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1. Disability income policies can provide coverage for a loss of income when
returning to work only part-time after recovering from total disability. What
is the benefit that is based on the insured's loss of earnings after recovery
from a disability? - ANSWER Residual disability
A residual disability will pay an amount to make up the difference between what
the insured would have earned before the loss.
2. An insured is involved in an accident that renders him permanently deaf,
although he does not sustain any other major injuries. The insured is still
able to perform his current job. To what extent will he receive Presumptive
Disability benefits? - ANSWER Full benefits
Presumptive Disability plans offer full benefits for specified conditions.
3. Which of the following is NOT provided by an HMO?
a) Reimbursement
b) Services
c) Financing
d) Patient care - ANSWER a) Reimbursement
The HMO provides benefits in the form of services rather than in the form of
reimbursement for the services of the physician or hospital.
, 4. In order to maintain coverage under COBRA, how soon from termination of
employment must an employee exercise extension of benefits? - ANSWER
60 days
Under COBRA, terminated employees must exercise extension of benefits within
60 days of separation from employment.
5. 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. how would this claim be handled? -
ANSWER The insurer is considered to be notified since the notification to
agent equals notification to the insurer.
Notice to the agent equals notice to the insurer. The agent is the insurer's
representative.
6. Which of the following is NOT a feature of a guaranteed renewable
provision?
a) The insured has a unilateral right to renew the policy for the life of the
contract.
b) Coverage is not renewable beyond the insured's age 65.
c) The insured's benefits cannot be reduced
d) The insurer can increase the policy premium on an individual basis. -
ANSWER d) The insurer can increase the policy premium on an
individual basis.
Guaranteed renewable provision has all the same features that the
noncancellable provision does, with the exception that the insurer can increase
the policy premium on the policy anniversary date. However, the premiums can
only be increased on a class basis, not on an individual policy.
, 7. Which of the following is NOT required to be stated in the outline of
coverage provided with a long-term care policy?
a) The right to return the policy for a refund
b) Basic information about the insurance company
c) Basic information about supplementary policies
d) The policy number - ANSWER c) Basic information about
supplementary policies
outline of coverage must follow standard format included in insurance regulations.
Must include information about the insurance company, the policy number,
important features of the policy, and explain the right to return the policy for a
refund.
8. All of the following are required provisions in all individual health insurance
policies delivered in this state EXCEPT
a) Grace period.
b) Reinstatement.
c) Misstatement of age.
d) Entire contract. - ANSWER c) Misstatement of age.
Misstatement of age is an optional health insurance policy provision, meaning
that it may be included in a policy at the option of the insurer.
9. An individual applies for a life policy. Two years ago he suffered a head
injury from an accident, so he cannot remember parts of his past, but is
otherwise competent. He has also been hospitalized for drug abuse, but does
not remember this when applying for insurance. The insurer issues the
policy and learns of his history one year later. What will probably happen? -
ANSWER The policy will not be affected.
In insurance, fraud is the intentional misrepresentation of material information
that is crucial when deciding whether or not to write a contract for an applicant.
If an insurer finds that an applicant has committed fraud, it can void the
, contract, provided that the discovery occurs within the first two years of the
effective policy date. In this particular instance the applicant did not commit
intentional fraud.
10.A long-term care shopper's guide must be presented at what point? -
ANSWER Prior to the time of application A long-term care insurance
shopper's guide must be provided in the format developed by the National
Association of Insurance Commissioners (NAIC). The shopper's guide must
be presented to the applicant prior to completing the application.
11.In individual health insurance coverage, the insurer must cover a newborn
from the moment of birth, and if additional premium payment is required,
how many days should be allowed for payment? - ANSWER Within 30
days of birth
12.The insured must notify the insurer of a newly born dependent, and if
additional payment is required, pay within 30 days.
In order to maintain an insurance license, an agent will need to satisfy Florida's
continuing education requirement of : - ANSWER 24 hours of continuing
education in every 2-year period.
An insured submits a proof of loss form within 10 days of a loss. The insurer,
however, does not acknowledge the form for 3 months. Which of the following
violations has the insurer committed? - ANSWER Unfair claims settlement
Failing to affirm or deny coverage of claims within a reasonable time after proof of
loss statements are completed and submitted by insureds is an example of unfair
claims settlement.
If a person accumulates more continuing education hours than is necessary to
fulfill the requirements for a 2-year period, what will occur? - ANSWER The