Louisiana Life and Health Insurance Exam questions
with solved solutions
All of the following are correct about the required provisions of a health insurance
policy EXCEPT
A. The entire contract clause means the signed application, policy, endorsements,
and attachments constitute the entire contract.
B. A reinstated policy provides immediate coverage for an illness.
C. Policies become incontestable after being in force for 3 years.
D. A grace period of 31 days is found in an annual pay policy. - ANSWER>>B. A
reinstated policy provides immediate coverage for an illness.
Accidental injury is covered immediately, but to protect the insurer against
adverse selection, losses resulting from sickness are covered only if the sickness
occurs at least 10 days after the reinstatement date.
An insured pays a monthly premium of $100 for health insurance. What would be
the duration of the grace period under the policy?
A. 15 days
B. 30 days
C. 60 days
D. 7 days - ANSWER>>B. 30 days
,The grace period is 30 days for all health insurance policies in Louisiana.
Question 11 of 15
An applicant for an individual health policy failed to complete the application
properly. Before being able to complete the application and pay the initial
premium, she is confined to a hospital. This will not be covered by insurance
because she has not met the conditions specified in the
A. Insuring Clause.
B. Pre-existing Conditions Clause.
C. Eligibility Clause.
D. Consideration Clause. - ANSWER>>D. Consideration Clause.
The consideration clause specifies that both parties to the contract must give
some valuable consideration. The payment of the premium is the consideration
given by the applicant. Because the applicant had not paid an initial premium, she
is not covered by insurance.
Question 12 of 15
Under the mandatory uniform provision Notice of Claim, the first notice of injury
or sickness covered under an accident and health policy must contain
A. An estimate of the total amount of medical and hospital expense for the loss.
B. A complete physician's statement.
C. A statement that is sufficiently clear to identify the insured and the nature of
the claim.
,D. A statement from the insured's employer showing that the insured was unable
to work. - ANSWER>>C. A statement that is sufficiently clear to identify the
insured and the nature of the claim.
The Insurance Code requires that each policy must include, "Written notice of
claim must be given to the insurer within 20 days after the occurrence or
commencement of any loss covered by the policy, or as soon thereafter as is
reasonably possible".
Question 13 of 15
The expense for an autopsy covered under the physical exam and autopsy
provision is paid by
A. The estate of the insured.
B. The insurer.
C. The state's autopsy fund.
D. The limits of coverage under the health insurance policy. - ANSWER>>B. The
insurer
Where not forbidden by state law, the insurer, at its own expense, may cause an
autopsy to be performed on a deceased insured.
An insured notifies the insurance company that he has become disabled. What
provision states that claims must be paid immediately upon written proof of loss?
A. Time of Payment of Claims
B. Incontestability
C. Physical Exam and Autopsy
, D. Legal Actions - ANSWER>>A. Time of Payment of Claims
The Time of Payment of Claims provision specifies that claims are to be paid
immediately upon written proof of loss.
Which renewability provision allows an insurer to terminate a policy for any
reason, and to increase the premiums for any class of insureds?
A. Conditionally renewable
B. Cancellable
C. Guaranteed renewable
D. Optionally renewable - ANSWER>>D. Optionally renewable
The renewability provision in an optionally renewable policy gives the insurer the
option to terminate the policy for any reason on the date specified in the contract
(usually a renewal date). Furthermore, this provision allows the insurer to
increase the premium for any class of optionally renewable insureds.
When an insurer issues an individual health insurance policy that is guaranteed
renewable, the insurer agrees
A. To charge a lower premium every year the policy is renewed.
B.Not to change the premium rate for any reason.
C. To renew the policy indefinitely.
D. To renew the policy until the insured has reached age 65. - ANSWER>>D. To
renew the policy until the insured has reached age 65.
with solved solutions
All of the following are correct about the required provisions of a health insurance
policy EXCEPT
A. The entire contract clause means the signed application, policy, endorsements,
and attachments constitute the entire contract.
B. A reinstated policy provides immediate coverage for an illness.
C. Policies become incontestable after being in force for 3 years.
D. A grace period of 31 days is found in an annual pay policy. - ANSWER>>B. A
reinstated policy provides immediate coverage for an illness.
Accidental injury is covered immediately, but to protect the insurer against
adverse selection, losses resulting from sickness are covered only if the sickness
occurs at least 10 days after the reinstatement date.
An insured pays a monthly premium of $100 for health insurance. What would be
the duration of the grace period under the policy?
A. 15 days
B. 30 days
C. 60 days
D. 7 days - ANSWER>>B. 30 days
,The grace period is 30 days for all health insurance policies in Louisiana.
Question 11 of 15
An applicant for an individual health policy failed to complete the application
properly. Before being able to complete the application and pay the initial
premium, she is confined to a hospital. This will not be covered by insurance
because she has not met the conditions specified in the
A. Insuring Clause.
B. Pre-existing Conditions Clause.
C. Eligibility Clause.
D. Consideration Clause. - ANSWER>>D. Consideration Clause.
The consideration clause specifies that both parties to the contract must give
some valuable consideration. The payment of the premium is the consideration
given by the applicant. Because the applicant had not paid an initial premium, she
is not covered by insurance.
Question 12 of 15
Under the mandatory uniform provision Notice of Claim, the first notice of injury
or sickness covered under an accident and health policy must contain
A. An estimate of the total amount of medical and hospital expense for the loss.
B. A complete physician's statement.
C. A statement that is sufficiently clear to identify the insured and the nature of
the claim.
,D. A statement from the insured's employer showing that the insured was unable
to work. - ANSWER>>C. A statement that is sufficiently clear to identify the
insured and the nature of the claim.
The Insurance Code requires that each policy must include, "Written notice of
claim must be given to the insurer within 20 days after the occurrence or
commencement of any loss covered by the policy, or as soon thereafter as is
reasonably possible".
Question 13 of 15
The expense for an autopsy covered under the physical exam and autopsy
provision is paid by
A. The estate of the insured.
B. The insurer.
C. The state's autopsy fund.
D. The limits of coverage under the health insurance policy. - ANSWER>>B. The
insurer
Where not forbidden by state law, the insurer, at its own expense, may cause an
autopsy to be performed on a deceased insured.
An insured notifies the insurance company that he has become disabled. What
provision states that claims must be paid immediately upon written proof of loss?
A. Time of Payment of Claims
B. Incontestability
C. Physical Exam and Autopsy
, D. Legal Actions - ANSWER>>A. Time of Payment of Claims
The Time of Payment of Claims provision specifies that claims are to be paid
immediately upon written proof of loss.
Which renewability provision allows an insurer to terminate a policy for any
reason, and to increase the premiums for any class of insureds?
A. Conditionally renewable
B. Cancellable
C. Guaranteed renewable
D. Optionally renewable - ANSWER>>D. Optionally renewable
The renewability provision in an optionally renewable policy gives the insurer the
option to terminate the policy for any reason on the date specified in the contract
(usually a renewal date). Furthermore, this provision allows the insurer to
increase the premium for any class of optionally renewable insureds.
When an insurer issues an individual health insurance policy that is guaranteed
renewable, the insurer agrees
A. To charge a lower premium every year the policy is renewed.
B.Not to change the premium rate for any reason.
C. To renew the policy indefinitely.
D. To renew the policy until the insured has reached age 65. - ANSWER>>D. To
renew the policy until the insured has reached age 65.
