COMPLETE QUESTIONS AND ANSWERS | 2025/2026 LATEST UPDATED
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An insurance company receives E's application for an individual health policy. E did not
complete all of the medical history questions because she could not remember the exact dates. E
signed the policy and submitted it to the insurance company anyway. A few weeks later, E suffers
a heart attack and is hospitalized without completing the medical history questions and paying
the initial premium. E is not insured. Which of the following clauses details the conditions that E
did not meet? - (ANSWER)Consideration clause
An insured pays premiums on an annual basis for an individual health insurance policy. What is
the MINIMUM number of days for the Grace Period provision? - (ANSWER)31
Which of these circumstances is a Business Disability Buy-Sell policy designed to help in the
sale of a business? - (ANSWER)Business owner becoming disabled
The Notice of Claims provision requires a policyowner to - (ANSWER)notify an insurer of a
claim within a specified time
,Under which of the following circumstances do the benefits under COBRA continuation
coverage expire? - (ANSWER)All group health plans are eliminated by the employer
Which of the following statements describes what an Accident and Health policyowner may
NOT do? - (ANSWER)Adjust the premium payments
According to the Time Payment of Claims provision, the insurer must pay Disability Income
benefits no less frequently than which of the following options? - (ANSWER)Monthly
Which statement is TRUE regarding a group accident & health policy issued to an employer? -
(ANSWER)The employer is the policyowner and each employee receives a certificate of
coverage
What should an insured do if the insurer does not send claims forms within the time period set
forth in a health policy's Claims Forms provision? - (ANSWER)Submit the claim in any form
Which health policy clause stipulates that an insurance company must attach a copy of the
application to the policy to ensure that it is part of the contract? - (ANSWER)Entire Contract
,Many small business owners worry how their business would survive financially if the owner
becomes disabled. The policy which BEST addresses this concern is - (ANSWER)Business
Overhead Expense
T is covered by two health insurance plans: a group plan through his employer and his spouse's
plan as a dependent. When T submits a claim, his employer's plan is considered what type of
carrier under the Model Group Coordination of Benefits provision? - (ANSWER)Primary
carrier
When an employee is required to pay a portion of the premium for an employer/employee group
health plan, the employee is covered under which of the following plans? -
(ANSWER)Contributory
Which of the following statements is correct regarding an employer/employee group health plan?
- (ANSWER)the employer receives a master policy and the employees receive certificates
What is considered to be a characteristic of a Conditionally Renewable Health Insurance policy?
- (ANSWER)Premiums may increase at time of renewal
J, an Accidental Death and Dismemberment (AD&D) policy holder, dies after injuries sustained
in an accident. J's ages as stated on the application five years ago was found to be understated by
, ten years. Which of the following actions will the insurance company take? - (ANSWER)The
insurer will adjust the benefit to what the premiums paid would have purchased at the time the
insured's actual age
Which of the following statements BEST describes how a policy that uses the "accidental bodily
injury" definition of an accident differs from one that used the "accidental means" definition? -
(ANSWER)Less restrictive
M's insurance company denied a reinstatement application for her lapsed health insurance policy.
The company did not notify M of this denial. How many days from the reinstatement application
date does the insurance company have to notify M of the denial before the policy will be
automatically placed back in force? - (ANSWER)45 days
With Optionally Renewable Health policies, the insurer may - (ANSWER)review the policy
annually and determine whether or not to renew it
Which of the following BEST describes a short-term medical expense policy? -
(ANSWER)Nonrenewable