Louisiana Life and Health Insurance Updated Exam 2026
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A health insurance policy clause that prevents an insurance company from denying
payment of a claim after a specified period of time is known as the
A. Insuring clause.
B. Time Limit on Certain Defenses clause.
C. Misstatement of Age clause.
D. Reinstatement clause. - ANSWERS-B. Time Limit on Certain Defenses clause.
The Time Limit on Certain Defenses provision guarantees that a misstatement made in
the application, unless it is fraudulent, cannot be contested after the first 3 years of the
policy.
An insured purchases a health policy in 2000 and submits a claim in 2005. The
insurance company discovers at that time that the insured misstated the information
about his health condition. What will the insurer most likely do?
A. Deny the claim
B. Pay a decreased benefit
,C. Void the policy
D. Pay the full benefit - ANSWERS-D. Pay the full benefit
The Time Limit on Certain Defenses provision stipulates that no statement or
misstatement (except fraudulent misstatements) made in the application at the time of
issue will be used to void a policy or deny a claim after the policy has been in force for 3
years.
While a claim is pending, an insurance company may require
A. The insured to be examined only once annually.
B. An independent examination only once every 45 days.
C. An independent examination as often as reasonably required.
D. The insured to be examined only within the first 30 days. - ANSWERS-C. An
independent examination as often as reasonably required.
While a claim is pending, an insurance company may require an independent exam as
often as reasonably required.
Which of the following statements is true concerning the alteration of optional policy
provisions?
A. An insurer may change the wording of optional policy provisions that would adversely
affect the policyholder but must first receive state permission before the change goes
into effect.
B. Once any kind of provision is written, it cannot be changed.
,C. An insurer may change the wording of optional provisions, as long as the change
does not adversely affect the policyholder.
D. An insurer may change the wording of optional provisions, regardless of its effect on
the policyholder. - ANSWERS-C. An insurer may change the wording of optional
provisions, as long as the change does not adversely affect the policyholder.
Optional policy provisions can be changed by an insurer, as long as the changes do not
adversely affect the policyholder.
If the insured under a disability income insurance policy changes to a more hazardous
occupation after the policy has been issued, and a claim is filed, the insurance company
should do which of the following?
A. Adjust the benefit in accordance with the increased risk
B. Cancel the policy
C. Increase the premium
D. Exclude coverage for on-the-job injury - ANSWERS-A. Adjust the benefit in
accordance with the increased risk
A part of the premium rating concerns the hazard of occupation.
All of the following are correct about the required provisions of a health insurance policy
EXCEPT
A. The entire contract clause means the signed application, policy, endorsements, and
attachments constitute the entire contract.
, B. A reinstated policy provides immediate coverage for an illness.
C. Policies become incontestable after being in force for 3 years.
D. A grace period of 31 days is found in an annual pay policy. - ANSWERS-B. A
reinstated policy provides immediate coverage for an illness.
Accidental injury is covered immediately, but to protect the insurer against adverse
selection, losses resulting from sickness are covered only if the sickness occurs at least
10 days after the reinstatement date.
An insured pays a monthly premium of $100 for health insurance. What would be the
duration of the grace period under the policy?
A. 15 days
B. 30 days
C. 60 days
D. 7 days - ANSWERS-B. 30 days
The grace period is 30 days for all health insurance policies in Louisiana.
An applicant for an individual health policy failed to complete the application properly.
Before being able to complete the application and pay the initial premium, she is
confined to a hospital. This will not be covered by insurance because she has not met
the conditions specified in the
A. Insuring Clause.
WITH Recent Newest Verified And Well Analyzed Exam
Questions (Actual Exam 2026-2027) Correct Detailed &
Verified ANSWERS (100% Accurate Solutions) ALREADY
GRADED A+||NEWEST VERSION Of The Exam Guarantee
Pass!!
A health insurance policy clause that prevents an insurance company from denying
payment of a claim after a specified period of time is known as the
A. Insuring clause.
B. Time Limit on Certain Defenses clause.
C. Misstatement of Age clause.
D. Reinstatement clause. - ANSWERS-B. Time Limit on Certain Defenses clause.
The Time Limit on Certain Defenses provision guarantees that a misstatement made in
the application, unless it is fraudulent, cannot be contested after the first 3 years of the
policy.
An insured purchases a health policy in 2000 and submits a claim in 2005. The
insurance company discovers at that time that the insured misstated the information
about his health condition. What will the insurer most likely do?
A. Deny the claim
B. Pay a decreased benefit
,C. Void the policy
D. Pay the full benefit - ANSWERS-D. Pay the full benefit
The Time Limit on Certain Defenses provision stipulates that no statement or
misstatement (except fraudulent misstatements) made in the application at the time of
issue will be used to void a policy or deny a claim after the policy has been in force for 3
years.
While a claim is pending, an insurance company may require
A. The insured to be examined only once annually.
B. An independent examination only once every 45 days.
C. An independent examination as often as reasonably required.
D. The insured to be examined only within the first 30 days. - ANSWERS-C. An
independent examination as often as reasonably required.
While a claim is pending, an insurance company may require an independent exam as
often as reasonably required.
Which of the following statements is true concerning the alteration of optional policy
provisions?
A. An insurer may change the wording of optional policy provisions that would adversely
affect the policyholder but must first receive state permission before the change goes
into effect.
B. Once any kind of provision is written, it cannot be changed.
,C. An insurer may change the wording of optional provisions, as long as the change
does not adversely affect the policyholder.
D. An insurer may change the wording of optional provisions, regardless of its effect on
the policyholder. - ANSWERS-C. An insurer may change the wording of optional
provisions, as long as the change does not adversely affect the policyholder.
Optional policy provisions can be changed by an insurer, as long as the changes do not
adversely affect the policyholder.
If the insured under a disability income insurance policy changes to a more hazardous
occupation after the policy has been issued, and a claim is filed, the insurance company
should do which of the following?
A. Adjust the benefit in accordance with the increased risk
B. Cancel the policy
C. Increase the premium
D. Exclude coverage for on-the-job injury - ANSWERS-A. Adjust the benefit in
accordance with the increased risk
A part of the premium rating concerns the hazard of occupation.
All of the following are correct about the required provisions of a health insurance policy
EXCEPT
A. The entire contract clause means the signed application, policy, endorsements, and
attachments constitute the entire contract.
, B. A reinstated policy provides immediate coverage for an illness.
C. Policies become incontestable after being in force for 3 years.
D. A grace period of 31 days is found in an annual pay policy. - ANSWERS-B. A
reinstated policy provides immediate coverage for an illness.
Accidental injury is covered immediately, but to protect the insurer against adverse
selection, losses resulting from sickness are covered only if the sickness occurs at least
10 days after the reinstatement date.
An insured pays a monthly premium of $100 for health insurance. What would be the
duration of the grace period under the policy?
A. 15 days
B. 30 days
C. 60 days
D. 7 days - ANSWERS-B. 30 days
The grace period is 30 days for all health insurance policies in Louisiana.
An applicant for an individual health policy failed to complete the application properly.
Before being able to complete the application and pay the initial premium, she is
confined to a hospital. This will not be covered by insurance because she has not met
the conditions specified in the
A. Insuring Clause.
