NY State Insurance License Practice Exam/ 207
Q&A/ 2024-2025
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
2. pre-existing condition
3. hazardous condition
4. grandfathered condition - Answer: 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
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,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 - Answer: 3. A Medicare Supplement core benefit
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 - Answer: 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 - Answer: 1. After a stated period of time, claims cannot be denied
due to material misrepresentation on the application
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,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 - Answer: 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 - Answer: 2. 12 months
Which of the following types of insurers limits the exposures it writes to those of
its owners?
1. Restricted insurer
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, 2. Limited insurer
3. Confined insurer
4. Captive insurer - Answer: 4. Captive insurer
Notice of information practices must be given to a policyholder at least
1. every year
2. every two years
3. every three years
4. every four years - Answer: 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 - Answer: 2. Time
period a disabled person must wait before benefits are paid
An individual long-term policy must be renewable
1. To age 65
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Q&A/ 2024-2025
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
2. pre-existing condition
3. hazardous condition
4. grandfathered condition - Answer: 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
Page 1 of 91
,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 - Answer: 3. A Medicare Supplement core benefit
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 - Answer: 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 - Answer: 1. After a stated period of time, claims cannot be denied
due to material misrepresentation on the application
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,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 - Answer: 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 - Answer: 2. 12 months
Which of the following types of insurers limits the exposures it writes to those of
its owners?
1. Restricted insurer
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, 2. Limited insurer
3. Confined insurer
4. Captive insurer - Answer: 4. Captive insurer
Notice of information practices must be given to a policyholder at least
1. every year
2. every two years
3. every three years
4. every four years - Answer: 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 - Answer: 2. Time
period a disabled person must wait before benefits are paid
An individual long-term policy must be renewable
1. To age 65
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