Accident & Health Insurance Exam Questions | Actual
Exam Questions & 100% Correct Answers | Latest Update
2026 | Exam Prep
1. If an agent fails to have the applicant review and sign the application, what
potential issue could arise during the claims process?
The agent will be held liable for any claims.
The applicant will receive a higher benefit amount.
The policy will automatically be issued without restrictions.
The claim may be denied due to discrepancies in the application.
2. Which of the following statements correctly describes the relationship
between a disability income (DI) insurance policy's benefit amount and the
insured's income?
DI benefits can be any amount the insured is willing to pay for.
DI policy benefits are unrelated to income.
DI policy benefits may never exceed the insured's income.
DI policy benefits may never be less than the insured's income.
3. The maximum number of in-hospital days coverage provided by an individual
policy under minimum standards is:
30 days
180 days
45 days
90 days
,4. Illinois law requires that a licensed insurance producer notify the Director, in
writing, of any change in their residential address within m
60 days
30 days
10 days
90 days
5. If an insurance producer claims that a health insurance policy covers all
medical expenses without verifying the policy details, what could this action
be classified as?
Defamation
False Advertising
Misrepresentation
Twisting
6. In New Jersey, what is the maximum length of time a health insurer may
require a probationary period for an illness?
10 days
60 days
20 days
30 days
7. What is one of the mandatory provisions in a health insurance policy?
Change of Occupation
Time Limit on Certain Defenses
, Illegal Occupation
Intoxicant/Narcotic Usage
8. If an insurance company issues deceptive statements about its assets, this
action is
an unfair trade practice.
falsification.
unfair discrimination.
false advertising.
9. Describe the role of the Guarantee Association in protecting policyholders
when an insurer becomes insolvent.
The Guarantee Association only assists with claims processing during
normal operations of an insurer.
The Guarantee Association provides financial protection to
policyholders by covering losses up to a specified limit when their
insurer is unable to fulfill its obligations due to insolvency.
The Guarantee Association is responsible for regulating insurance
premiums.
The Guarantee Association offers additional benefits to policyholders
regardless of insurer status.
10. If a subscriber has a PPO plan and needs to see a specialist, what steps
should they take to ensure coverage?
They can directly schedule an appointment with the specialist
without needing a referral.
They must submit a request for pre-authorization before seeing the
specialist.
, They need to check if the specialist is in-network before scheduling.
They must first obtain a referral from their primary care physician.
11. What is the term used to describe a document that provides temporary
insurance coverage before a policy is officially issued?
Policy Endorsement
Premium Notice
Binder
Claim Form
12. Which of the following Health Insurance renewability provisions guarantees
the amount of future premiums?
Conditionally Renewable
Noncancelable
Guaranteed Renewable
Optionally Renewable
13. If an insured individual files a claim for a loss that is covered under their
policy, what is the insurer's expected action?
deny the claim
offer a settlement
increase the premium
pay covered losses
14. Describe the implications of a cancelable policy for both the insured and the
insurer.
Exam Questions & 100% Correct Answers | Latest Update
2026 | Exam Prep
1. If an agent fails to have the applicant review and sign the application, what
potential issue could arise during the claims process?
The agent will be held liable for any claims.
The applicant will receive a higher benefit amount.
The policy will automatically be issued without restrictions.
The claim may be denied due to discrepancies in the application.
2. Which of the following statements correctly describes the relationship
between a disability income (DI) insurance policy's benefit amount and the
insured's income?
DI benefits can be any amount the insured is willing to pay for.
DI policy benefits are unrelated to income.
DI policy benefits may never exceed the insured's income.
DI policy benefits may never be less than the insured's income.
3. The maximum number of in-hospital days coverage provided by an individual
policy under minimum standards is:
30 days
180 days
45 days
90 days
,4. Illinois law requires that a licensed insurance producer notify the Director, in
writing, of any change in their residential address within m
60 days
30 days
10 days
90 days
5. If an insurance producer claims that a health insurance policy covers all
medical expenses without verifying the policy details, what could this action
be classified as?
Defamation
False Advertising
Misrepresentation
Twisting
6. In New Jersey, what is the maximum length of time a health insurer may
require a probationary period for an illness?
10 days
60 days
20 days
30 days
7. What is one of the mandatory provisions in a health insurance policy?
Change of Occupation
Time Limit on Certain Defenses
, Illegal Occupation
Intoxicant/Narcotic Usage
8. If an insurance company issues deceptive statements about its assets, this
action is
an unfair trade practice.
falsification.
unfair discrimination.
false advertising.
9. Describe the role of the Guarantee Association in protecting policyholders
when an insurer becomes insolvent.
The Guarantee Association only assists with claims processing during
normal operations of an insurer.
The Guarantee Association provides financial protection to
policyholders by covering losses up to a specified limit when their
insurer is unable to fulfill its obligations due to insolvency.
The Guarantee Association is responsible for regulating insurance
premiums.
The Guarantee Association offers additional benefits to policyholders
regardless of insurer status.
10. If a subscriber has a PPO plan and needs to see a specialist, what steps
should they take to ensure coverage?
They can directly schedule an appointment with the specialist
without needing a referral.
They must submit a request for pre-authorization before seeing the
specialist.
, They need to check if the specialist is in-network before scheduling.
They must first obtain a referral from their primary care physician.
11. What is the term used to describe a document that provides temporary
insurance coverage before a policy is officially issued?
Policy Endorsement
Premium Notice
Binder
Claim Form
12. Which of the following Health Insurance renewability provisions guarantees
the amount of future premiums?
Conditionally Renewable
Noncancelable
Guaranteed Renewable
Optionally Renewable
13. If an insured individual files a claim for a loss that is covered under their
policy, what is the insurer's expected action?
deny the claim
offer a settlement
increase the premium
pay covered losses
14. Describe the implications of a cancelable policy for both the insured and the
insurer.
