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/NV Health Final Exam 1 | Latest 2025/ 2026 Update | Questions and Answers |With Complete Solution

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/NV Health Final Exam 1 | Latest 2025/ 2026 Update | Questions and Answers |With Complete Solution

Institution
NV Health
Course
NV Health

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/NV Health Final Exam 1 | Latest 2025/ 2026
Update | Questions and Answers | 100% Correct|
GRADED A (Verified Solutions).
Which law requires the applicant be notified before a consumer report is ordered:
Fair Credit Reporting Act




The Insuring Clause of an A&H policy usually states all of the following, EXCEPT:
A. That insurance against loss is provided
B. That a loss must result directly from stated accidents or sicknesses
C. The method of premium payment
D. The identities of the insurance company and the insured
C. The method of premium payment




Which of the following statements about Medicare is/are true?


I. Payments are made directly to the hospital providing services rather than to the insured
II. Benefits can continue beyond the hospitalization period
Correct Answer: Both I and II




The Misstatement of Age provision gives the insurance company the right to:
A. Bring suit for fraud
B. Cancel the contract
C. Adjust benefits payable
D. Reduce dividends payable

,C. Adjust benefits payable




Which of the following statements about group A&H provisions and practices is/are true?


I. Insurance company practices are generally less liberal under Group policies than under
Individual policies
II. Experience rating is generally utilized under Group policies
Correct Answer: II only




A&H insurance provides coverage for sickness and injury that includes which of the following
benefits?


I. Income benefits due to loss of time from work
II. Benefit payments for hospital care
Correct Answer: Both I and II


Explanation:


There are three different types of A&H insurance: 1) Medical Expense; 2) Disability Income and
3) AD&D. A&H is a general term including all three types.




The part of a HMO policy, which provides for the claim to be shared between the insurer and the
insured, is known as which of the following?
A. Deductible
B. Out of pocket maximum
C. Co-pay

, D. Usual, customary and reasonable
C. Co-pay




Answers given by applicants to questions on applications for A&H insurance are considered
which of the following?


I. Representations
II. Warranties
I only - - Representations




A&H coverage becomes effective when the:
A. First premium has been paid and received in the insurance company's home office
B. First premium has been paid and the application has been approved
C. Producer delivers the policy to the insured
D. Medical examination has been completed and the premium paid
B. First premium has been paid and the application has been approved




Which of the following policies can be written on a Non-cancelable and Guaranteed Renewable
basis?


I. A Major Medical Expense policy
II. A Disability Income policy
II only - A Disability Income policy


Explanation:

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