Accident and Health Insurance Study Guide | Questions &
Answers | Complete Review | Graded A+
1. T has just returned to work after total disability but is only able to work half
the day. T's policy pays the difference between what the employer pays T and
what T earned prior to disability. T has:
Residual Disability
Any Occupation
Own Occupation
Partial Disability
2. 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
3. What is one condition under which a producer may be exempt from
continuing education requirements for license renewal?
The producer has been licensed for less than 10 years.
The producer has a degree in insurance.
The producer is called up to military duty and secures a military
waiver.
The producer has completed 20 hours of coursework.
4. Gives insurer the right to have insured take a physical exam when a claim is
filed. And If a claim arises from the insured's death, the insurer has a right to
, order this and the insurer will pay for it.
Proof of loss
Payment of claims
Physical examination and autopsy provision
Unpaid premium
5. If an insured under a limited group plan becomes totally disabled and the
group benefits are discontinued, how would the insured's coverage be
affected if they recover after 45 days?
The insured would lose all coverage immediately after the
discontinuation of benefits.
The insured would have coverage for 45 days after the
discontinuation of benefits, as it falls within the 90-day limit.
The insured would have coverage for 90 days from the date of
recovery.
The insured would have coverage for 30 days after recovery
regardless of the discontinuation.
6. 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
,7. Describe the primary purpose of a Disability Buy-Out policy in relation to
business entities.
The primary purpose is to cover salary expenses during disability.
The primary purpose is to provide health insurance benefits.
The primary purpose is to ensure that the business can buy out the
interest of a disabled owner.
The primary purpose is to provide direct income to the disabled
employee.
8. What is the maximum number of days coverage applies after the
discontinuation of a limited group plan due to total disability?
12 months
30 days
90 days
60 days
9. If an individual receives an Unconditional Receipt for their health insurance
application, what implications does this have for their coverage during the
waiting period for policy approval?
They are not covered at all until the policy is issued.
They are covered for claims that occur during the waiting period.
They must wait for the policy to be issued before any claims can be
made.
They are only covered for specific types of claims outlined in the
receipt.
, 10. Describe the implications of a noncancelable policy for the insured
individual.
The insured can expect limited benefits and potential cancellation of
coverage.
The insured is guaranteed that their premium will not increase and
the policy cannot be canceled except for nonpayment.
The insured can have their policy canceled at any time before age 50.
The insured must switch occupations to maintain coverage.
11. Discuss the implications of policy reinstatement on coverage for pre-existing
conditions.
The insurer is obligated to cover all losses regardless of the
reinstatement date.
Reinstatement guarantees coverage for all types of losses
immediately.
Pre-existing conditions are always covered after policy reinstatement.
If a policy is reinstated, coverage may not apply to losses that occur
shortly after reinstatement, especially if they are related to pre-
existing conditions.
12. Why is C not required to notify the Illinois Director of Insurance about his
move?
C is required to notify because he is a resident license holder.
C is not required to notify because he holds a non-resident license.
C is not required to notify because he has an expired license.
C is exempt due to his insurance policy provisions.
Answers | Complete Review | Graded A+
1. T has just returned to work after total disability but is only able to work half
the day. T's policy pays the difference between what the employer pays T and
what T earned prior to disability. T has:
Residual Disability
Any Occupation
Own Occupation
Partial Disability
2. 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
3. What is one condition under which a producer may be exempt from
continuing education requirements for license renewal?
The producer has been licensed for less than 10 years.
The producer has a degree in insurance.
The producer is called up to military duty and secures a military
waiver.
The producer has completed 20 hours of coursework.
4. Gives insurer the right to have insured take a physical exam when a claim is
filed. And If a claim arises from the insured's death, the insurer has a right to
, order this and the insurer will pay for it.
Proof of loss
Payment of claims
Physical examination and autopsy provision
Unpaid premium
5. If an insured under a limited group plan becomes totally disabled and the
group benefits are discontinued, how would the insured's coverage be
affected if they recover after 45 days?
The insured would lose all coverage immediately after the
discontinuation of benefits.
The insured would have coverage for 45 days after the
discontinuation of benefits, as it falls within the 90-day limit.
The insured would have coverage for 90 days from the date of
recovery.
The insured would have coverage for 30 days after recovery
regardless of the discontinuation.
6. 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
,7. Describe the primary purpose of a Disability Buy-Out policy in relation to
business entities.
The primary purpose is to cover salary expenses during disability.
The primary purpose is to provide health insurance benefits.
The primary purpose is to ensure that the business can buy out the
interest of a disabled owner.
The primary purpose is to provide direct income to the disabled
employee.
8. What is the maximum number of days coverage applies after the
discontinuation of a limited group plan due to total disability?
12 months
30 days
90 days
60 days
9. If an individual receives an Unconditional Receipt for their health insurance
application, what implications does this have for their coverage during the
waiting period for policy approval?
They are not covered at all until the policy is issued.
They are covered for claims that occur during the waiting period.
They must wait for the policy to be issued before any claims can be
made.
They are only covered for specific types of claims outlined in the
receipt.
, 10. Describe the implications of a noncancelable policy for the insured
individual.
The insured can expect limited benefits and potential cancellation of
coverage.
The insured is guaranteed that their premium will not increase and
the policy cannot be canceled except for nonpayment.
The insured can have their policy canceled at any time before age 50.
The insured must switch occupations to maintain coverage.
11. Discuss the implications of policy reinstatement on coverage for pre-existing
conditions.
The insurer is obligated to cover all losses regardless of the
reinstatement date.
Reinstatement guarantees coverage for all types of losses
immediately.
Pre-existing conditions are always covered after policy reinstatement.
If a policy is reinstated, coverage may not apply to losses that occur
shortly after reinstatement, especially if they are related to pre-
existing conditions.
12. Why is C not required to notify the Illinois Director of Insurance about his
move?
C is required to notify because he is a resident license holder.
C is not required to notify because he holds a non-resident license.
C is not required to notify because he has an expired license.
C is exempt due to his insurance policy provisions.
