ACCIDENT AND HEALTH STUDY GUIDE 2025/2026
QUESTIONS AND SOLUTION RATED A+
✔✔reports - ✔✔applicant must be made aware of reports being don on them
✔✔HIV consent - ✔✔written consent to do HIV test
✔✔sexual orientation - ✔✔cant be asked questions
✔✔genetic testing - ✔✔prohibited
✔✔HIPAA - ✔✔acts to protect medical privacy
✔✔USA patriot act - ✔✔anti money laundering, can detect acts to prevent terrorism
✔✔underwriting - ✔✔-the process of selecting risk
-seeing if parties have insurable interest
✔✔reports - ✔✔-attending physicians statement (APS)
-MIB: medical report, written consent
-consumer reports: reputation
-special questioners
-inspection reports
-credit reports
✔✔risk classification - ✔✔substandard- high risk
standard- normal risk
preferred- lowest risk
✔✔delivery - ✔✔occurs when agent personally delivers policy or mails it
✔✔mandatory health provisions - ✔✔12 mandatory provisions
-entire contract
-incontestability: 2 years, age is exception
-grace period: 30 days
-reinstatement: automatic, sickness is 10 days
-notice of claims: 20 days
-claims forms: 15 days
-proof of loss: 90 days
-time payment of claims: no less than monthly
-payment of claims- specifies who is paid
-exam:insurer must pay
-legal action: 60 days, 2 years
-change of beneficiary: only possible if revocable not irrevocable
, ✔✔optional provisions - ✔✔11 optional provisions
-change of occupation
-misstatement of age/sex
-other insurance
-two insurers split
-relations to earnings unpaid premiums
-unpaid premiums
-cancellation
-conformity of state statues
-illegal occupation
-intoxicants or narcotics
✔✔insuring clause - ✔✔companys commitment to pay
✔✔consideration clause - ✔✔Policyowners responsibility to pay the premium
✔✔free look - ✔✔period of time for complete refund, 10 days
✔✔probationary period - ✔✔time before policy starts
✔✔elimination period - ✔✔After disability, how many days before payments start, like a
time deductible instead of money deductible
✔✔Waiver of Premium - ✔✔premium waives during disability
✔✔lifetime, annual, per cause benefits - ✔✔the limits that a policy will pay
✔✔riders - ✔✔impairment waivers- exclusion of condition
✔✔guaranteed insurability - ✔✔allows the insured to buy additional coverage without
proof of insurability, premium may go up
✔✔multiple indemnity - ✔✔Pays for accidental death or dismemberment (ADD)
✔✔Rights of Renewability - ✔✔right insurance company has to renew policy
✔✔non cancelable - ✔✔insurer can cancel or raise premiums
✔✔cancelable - ✔✔Insurer can cancel or raise premium at anytime
✔✔guarenteed renewable - ✔✔cant cancel except on date, can raise premiums on
group
✔✔optionally renewable - ✔✔insurer cancel or raise premiums
QUESTIONS AND SOLUTION RATED A+
✔✔reports - ✔✔applicant must be made aware of reports being don on them
✔✔HIV consent - ✔✔written consent to do HIV test
✔✔sexual orientation - ✔✔cant be asked questions
✔✔genetic testing - ✔✔prohibited
✔✔HIPAA - ✔✔acts to protect medical privacy
✔✔USA patriot act - ✔✔anti money laundering, can detect acts to prevent terrorism
✔✔underwriting - ✔✔-the process of selecting risk
-seeing if parties have insurable interest
✔✔reports - ✔✔-attending physicians statement (APS)
-MIB: medical report, written consent
-consumer reports: reputation
-special questioners
-inspection reports
-credit reports
✔✔risk classification - ✔✔substandard- high risk
standard- normal risk
preferred- lowest risk
✔✔delivery - ✔✔occurs when agent personally delivers policy or mails it
✔✔mandatory health provisions - ✔✔12 mandatory provisions
-entire contract
-incontestability: 2 years, age is exception
-grace period: 30 days
-reinstatement: automatic, sickness is 10 days
-notice of claims: 20 days
-claims forms: 15 days
-proof of loss: 90 days
-time payment of claims: no less than monthly
-payment of claims- specifies who is paid
-exam:insurer must pay
-legal action: 60 days, 2 years
-change of beneficiary: only possible if revocable not irrevocable
, ✔✔optional provisions - ✔✔11 optional provisions
-change of occupation
-misstatement of age/sex
-other insurance
-two insurers split
-relations to earnings unpaid premiums
-unpaid premiums
-cancellation
-conformity of state statues
-illegal occupation
-intoxicants or narcotics
✔✔insuring clause - ✔✔companys commitment to pay
✔✔consideration clause - ✔✔Policyowners responsibility to pay the premium
✔✔free look - ✔✔period of time for complete refund, 10 days
✔✔probationary period - ✔✔time before policy starts
✔✔elimination period - ✔✔After disability, how many days before payments start, like a
time deductible instead of money deductible
✔✔Waiver of Premium - ✔✔premium waives during disability
✔✔lifetime, annual, per cause benefits - ✔✔the limits that a policy will pay
✔✔riders - ✔✔impairment waivers- exclusion of condition
✔✔guaranteed insurability - ✔✔allows the insured to buy additional coverage without
proof of insurability, premium may go up
✔✔multiple indemnity - ✔✔Pays for accidental death or dismemberment (ADD)
✔✔Rights of Renewability - ✔✔right insurance company has to renew policy
✔✔non cancelable - ✔✔insurer can cancel or raise premiums
✔✔cancelable - ✔✔Insurer can cancel or raise premium at anytime
✔✔guarenteed renewable - ✔✔cant cancel except on date, can raise premiums on
group
✔✔optionally renewable - ✔✔insurer cancel or raise premiums
