GA Health Insurance Exam Questions And Answers With Verified Updates

For which of the following expenses does a Basic Hospital policy pay? - Hospital room and board A policy owner would like to change the beneficiary on an Accidental Death and Dismemberment (AD&D) insurance policy and make the change permanent. Which type of designation would fulfill this need? - Irrevocable Which of the following BEST describes how a Preferred Provider Organization (PPO) is less restrictive than a Health Maintenance Organization (HMO)? - more physician to choose from A prepaid application for individual Disability Income insurance was recently submitted to an insurer. When the insurer received the Medical Information Bureau (MIB) report, the report showed that the applicant had suffered a stroke 18 months ago, something that was not disclosed on the application. Which of the following actions would the insurance company NOT take? - send a notice to the MIB that the applicant was declined A "reimbursement policy" pays what amount of covered Long-Term Care expenses? - actual covered expenses up to the daily maximum A characteristic of Preferred Provider Organization (PPO) would be: - discounted fees for the patient A comprehensive major medical health insurance policy contains an Eligible Expenses provisions which identifies the types of health care services that are converted. All of the following health care services are typically converted, EXCEPT for: - experimental and investigative services A domestic insurance company in Georgia is considered a company that: - is incorporated and formed in Georgia A domestic insurance company MUST be examined by the Commissioner every ___ years. - 5A major medical policy typically: - provides benefits for reasonable and necessary medical expenses, subject to policy limits A producer must notify the Commissioner within ___ days of an address change. - 30 Accidental Death coverage is provided to commercial airline passengers in which of the following types of policies? - Blanket Accident policy According to the Time Payment of Claims provision, the insurer must pay Disability Income benefits no less frequently than which of the following options? - monthly After an insured gives notice of loss, what must he/she do if the insurer does not furnish forms? - file written proof of loss Agent J takes an application and initial premium from an applicant and sends the application and premium check to the insurance company. The insurance company returns the check back to J because the check is made out to J instead of the insurance company. What action should J take? - return to the customer, collect a new check made out to the insurance company, and send the new check out to the insurance company All accident and sickness plans MUST provide coverage on newborn children for ___ days - 31 All of the following are limited benefit plans: - cancer policies, dental policies, critical illness policies An agent takes an individual Disability Income application, collects the appropriate premium, and issues the prospective insured a conditional receipt. The next step the insurance company will take is to: - determine if the applicant in an acceptable risk by completing standard underwriting procedures An agent's license can be suspended or revoked by: - writing primarily controlled businessAn example of an unfair claims practice would be: - failing to effectuate prompt, fair, and equitable settlements of a claim An example of an unfair claims settlement practice is: - turning down a claim without providing the basis of denial An insurance agent is guilty of ___ if the agent misrepresents a policy to induce a policy owner to surrender an existing policy. - twisting An insurance agent is in violation of the Rules Governing Advertisement of Life Insurance and Annuities if the agent takes which of the following actions during a sales presentation? - refers to guaranteed policy dividends An insurance company normally has 2 years to contest information provided on an accident and health application. This 2 year period begins on the date that the: - insurer dates the policy An insurance company which engages in boycott, coercion, and intimidation that results in the unreasonable restraint of trade is committing a prohibited act under Georgia insurance laws covering: - unfair trade policies An insured covered by Accidental Death and Dismemberment (AD&D) insurance has just died. What will happen if the primary beneficiary had already died before the insured and contingent beneficiary? - proceeds will go to the contingent beneficiary An insured must notify an insurer of a medical claim within how many days after an accident? - 20 An insured owns an individual Disability Income policy with a 30-day Elimination Period for sickness and accidents and a monthly indemnity benefit of $500. If the insured is disabled for 3 1/2 months, what is the MAXIMUM amount he would receive for an approved claim? - $1,250 An insurer receives proof of loss for an acceptable medical expense claim under an Individual Health Insurance Policy. Under the Time of Payment of Claims provision, the insurer MUST pay the benefits: - immediatelyB is a teacher who was injured in a car accident and cannot work. She is now receiving monthly benefits as a result of this accident. Which type of policy does B have? - Disability Income