; coverage does not
begin until the insurer has approved the application and issued the policy
Sources of Insurability Information - ✔✔Attending Physician Report, Medical Info. and
Consumer Reports, Medical exam report and Fair Credit Reporting Act; applicant must be
advised of the sources to be used and how the info is gathered.
Attending Physicians report - ✔✔Requested by underwriter. A report or statement from the
proposed insured's own physician detailing the specifics of an accident or disease, or treatment
and prognosis.
Medical Information Bureau (MIB) - ✔✔A membership corporation owned by member
insurance companies; a non-profit which receives adverse medical info. from insur. companies
and maintains confidential medical impairment info on individuals history. An applicant cannot
be refused due to adverse information.
Medical exam report - ✔✔Conducted by physicians or paramedics at the insurance company's
expense. Usually not required with health insurance, more common with life insurance
underwriting. It is required by law that an insurer informs the applicant of all sources that will
be contacted and how the info will be gathered
, Investigative Consumer Report - ✔✔Similar to consumer reports in that they also provide
information on the consumer's character, reputation, and habits, but through investigation and
interviews with associates, friends & neighbors. Consumer must be advised in writing within 3
days
Free Look Period - ✔✔An amount of time provided to an insured in order to examine the
insurance policy. allows the insured to review the policy & return it for a refund within a certain
time
Effective Date of Coverage - ✔✔Time when policy is delivered; if the premium is not paid with
the application, the agent must obtain the premium and a statement of continued good health.
agents responsibility - ✔✔compare benefits, limitations & exclusions found in the current and
the proposed replacement policy
ensure the current policy is not cancelled before the new policy is issued
HIV exams - ✔✔require prior informed written consent from the applicant; HIV exam results
may be disclosed to underwriters, but not agents.
Basic Hospital Expense Coverage - ✔✔cover hospital room and board, and miscellaneous
hospital expenses, such as lab, x-ray charges, medicines, use of operating room/supplies, while
the insured is confined in a hospital.
miscellaneous hospital expenses - ✔✔Pays for other expenses associated with a hospital stay;
expressed either as a multiple of the room and board charge or as a flat amount
basic medical expense coverage - ✔✔provides coverage for nonsurgical services a physician
provides
Basic Surgical Expense Coverage - ✔✔• Commonly written in conjunction with hospital expense
policies
