NY STATE INSURANCE LICENSE (2026 SUMMER-FALL) PRACTICE EXAM QUESTIONS
WITH WELL DETAILED SOLUTIONS
Under what circumstance does an accident and health insurer have the right to request an
autopsy?
1. When the claim exceeds an amount specified in the policy
2. When 2 days have passed after death
3. When not prohibited by state law
4. When consent is given by the beneficiary
3. When not prohibited by state law
Which of the following accurately describes the "time limit on certain defenses"?
1. After a stated period of time, claims cannot be denied due to material misrepresentation
on the application
2. All claims can be disputed after two years
3. An insured cannot file a lawsuit within 90 days of the claim being filed
4. The right to return an accident and health policy must be within 10 days of policy delivery
,1. After a stated period of time, claims cannot be denied due to material misrepresentation
on the application
Patrick purchased a long-term care policy. He has a health condition for which medical
treatment was recommended by a physician within 6 months prior to the policy's effective
date. This condition is called a(n)
1. antecedent condition
2. pre-existing condition
3. hazardous condition
4. grandfathered condition
2. pre-existing condition
Which of the following describes coverage for the Medicare Part B coinsurance?
1. Only a Long-term care policy will cover Medicare Part B coinsurance
2. A Medicare Supplement optional benefit
3. A Medicare Supplement core benefit
4. Medicare Part B does not require a coinsurance so no additional coverage is needed
,3. A Medicare Supplement core benefit
Larry has a Major Medical Expense policy for his family with a $1,000 per family/per year
deductible and an 80/20 coinsurance provision. If Larry's family files four claims of $400,
$800, $100, and $700 in one year, how much will the insurance company pay?
1. $500
2. $800
3. $1,000
4. $1,200
2. $800
(($400 + $800 + $100 + $700 = $2,000. The insurance company pays 80% of $1,000
(outstanding balance after deductible is paid), or $800.))
Long-term care policies issued in New York must provide benefits for at least
1. 6 months
2. 12 months
3. 18 months
, 4. 24 months
2. 12 months
Which of the following types of insurers limits the exposures it writes to those of its
owners?
1. Restricted insurer
2. Limited insurer
3. Confined insurer
4. Captive insurer
4. Captive insurer
Notice of information practices must be given to a policyholder at least
1. every year
2. every two years
3. every three years
WITH WELL DETAILED SOLUTIONS
Under what circumstance does an accident and health insurer have the right to request an
autopsy?
1. When the claim exceeds an amount specified in the policy
2. When 2 days have passed after death
3. When not prohibited by state law
4. When consent is given by the beneficiary
3. When not prohibited by state law
Which of the following accurately describes the "time limit on certain defenses"?
1. After a stated period of time, claims cannot be denied due to material misrepresentation
on the application
2. All claims can be disputed after two years
3. An insured cannot file a lawsuit within 90 days of the claim being filed
4. The right to return an accident and health policy must be within 10 days of policy delivery
,1. After a stated period of time, claims cannot be denied due to material misrepresentation
on the application
Patrick purchased a long-term care policy. He has a health condition for which medical
treatment was recommended by a physician within 6 months prior to the policy's effective
date. This condition is called a(n)
1. antecedent condition
2. pre-existing condition
3. hazardous condition
4. grandfathered condition
2. pre-existing condition
Which of the following describes coverage for the Medicare Part B coinsurance?
1. Only a Long-term care policy will cover Medicare Part B coinsurance
2. A Medicare Supplement optional benefit
3. A Medicare Supplement core benefit
4. Medicare Part B does not require a coinsurance so no additional coverage is needed
,3. A Medicare Supplement core benefit
Larry has a Major Medical Expense policy for his family with a $1,000 per family/per year
deductible and an 80/20 coinsurance provision. If Larry's family files four claims of $400,
$800, $100, and $700 in one year, how much will the insurance company pay?
1. $500
2. $800
3. $1,000
4. $1,200
2. $800
(($400 + $800 + $100 + $700 = $2,000. The insurance company pays 80% of $1,000
(outstanding balance after deductible is paid), or $800.))
Long-term care policies issued in New York must provide benefits for at least
1. 6 months
2. 12 months
3. 18 months
, 4. 24 months
2. 12 months
Which of the following types of insurers limits the exposures it writes to those of its
owners?
1. Restricted insurer
2. Limited insurer
3. Confined insurer
4. Captive insurer
4. Captive insurer
Notice of information practices must be given to a policyholder at least
1. every year
2. every two years
3. every three years
