North Carolina Health Insurance Exam
questions with correct answers 37pg
When |Linda |suffered |a |broken |hip, |she |notified |her |agent, |in |writing, |within |12 |days |of |the |loss.
|However, |her |agent |did |not |notify |the |insurance |company |until |60 |days |after |the |loss. |Which |of |the
|following |statements |correctly |explains |how |this |claim |would |be |handled?
A. |The |insurer |is |considered |to |be |notified |since |the |notification |to |agent |equals |notification |to |the
|insurer
B. |The |insurer |may |delay |the |payment |of |this |claim |for |up |to |6 |months
C. |The |insurer |may |settle |this |claim |for |less |than |it |otherwise |would |have |had |the |notification |been
|provided |in |a |timely |manner |
D. |The |insurer |may |deny |the |claim |since |it |was |not |notified |within |the |required |20 |day |time |frame |-
|VERIFIED |ANSWER✔✔-A.
While |repairing |the |roof |of |his |house |an |insured |accidentally |falls |off |and |breaks |his |arm |and |sustains
|a |head |injury |that |results |in |total |blindness |of |both |eyes. |His |policy |contains |an |Accidental |Death |&
|Dismemberment |Rider. |What |is |the |extent |of |benefits |that |he |will |receive?
A. |Reciprocal |Amount |
B. |Principal |Sum
C. |Capital |Sum
D. |50% |of |the |Principal |- |VERIFIED |ANSWER✔✔-B.
Which |of |the |following |is |true |regarding |inpatient |hospital |care |for |HMO |members?
A. |Inpatient |hospital |care |is |not |part |of |HMO |services
B. |Care |can |be |provided |outside |of |the |service |area
C. |Can |can |only |be |provided |in |the |service |area
D. |Services |for |treatment |of |mental |disorders |are |unlimited |- |VERIFIED |ANSWER✔✔-B.
As |it |pertains |to |group |health |insurance, |the |continuation |provision |stipulates |that
A. |Terminated |employees |may |convert |to |an |individual |policy |only |upon |proof |of |insurability |
,B. |Group |coverage |must |be |extended |for |terminated |employees |up |to |a |certain |period |of |time |at |the
|employers |expense
C. |Group |coverage |must |be |extended |for |terminated |employees |up |to |a |certain |period |of |time |at |the
|employees |expense
D. |Retiring |employees |must |be |allowed |to |convert |their |group |coverage |to |individual |policies |-
|VERIFIED |ANSWER✔✔-C.
All |of |the |following |apply |to |short |term |disability |plans |EXCEPT
A. |Individual |plans |can |provide |benefit |periods |of |up |to |2 |years
B. |A |benefit |period |of |26 |weeks |is |most |common |for |group |plans
C. |Both |group |and |individual |plans |are |renewable |
D. |Group |plans |can |provide |benefit |periods |of |up |to |52 |weeks |- |VERIFIED |ANSWER✔✔-C.
Which |describes |the |features |of |a |comprehensive |major |medical |policy?
A. |There |is |no |coinsurance
B. |Basic |medical |expense |benefits |are |provided |in |single |package
C. |The |deductible |is |always |expressed |as |a |deferred |amount
D. |It |is |the |same |as |major |medical |insurance |- |VERIFIED |ANSWER✔✔-B.
If |an |insurer |accepts |premium |payments |by |credit |card, |who |is |responsible |for |paying |the |fees
|charged |by |a |credit |card |company?
A. |Credit |card |company
B. |Insurer |accepting |payment
C. |Policy |owners, |as |part |of |premium |
D. |Insured |- |VERIFIED |ANSWER✔✔-B.
When |a |disabled |dependent |child |reaches |the |age |limit |for |coverage, |how |long |does |the |policyowner
|have |to |provide |proof |of |dependency |in |order |for |the |dependent |to |remain |covered |under |the
|policy?
A. |15 |days
B. |31 |days
,C. |60 |days
D. |10 |days |- |VERIFIED |ANSWER✔✔-B.
If |a |licensee |is |convicted |of |a |criminal |violation |, |the |licensees |insurance |license |is?
A. |Suspended |after |hearing
B. |Automatically |suspended
C. |Automatically |revoked
D. |Not |affected |- |VERIFIED |ANSWER✔✔-B.
All |of |the |following |are |differences |between |Individual |and |group |health |insurance |EXCEPT |
A. |In |individual |policies, |the |individual |selects |coverage |options, |while |in |a |group |plan |all |employees
|are |covered |for |the |same |coverage |which |is |chosen |by |employer
B. |Individual |coverage |can |be |written |on |an |occupation |or |no |occupational |basis
C. |Individual |policies |are |renewable, |while |group |terminates |when |the |individual |leaves
D. |Individual |insurance |does |not |require |medical |examinations, |while |group |insurance |does |not
|require |medical |examinations |- |VERIFIED |ANSWER✔✔-D.
A |licensee |decides |to |terminate |his |residency |in |the |state. |Which |of |the |following |would |be |an
|appropriate |action?
A. |Delivering |the |license |to |the |commissioner |within |30 |days
B. |Allowing |the |license |to |expire
C. |Notifying |the |NAIC
D. |Notifying |the |commissioner |within |10 |days |- |VERIFIED |ANSWER✔✔-A.
Which |of |the |following |is |not |a |feature |of |a |noncancelable |policy?
A. |The |insurer |may |terminate |the |contract |only |at |renewal |for |certain |conditions
B. |The |premiums |cannot |be |increased |beyond |the |amount |stated |in |the |policy
C. |The |guarantee |to |renew |coverage |usually |applies |until |the |insured |reaches |certain |age
D. |The |insured |has |the |right |to |renew |the |policy |for |the |life |of |the |contract |- |VERIFIED |ANSWER✔✔-
A.
, Which |of |the |following |must |an |insurer |obtain |in |order |to |transact |insurance |within |a |given |state?
A. |Certificate |of |authority
B. |Producer |certificate
C. |Business |entity |license
D. |Insurers |license |- |VERIFIED |ANSWER✔✔-A.
Group |health |insurance |is |characterized |by |all |of |the |following |except
A. |A |master |contract
B. |Lower |administrative |costs
C. |Conversion |privilege
D. |Adverse |selection |- |VERIFIED |ANSWER✔✔-D.
A |hospital |indemnity |policy |will |pay
A. |A |benefit |for |each |day |the |insured |is |in |the |hospital
B. |Income |lost |while |the |insured |is |in |the |hospital
C. |All |expenses |incurred |by |the |stay |in |the |hospital
D. |Any |expenses |incurred |by |the |stay |in |the |hospital, |minus |coinsurance |payments |and |deductibles |-
|VERIFIED |ANSWER✔✔-A.
Which |of |the |following |would |qualify |as |a |competent |party |in |an |insurance |contract?
A. |The |applicant |is |a |12 |year |old |student |
B. |The |applicant |is |under |the |influence |of |a |mind |impairing |medication |at |the |time |of |the |application
C. |The |applicant |has |a |prior |felony |conviction
D. |The |applicant |is |intoxicated |at |the |time |of |the |application |- |VERIFIED |ANSWER✔✔-C.
A |father |owns |a |life |insurance |policy |on |his |15-year-old |daughter. |The |policy |contains |the |optional
|Payor |Benefit |rider. |If |the |father |becomes |disabled, |what |will |happen |to |the |life |insurance
|premiums?
A. |The |premiums |would |become |tax-deductible |until |the |insured's |18th |birthday
questions with correct answers 37pg
When |Linda |suffered |a |broken |hip, |she |notified |her |agent, |in |writing, |within |12 |days |of |the |loss.
|However, |her |agent |did |not |notify |the |insurance |company |until |60 |days |after |the |loss. |Which |of |the
|following |statements |correctly |explains |how |this |claim |would |be |handled?
A. |The |insurer |is |considered |to |be |notified |since |the |notification |to |agent |equals |notification |to |the
|insurer
B. |The |insurer |may |delay |the |payment |of |this |claim |for |up |to |6 |months
C. |The |insurer |may |settle |this |claim |for |less |than |it |otherwise |would |have |had |the |notification |been
|provided |in |a |timely |manner |
D. |The |insurer |may |deny |the |claim |since |it |was |not |notified |within |the |required |20 |day |time |frame |-
|VERIFIED |ANSWER✔✔-A.
While |repairing |the |roof |of |his |house |an |insured |accidentally |falls |off |and |breaks |his |arm |and |sustains
|a |head |injury |that |results |in |total |blindness |of |both |eyes. |His |policy |contains |an |Accidental |Death |&
|Dismemberment |Rider. |What |is |the |extent |of |benefits |that |he |will |receive?
A. |Reciprocal |Amount |
B. |Principal |Sum
C. |Capital |Sum
D. |50% |of |the |Principal |- |VERIFIED |ANSWER✔✔-B.
Which |of |the |following |is |true |regarding |inpatient |hospital |care |for |HMO |members?
A. |Inpatient |hospital |care |is |not |part |of |HMO |services
B. |Care |can |be |provided |outside |of |the |service |area
C. |Can |can |only |be |provided |in |the |service |area
D. |Services |for |treatment |of |mental |disorders |are |unlimited |- |VERIFIED |ANSWER✔✔-B.
As |it |pertains |to |group |health |insurance, |the |continuation |provision |stipulates |that
A. |Terminated |employees |may |convert |to |an |individual |policy |only |upon |proof |of |insurability |
,B. |Group |coverage |must |be |extended |for |terminated |employees |up |to |a |certain |period |of |time |at |the
|employers |expense
C. |Group |coverage |must |be |extended |for |terminated |employees |up |to |a |certain |period |of |time |at |the
|employees |expense
D. |Retiring |employees |must |be |allowed |to |convert |their |group |coverage |to |individual |policies |-
|VERIFIED |ANSWER✔✔-C.
All |of |the |following |apply |to |short |term |disability |plans |EXCEPT
A. |Individual |plans |can |provide |benefit |periods |of |up |to |2 |years
B. |A |benefit |period |of |26 |weeks |is |most |common |for |group |plans
C. |Both |group |and |individual |plans |are |renewable |
D. |Group |plans |can |provide |benefit |periods |of |up |to |52 |weeks |- |VERIFIED |ANSWER✔✔-C.
Which |describes |the |features |of |a |comprehensive |major |medical |policy?
A. |There |is |no |coinsurance
B. |Basic |medical |expense |benefits |are |provided |in |single |package
C. |The |deductible |is |always |expressed |as |a |deferred |amount
D. |It |is |the |same |as |major |medical |insurance |- |VERIFIED |ANSWER✔✔-B.
If |an |insurer |accepts |premium |payments |by |credit |card, |who |is |responsible |for |paying |the |fees
|charged |by |a |credit |card |company?
A. |Credit |card |company
B. |Insurer |accepting |payment
C. |Policy |owners, |as |part |of |premium |
D. |Insured |- |VERIFIED |ANSWER✔✔-B.
When |a |disabled |dependent |child |reaches |the |age |limit |for |coverage, |how |long |does |the |policyowner
|have |to |provide |proof |of |dependency |in |order |for |the |dependent |to |remain |covered |under |the
|policy?
A. |15 |days
B. |31 |days
,C. |60 |days
D. |10 |days |- |VERIFIED |ANSWER✔✔-B.
If |a |licensee |is |convicted |of |a |criminal |violation |, |the |licensees |insurance |license |is?
A. |Suspended |after |hearing
B. |Automatically |suspended
C. |Automatically |revoked
D. |Not |affected |- |VERIFIED |ANSWER✔✔-B.
All |of |the |following |are |differences |between |Individual |and |group |health |insurance |EXCEPT |
A. |In |individual |policies, |the |individual |selects |coverage |options, |while |in |a |group |plan |all |employees
|are |covered |for |the |same |coverage |which |is |chosen |by |employer
B. |Individual |coverage |can |be |written |on |an |occupation |or |no |occupational |basis
C. |Individual |policies |are |renewable, |while |group |terminates |when |the |individual |leaves
D. |Individual |insurance |does |not |require |medical |examinations, |while |group |insurance |does |not
|require |medical |examinations |- |VERIFIED |ANSWER✔✔-D.
A |licensee |decides |to |terminate |his |residency |in |the |state. |Which |of |the |following |would |be |an
|appropriate |action?
A. |Delivering |the |license |to |the |commissioner |within |30 |days
B. |Allowing |the |license |to |expire
C. |Notifying |the |NAIC
D. |Notifying |the |commissioner |within |10 |days |- |VERIFIED |ANSWER✔✔-A.
Which |of |the |following |is |not |a |feature |of |a |noncancelable |policy?
A. |The |insurer |may |terminate |the |contract |only |at |renewal |for |certain |conditions
B. |The |premiums |cannot |be |increased |beyond |the |amount |stated |in |the |policy
C. |The |guarantee |to |renew |coverage |usually |applies |until |the |insured |reaches |certain |age
D. |The |insured |has |the |right |to |renew |the |policy |for |the |life |of |the |contract |- |VERIFIED |ANSWER✔✔-
A.
, Which |of |the |following |must |an |insurer |obtain |in |order |to |transact |insurance |within |a |given |state?
A. |Certificate |of |authority
B. |Producer |certificate
C. |Business |entity |license
D. |Insurers |license |- |VERIFIED |ANSWER✔✔-A.
Group |health |insurance |is |characterized |by |all |of |the |following |except
A. |A |master |contract
B. |Lower |administrative |costs
C. |Conversion |privilege
D. |Adverse |selection |- |VERIFIED |ANSWER✔✔-D.
A |hospital |indemnity |policy |will |pay
A. |A |benefit |for |each |day |the |insured |is |in |the |hospital
B. |Income |lost |while |the |insured |is |in |the |hospital
C. |All |expenses |incurred |by |the |stay |in |the |hospital
D. |Any |expenses |incurred |by |the |stay |in |the |hospital, |minus |coinsurance |payments |and |deductibles |-
|VERIFIED |ANSWER✔✔-A.
Which |of |the |following |would |qualify |as |a |competent |party |in |an |insurance |contract?
A. |The |applicant |is |a |12 |year |old |student |
B. |The |applicant |is |under |the |influence |of |a |mind |impairing |medication |at |the |time |of |the |application
C. |The |applicant |has |a |prior |felony |conviction
D. |The |applicant |is |intoxicated |at |the |time |of |the |application |- |VERIFIED |ANSWER✔✔-C.
A |father |owns |a |life |insurance |policy |on |his |15-year-old |daughter. |The |policy |contains |the |optional
|Payor |Benefit |rider. |If |the |father |becomes |disabled, |what |will |happen |to |the |life |insurance
|premiums?
A. |The |premiums |would |become |tax-deductible |until |the |insured's |18th |birthday
