Verified Answers 2024-2025 Update|
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Which of the following reimburses its insureds for covered medical expenses?
- health maintenance organizations
- preferred provider organizations
- commercial insurers
- service providers -CORRECT>> COMMERCIAL INSURERS
- Commercial insurance companies function on the reimbursement approach. Policyowners
obtain medical treatment from whatever source they feel is most appropriate and submit their
charges to their insurer for reimbursement
A business entity can be defined as a(n)
- agency that must only operate outside of TN
- agency that must only operate inside of TN
- association or a limited liability company
- business that requires approval by the Attorney General to transact business -
CORRECT>> ASSOCIATION OR A LIMITED LIABILITY COMPANY
- The definition of a business entity includes an association or limited liability company
Which of the following health insurance policy provisions specifies the health care services a
policy will provide?
- insuring clause
- usual, customary, and reasonable clause
- consideration clause
- benefit clause -CORRECT>> INSURING CLAUSE
- The insuring clause identifies the specific type of health care services that are covered by that
policy
A Disability Income policy that only the policyowner can terminate and which the rates will
never go up is considered to be
,- optionally renewable
- noncancellable
- cancellable
- guaranteed renewable -CORRECT>> NONCANCELLABLE
- A disability income policy that only the policyowner can terminate and on which the rates will
never increase is a noncancellable policy
A producer may apply for one or more of the following licenses:
- life insurance
- personal lines property
- accident and health or sickness insurance
- all of the above -CORRECT>> ALL OF THE ABOVE
A provision in a life insurance policy that pays the policyowner an amount that does not surpass
the guaranteed cash value is called the:
- policy loan provision
- automatic premium loan provision
- accelerated benefits provision
- consideration clause -CORRECT>> POLICY LOAN PROVISION
- a policy loan will pay the policyowner an amount that, with interest, does NOT exceed the
guaranteed cash value
Long Term Care policies will usually pay for eligible benefits using which of the following
methods?
- Delayed
- fee for service
- expense incurred
- respite -CORRECT>> EXPENSE INCURRED
- Most long term care policies pay on a reimbursement (or expense-incurred) basis, up to policy
limits
,Which of the following is NOT a limited benefit plan?
- Dental policy
- life insurance policy
- critical illness policy
- cancer policy -CORRECT>> LIFE INSURANCE POLICY
- is not a limited benefit plan
In TN, the definition of "individual" may include which of the following?
- The individual's children
- the individual's business associates
- the individuals legal representative
- the individuals financial accounts -CORRECT>> THE INDIVIDUALS LEGAL REPRESENTATIVE
- The term "individual" can be associated with an individuals legal representative
What is the purpose of the Time of Payment Claims Provision?
- Requires the insured to wait 60 days after submitting Proof of Loss before filing a lawsuit
- prevents delayed claim payments made by the insurer
- requires a probation period for each claim filed by the insured
- protects the insurer from frivolous lawsuits -CORRECT>> PREVENTS DELAYED CLAIM
PAYMENTS MADE BY THE INSURER
- The purpose of the Time of Payment of Claims provision is to prevent the insurance company
from delaying claim payments
What is considered to be a characteristic of an immediate annuity?
- Benefit payments start within one payment period of purchase
- benefit payments start within 5 years of initial purchase
- normally tied to a specific equity or stock index
, - periodical contributions begin immediately -Answer✅ BENEFIT PAYMENTS START WITHIN
ONE PAYMENT PERIOD OF PURCHASE
- an immediate annuity is designed to make its first benefit payment to the annuitant at one
payment interval from the date of purchase
A licensed producer can be BEST described as a(n)
- someone who places insurance advertisements in a newspaper
- underwriting officer of an insurance company
- individual who places insurance on behalf of anyone seeking insurance
- administrator answering calls for an insurance agency -CORRECT>> INDIVIDUAL WHO
PLACES INSURANCE ON BEHALF OF ANYONE SEEKING INSURANCE
- A person who places insurance on behalf of anyone seeking insurance must be licensed as a
producer
What is the max fine that can be imposed by the Commissioner to a producer who violates an
insurance law?
- $250 per violation
- $500 per violation
- $1,000 per violation
- no limit to the fine -CORRECT>> $1,000 PER VIOLATION
- If the Commissioner finds a producer to be in violation of insurance laws, the Commissioner
may impose a fine of no more than $1000 per violation
A father who dies within 3 years after purchasing a life insurance policy on his infant daughter
can have the policy premiums waived under which provision?
- Payor provision
- accelerated benefits provision
- assignment provision
- waiver of premium provision -CORRECT>> PAYOR PROVISION