ACCIDENT AND HEALTH INSURANCE EXAM QUESTIONS | 231
QUESTIONS AND ANSWERS | NEW 2026 UPDATE | WITH
COMPLETE SOLUTION.
H has suffered a covered disability away from her job and will shortly begin
collecting benefits. The insurer sends a letter to H stating that she will not
receive any benefit amounts greater than her income. This clause is known as:
A: Over-insurance clause
B: free look
C: relation of earning to insurance
D: relation of economic value Answer - C: relation of earning to insurance
The insured should be aware of the issue date upon delivery a policy and the
date should be listed on:
A: the policy summary
B: the first page of the contract
C: the delivery receipt
D: upon conditional receipt Answer - B: the first page of the contract
The policy has all of the following rights EXCEPT:
A: Right to solely renew a guaranteed renewable policy.
B: Right to terminate a policy
C: Unilateral right to renew an Optionally renewable policy
,D: Right to assign a contract Answer - C: Unilateral right to renew an Optionally
renewable policy
The part of a contract that specifies which expenses may or may not be
covered is known as the:
A: Exclusion
B: Eligible Expense provision
C: Insuring Agreement
D: Consideration Clause Answer - B: Eligible Expense provision
Which of the following is considered to be a mandatory provision in a health
policy?
A: Time Limit on Certain Defenses
B: Change of Occupation
C: Illegal Occupation
D: Intoxicant/Narcotic Usage Answer - A: Time Limit on Certain Defenses
Which of the following may be considered an eligible expense found in a health
policy?
A: Cosmetic Surgery
B: Premium payment
C: cold cream
D: Bus fare to receive treatment for a covered loss Answer - D: Bus fare to
receive treatment for a covered loss
K has a policy that covers doctors visits but limits the number of visits per
calendar year and pays a limited indemnification limit per visit. K has:
A: Basic Medical Expense
,B: Physician Nonsurgical Coverage
C: Basic Surgical Policy
D: Basic Hospital Coverage Answer - B: Physician Nonsurgical Coverage
All of the following are CORRECT about Medicare EXCEPT:
A: An insured who is age 30 but collecting Social Security disability for the last
two years is eligible for Medicare.
B: An insured who is age 60 and is at the end stage of renal failure is eligible for
Medicare.
C: An insured who turns age 65 and is still employed is eligible for Medicare.
D: An insured who has Medicare Part A is eligible to enroll for Medigap policies
within six months of enrolling in Part A. Answer - D: An insured who has
Medicare Part A is eligible to enroll for Medigap policies within six months of
enrolling in Part A.
Under the Claim Forms provision in an Accident and Health policy, an insurance
company must supply an insured with claim forms within a MAXIMUM of how
many days after receiving notice of the loss?
A: 10
B: 15
C: 20
D: 30 Answer - B: 15
The purpose of the Fair Credit Reporting Act is to:
A: protect the consumer from having an adverse action against them based of
obsolete credit information
B: to ensure that credit information used in underwriting is accurate and
updated
, C: make sure that any financial institution handles an individual's credit in a
correct, proper manner
D: All of the Above Answer - D: All of the Above
Most Accident and Health policies require that claims must be paid _________
upon written proof of loss.
A: 30 days
B: Immediately
C: 60 days
D: 90 days Answer - B: Immediately
A LTC policy that will only pay for ADL given occasionally by a licensed
professional is:
A: Skilled Care
B: Intermediate Care
C: Custodial Care
D: None of the Above Answer - C: Custodial Care
Which of the following policy provisions are optional in a individual health
policy?
A: Entire Contract
B: Change of Occupation
C: Entire Contract
D: Reinstatement Answer - B: Change of Occupation
Which of the following elements is part of the entire contract clause?
A: The exchange of value between the parties
QUESTIONS AND ANSWERS | NEW 2026 UPDATE | WITH
COMPLETE SOLUTION.
H has suffered a covered disability away from her job and will shortly begin
collecting benefits. The insurer sends a letter to H stating that she will not
receive any benefit amounts greater than her income. This clause is known as:
A: Over-insurance clause
B: free look
C: relation of earning to insurance
D: relation of economic value Answer - C: relation of earning to insurance
The insured should be aware of the issue date upon delivery a policy and the
date should be listed on:
A: the policy summary
B: the first page of the contract
C: the delivery receipt
D: upon conditional receipt Answer - B: the first page of the contract
The policy has all of the following rights EXCEPT:
A: Right to solely renew a guaranteed renewable policy.
B: Right to terminate a policy
C: Unilateral right to renew an Optionally renewable policy
,D: Right to assign a contract Answer - C: Unilateral right to renew an Optionally
renewable policy
The part of a contract that specifies which expenses may or may not be
covered is known as the:
A: Exclusion
B: Eligible Expense provision
C: Insuring Agreement
D: Consideration Clause Answer - B: Eligible Expense provision
Which of the following is considered to be a mandatory provision in a health
policy?
A: Time Limit on Certain Defenses
B: Change of Occupation
C: Illegal Occupation
D: Intoxicant/Narcotic Usage Answer - A: Time Limit on Certain Defenses
Which of the following may be considered an eligible expense found in a health
policy?
A: Cosmetic Surgery
B: Premium payment
C: cold cream
D: Bus fare to receive treatment for a covered loss Answer - D: Bus fare to
receive treatment for a covered loss
K has a policy that covers doctors visits but limits the number of visits per
calendar year and pays a limited indemnification limit per visit. K has:
A: Basic Medical Expense
,B: Physician Nonsurgical Coverage
C: Basic Surgical Policy
D: Basic Hospital Coverage Answer - B: Physician Nonsurgical Coverage
All of the following are CORRECT about Medicare EXCEPT:
A: An insured who is age 30 but collecting Social Security disability for the last
two years is eligible for Medicare.
B: An insured who is age 60 and is at the end stage of renal failure is eligible for
Medicare.
C: An insured who turns age 65 and is still employed is eligible for Medicare.
D: An insured who has Medicare Part A is eligible to enroll for Medigap policies
within six months of enrolling in Part A. Answer - D: An insured who has
Medicare Part A is eligible to enroll for Medigap policies within six months of
enrolling in Part A.
Under the Claim Forms provision in an Accident and Health policy, an insurance
company must supply an insured with claim forms within a MAXIMUM of how
many days after receiving notice of the loss?
A: 10
B: 15
C: 20
D: 30 Answer - B: 15
The purpose of the Fair Credit Reporting Act is to:
A: protect the consumer from having an adverse action against them based of
obsolete credit information
B: to ensure that credit information used in underwriting is accurate and
updated
, C: make sure that any financial institution handles an individual's credit in a
correct, proper manner
D: All of the Above Answer - D: All of the Above
Most Accident and Health policies require that claims must be paid _________
upon written proof of loss.
A: 30 days
B: Immediately
C: 60 days
D: 90 days Answer - B: Immediately
A LTC policy that will only pay for ADL given occasionally by a licensed
professional is:
A: Skilled Care
B: Intermediate Care
C: Custodial Care
D: None of the Above Answer - C: Custodial Care
Which of the following policy provisions are optional in a individual health
policy?
A: Entire Contract
B: Change of Occupation
C: Entire Contract
D: Reinstatement Answer - B: Change of Occupation
Which of the following elements is part of the entire contract clause?
A: The exchange of value between the parties
