Already Graded
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
Ans: 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
Ans: 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
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,2. pre-existing condition
3. hazardous condition
4. grandfathered condition
Ans: 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
Ans: 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
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,Ans: 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
Ans: 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
Ans: 4. Captive insurer
Notice of information practices must be given to a policyholder at least
1. every year
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, 2. every two years
3. every three years
4. every four years
Ans: 3. Every three years
What is the elimination period of an individual disability policy?
1. Time period an insured must wait before coverage begins
2. Time period a disabled person must wait before benefits are paid
3. Time period after the policy issue date in which the provisions are still contestable
4. The point in time when benefits are no longer payable
Ans: 2. Time period a disabled person must wait before benefits are paid
An individual long-term policy must be renewable
1. To age 65
2. To age 75
3. To age 85
4. For life
Ans: 4. For life
When the New York Superintendent of Insurance examines a licensee's insurance records, the
primary purpose is to determine
1. The licensee's sales volume
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