NYstate insurance license practice
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exam questions & answers v v v v
Under what circumstance does an accident and health insurer have the right to
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request an autopsy?
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1. When the claim exceeds an amount specified in the policy
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2. When 2 days have passed after death
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3. When not prohibited by state law
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4. When consent is given by the beneficiary
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3. When not prohibited by state law
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Which of the following accurately describes the "time limit on certain defenses"?
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1. After a stated period of time, claims cannot be denied due to material
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misrepresentation on the application
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2. All claims can be disputed after two years
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,3. An insured cannot file a lawsuit within 90 days of the claim being filed
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4. The right to return an accident and health policy must be within 10 days of
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policy delivery
v v
1. After a stated period of time, claims cannot be denied due to material
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misrepresentation on the application
v v v v
Patrick purchased a long-term care policy. He has a health condition for which
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medical treatment was recommended by a physician within 6 months prior to the
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policy's effective date. This condition is called a(n)
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1. antecedent condition v
2. pre-existing condition v
3. hazardous condition v
4. grandfathered condition v
2. pre-existing condition v
Which of the following describes coverage for the Medicare Part B coinsurance?
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1. Only a Long-term care policy will cover Medicare Part B coinsurance
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,2. A Medicare Supplement optional benefit
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3. A Medicare Supplement core benefit
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4. Medicare Part B does not require a coinsurance so no additional coverage is
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needed
v
3. A Medicare Supplement core benefit
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Larry has a Major Medical Expense policy for his family with a $1,000 per
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family/per year deductible and an 80/20 coinsurance provision. If Larry's family files
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four claims of $400, $800, $100, and $700 in one year, how much will the
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insurance company pay?
v v v
1. $500
2. $800
3. $1,000
4. $1,200
2. $800
v
(($400 + $800 + $100 + $700 = $2,000. The insurance company pays 80% of
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$1,000 (outstanding balance after deductible is paid), or $800.))
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, Long-term care policies issued in New York must provide benefits for at least
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1. 6 months
v
2. 12 monthsv
3. 18 monthsv
4. 24 monthsv
2. 12 months
v v
Which of the following types of insurers limits the exposures it writes to those of its
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owners?
v
1. Restricted insurer v
2. Limited insurer v
3. Confined insurer v
4. Captive insurer v
4. Captive insurer
v v
v v v v
exam questions & answers v v v v
Under what circumstance does an accident and health insurer have the right to
v v v v v v v v v v v v
request an autopsy?
v v v
1. When the claim exceeds an amount specified in the policy
v v v v v v v v v
2. When 2 days have passed after death
v v v v v v
3. When not prohibited by state law
v v v v v
4. When consent is given by the beneficiary
v v v v v v
3. When not prohibited by state law
v v v v v v
Which of the following accurately describes the "time limit on certain defenses"?
v v v v v v v v v v v
1. After a stated period of time, claims cannot be denied due to material
v v v v v v v v v v v v
misrepresentation on the application
v v v v
2. All claims can be disputed after two years
v v v v v v v
,3. An insured cannot file a lawsuit within 90 days of the claim being filed
v v v v v v v v v v v v v
4. The right to return an accident and health policy must be within 10 days of
v v v v v v v v v v v v v v
policy delivery
v v
1. After a stated period of time, claims cannot be denied due to material
v v v v v v v v v v v v
misrepresentation on the application
v v v v
Patrick purchased a long-term care policy. He has a health condition for which
v v v v v v v v v v v v
medical treatment was recommended by a physician within 6 months prior to the
v v v v v v v v v v v v v
policy's effective date. This condition is called a(n)
v v v v v v v v
1. antecedent condition v
2. pre-existing condition v
3. hazardous condition v
4. grandfathered condition v
2. pre-existing condition v
Which of the following describes coverage for the Medicare Part B coinsurance?
v v v v v v v v v v v
1. Only a Long-term care policy will cover Medicare Part B coinsurance
v v v v v v v v v v
,2. A Medicare Supplement optional benefit
v v v v
3. A Medicare Supplement core benefit
v v v v
4. Medicare Part B does not require a coinsurance so no additional coverage is
v v v v v v v v v v v v
needed
v
3. A Medicare Supplement core benefit
v v v v
Larry has a Major Medical Expense policy for his family with a $1,000 per
v v v v v v v v v v v v v
family/per year deductible and an 80/20 coinsurance provision. If Larry's family files
v v v v v v v v v v v v
four claims of $400, $800, $100, and $700 in one year, how much will the
v v v v v v v v v v v v v v v
insurance company pay?
v v v
1. $500
2. $800
3. $1,000
4. $1,200
2. $800
v
(($400 + $800 + $100 + $700 = $2,000. The insurance company pays 80% of
v v v v v v v v v v v v v v
$1,000 (outstanding balance after deductible is paid), or $800.))
v v v v v v v v
, Long-term care policies issued in New York must provide benefits for at least
v v v v v v v v v v v v
1. 6 months
v
2. 12 monthsv
3. 18 monthsv
4. 24 monthsv
2. 12 months
v v
Which of the following types of insurers limits the exposures it writes to those of its
v v v v v v v v v v v v v v v
owners?
v
1. Restricted insurer v
2. Limited insurer v
3. Confined insurer v
4. Captive insurer v
4. Captive insurer
v v
