Life and health exam multiple choice questions and correct detailed answers

Who may terminate a producer's appointment? A. insurer B. insured C. producer D. policy owners - Correct AnswersA. Insurer Which of the following statements BEST describes a disability elimination period? A. A time describe rather than a dollar deductible/ B. A benefit or utilization period. C. A dollar deductible rather than a time deductible. D. A qualifying period - Correct AnswersA. A time deductible rather than a dollar deductible/ According to the Pennsylvania Health care Insurance Portability Act regulation, health coverage for eligible individuals must be offered on what basis? A. non-renewable B. guaranteed issue C. creditable coverage D. conditionally renewable - Correct AnswersC. Creditable renewable If a license has been found to have committed any fraudulent or dishonest practice, the insurance Commissioner may do all the following EXCEPT A. assess a fine. B. revoke the license. C. place the license under supervision. D. withhold the licensee's commission and/or fees. - Correct AnswersD. withhold the licensee's commission and/or fees. An insurer would consider which of the following in determining whether to accept a group life plan? A. Grace period. B. Beneficiary. C. Average age. D. Dependents. - Correct AnswersC. Average age. Which is NOT excluded in a long-term care policy? A. Alcoholism B. Alzheimer's disease C. Non-cognitive mental disorders D. Treatment caused by participation in criminal behavior - Correct AnswersB. Alzheimer's disease An insurer MUST offer a Long-Term Care Policy or certificate that A. has a nonforfeiture value. B. is subject to post claims underwriting. C. has no increase in premium. D. can be canceled due to claims - Correct AnswersB. is subject to post claims underwriting The MAJOR factor in determining the benefit amount paid under a disability income is A. occupation. B. wages. C. age. D. gender. - Correct AnswersB. wages Under which circumstance would a business purchase life insurance? A. to pay off a loan B. to expand the business C. to compensate executives D. to fund employee healthcare - Correct AnswersA. to pay off a loan If an insured has multiple policies with one insurer that give the insured benefits exceeding the company's allowable maximum, how much will the policies pay? A. 50% of the loss is paid by each policy B. only the maximum benefit is payable C. limits of both policies combined D. only the basic coverage amount - Correct AnswersC. limits of both policies combined The purpose of the spendthrift clause in a life insurance policy is to A. determine the order of death if the insured beneficiary die in the same accident B. prevent creditors of a beneficiary from claiming any future death benefits payable C. allow the insured to directly pay death benefit proceeds to a creditor D. establish the payout of death benefits if the primary beneficiary dies before - Correct AnswersB. prevent creditors of a beneficiary from claiming any future death benefits payable An individual who is NOT acceptable by an insurer at standard rates become of health, habits, pr occupation is called a A. rating risk. B. standard risk. C. preferred risk. D. substandard risk. - Correct AnswersD. substandard risk. The Pennsylvania Insurance Department is responsible for all of the following EXCEPT A. insurers B. producers. C. shareholders. D. Form approvals. - Correct AnswersC. shareholders. The MAIN purpose of insurance is to A. transfer risk. B. alter risk. C. retain risk. D. seduce risk - Correct AnswersA. transfer risk. The statement option that allows proceeds to remain with the insurer and the earnings to be paid to the beneficiary on a monthly basis is called A. interest only. B. lump sum. C. fixed period. D. fixed amount. - Correct AnswersA. interest only. An intentional false written or oral statement made by a producer for the purpose of replacing an existing policy to the detriment of the insured is A. twisting. B. determination. C. misrepresentation. D. illegal inducement. - Correct AnswersA. twisting. Group long-term disability benefit amounts are usually limited to what percentage of the participant's income? A. 50 B. 60 C. 90 D. 100 - Correct AnswersB. 60 Which of the following is a payment method for setting a health care provider claim? A. Settlement. B. Prepaid basis. C. Fee-for-service. D. Premium payment. - Correct AnswersC. Fee-for-service. What is disability insurance provision that specifies the condition under which the insured is automatically qualified for benefits regardless of their ability to work? A. Total disability. B. Partial disability. C. Residual disability. D. Presumptive disability. - Correct AnswersD. Presumptive disability. Which is an annuity benefit option that provides payment to a survivor for the remainder of a guaranteed period? A. pure life B. refund life annuity C. life annuity certain D. temporary annuity certain - Correct AnswersC. life annuity certain Sometimes when there is ambiguity in an insurance contract, the courts may rely on what doctrine to determine if coverage applies? A. Doctrine of indivisibility. B. Doctrine of good faith. C. Doctrine of reasonable expectations - Correct AnswersC. Doctrine of reasonable expectations. Pennsylvania, group and individual health insurance policies shall provide coverage for mammographic examination for women at what age? A. 30 years B. 40 years C. 45 years D. 50 years - Correct AnswersB. 40 years The purpose of the spendthrift clause in a life insurance policy is to A. determine the order of death if the insured and beneficiary die in the same accident. B. prevent creditors of a beneficiary from claiming any future death benefits payable to the beneficiary. C. allow the insured to directly pay the death benefits process to a creator. D. establish the payout of death benefits if the primary beneficiary dies before the contingent beneficiary - Correct AnswersB. prevent creditors of a beneficiary from claiming any future death benefits payable to the beneficiary. Under Pennsylvania's Uniform Request Provisions for accident and health insurance policies, within how many days after the occurrence of a loss must the claim be given in the insurer? A. 5 B. 10 C. 15 D. 20 - Correct AnswersD. 20 Under Pennsylvania insurance law, "partial disability" may be defined in relation to which of the following? A. the insured's need for some degree of ongoing medical treatment of care B. the insured's inability to perform one or more but not all of his or her essential duties C. the insured's inability to perform at least two or not at all of his or hers essential duties D. the long-term or chronic, but not completely debilitating, nature of the insured's medical condition - Correct AnswersB. the insured's inability to perform one or more but not all of his or her essential duties EXCEPT for fraud, what is the time limit after issue for an insurer to deny an individual health insurance claim based on material misrepresentation in the application for the insurance. A. 180 days B. 1 year C. 3 years D. 5 years - Correct AnswersB. 1 year A primary advantage of a limited payment policy over a continuous premium whole life policy is that a limit payment policy A. guarantees renewability. B. includes nontaxable dividends. C. allows the policyowner to pay the policy in a shorter period of time. D. is a nonparticipating contract paying higher dividends that a continuous pay policy. - Correct AnswersC. allows the policyowner to pay the policy in a shorter period of time. Under Pennsylvania's Uniform Request Provisions for accident and health insurance, legal actions may NOT be brought against the insurer after a period of how many years following the time written proof of loss was required to be furnished? A. two B. three C. four D. five - Correct AnswersB. three In Pennsylvania, a specified disease accident and health plan must provide a minimum benefit in the amount of 1. $2,000 2. $2,500 3. $5,000 4. $10,000 - Correct Answers3. $5,000 A producer that willfully violates any provision of Pennsylvania Insurance law may be imposed to a maximum penalty set by the Commissioner at ● $1,500 per violation ● $3,000 per violation ● $5,000 per violation - Correct Answers● $5,000 per violation Under the unpaid premium provision, if there an unpaid premium at the time a health claim becomes payable, then the A. claim is denied. B. Policy is canceled. C. premium may be deducted from the claim. D. claim is delayed until payment of the premium. - Correct AnswersC. premium may be deducted from the claim. Which type of life is characterized by premiums that are fully paid up within a stated period, after which no father premiums are REQUESTED? A. Lump sum insurance. B. Basic installment insurance. C. Prepaid premium insurance. D. Limited payment insurance . - Correct AnswersD. Limited payment insurance . Which of the following transactions typically includes an immediate payment to the policyowner prior to the death of the insurer? A. viatical settlement contracts B. qualified insurance plans C. cross-purchase plans D. buy-sell agreement - Correct AnswersA. viatical settlement contracts Nancy purchased a life insurance policy with a face amount of $250,000. Over a period of years, the cash value in the policy accumulates $50,000, and the face amount of the policy has become $300,000. This is an example of a A. modified premium whole life policy. B. participating whole life policy. C. limited pay life insurance policy. D. universal life policy. - Correct AnswersD. universal life policy. The Pennsylvania Insurance Department has both the right and the duty to complete which task in regards to licensed insurers? A. provide financial rehabilitation B. modify insurance contract conditions C. modify statute law to accompany contact conditions D. make periodic financial audits and market conducts conditions examinations - Correct AnswersA. provide financial rehabilitation Which of the following contracts enables the business owner who becomes disabled to transfer the business to a new owner and receive payment? A. Key-employee disability insurance. B. Business overhead expense policy.? C. Disability buy-sell policy. D. Disability reducing tear policy - Correct AnswersB. Business overhead expense policy.? In order to safeguard the insured from paying an unreasonable amount, may major medical policies contain an out-of-pocket MAXIMUM feature that limits A. health care insurance premiums. B. preexisting conditions converge. C. deductibles. D. health care expense payable by the insured. - Correct AnswersD. health care expense payable by the insured. Failure to fulfill the continuing requirements of Pennsylvania Insurance laws will result in a: A. $1,000 fine B. 30-day suspension C. License revocation D. Voluntary termination of the license - Correct AnswersD. Voluntary termination of the license Six years after a disability policy was issued, an insured changed occupation from less hazardous to more hazardous and failed to notify. Under the Change of Occupation provision, if a claim is filed the insurer will A. pay no benefit since the insured failed to inform the insurer of the change in occupation. B. pay the benefits as continued for since the policy is over 2 years old. C. reduce the benefit to an amount the actual premium paid would have purchased at the more hazardous occupations - Correct AnswersC. reduce the benefit to an amount the actual premium paid would have purchased at the more hazardous occupations. Reduce the payment by the exact amount of the premium of the premium underpayment. Which of the following gives the policyowner access to the cash value that accumulates inside the policy without having to terminate the policy? A. Reduced Paid-up insurance. B. Policy Loans. C. Fixed-period Installments. D. Spendthrift Clause - Correct AnswersB. Policy Loans. Sally has named her daughter. Martha, as beneficiary on her $100,000 life insurance policy. In order to change the beneficiary she is REQUIRED to get Martha's signature. What kind of beneficiary designation is this considered?