Exam (elaborations)
CHAPTER #8 - TEXAS LIFE AND HEALTH EXAM QUESTIONS AND ANSWERS
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CHAPTER #8 - TEXAS LIFE AND HEALTH EXAM QUESTIONS AND ANSWERS
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CHAPTER #8 - TEXAS LIFE ANDHEALTH EXAM QUESTIONS AND
ANSWERS
Health Insurance - Answer-provides protection to consumers for certain losses due to
covered sickness and/or accidents.
Sickness - Answer-an illness or disease that occurs after the policy is issued
Accidental Bodily Injury - Answer-a spontaneous, unforeseen, and unintended event
resulting in injury
policyowner - Answer-controls the policy, is responsible for making premium payments,
and maintains the right to make all decisions regarding coverages
benefits are payable to the - Answer-insured or assigned to a medical professional or
institutions
for a contract to be valid - Answer-insurable interest must exist between the owner
(applicant) and insured before the policy will be issued.
Insurance producers - Answer-educate consumers and help them meet their needs.
insurable interest - Answer-Relationship that must exist at the time of application in
which an insured's sickness or injury would result in a financial or economic loss by the
policyowner
application - Answer-formal request written by the applicant to the insurer for the insurer
to accept - primary source of information
An application for health insurance is completed by a producer and signed by the
applicant. The applicant remembers information that needs to be added to the
application before being submitted to the insurer and contacts the producer, who has
returned to the office. Which of the following statements is correct?
A
The producer must meet with the applicant in person to update the information and
have the applicant initial the changes
B
Once the application is signed, answers reported on the application cannot be changed
C
The producer can make any changes necessary with verbal consent of the applicant
, D
The applicant will have the opportunity to correct any information when the policy is
delivered - Answer-A; changes require written consent
If an incomplete application is accepted by the underwriter and a policy is issued without
requesting the missing information, which of the following statements applies?
A
The insurer waives its right to contest a claim based on the incomplete application
B
The insurer can void the contract at any time since this is considered fraudulent
C
The producer will be personally responsible out of pocket for any claims filed based on
the missing information in the application
D
The policy can be contested if a loss occurs within 2 years of the policy being issued -
Answer-A
the policy does not go into effect until: - Answer-the first premium has been paid - if
check is not signed, the coverage does not start then
Trial Application - Answer-submitted without a premium. An insurance applicant may be
concerned that he/she will not qualify for a policy and does not wish to pay the premium
up front. If the applicant is considered an acceptable risk, coverage would not take
effect until the policy is ultimately issued by the insurer, delivered by the agent, and the
premium is paid. This may also be referred to as a C.O.D., or collect on delivery.
applicant's signature - Answer-This gives the insurance company the right to obtain the
various investigative, medical, and financial reports to complete the underwriting
process.
insurance applicant - Answer-has a right to receive a copy of the report through the third
party that does the report, not by the insurance company
Underwriting Factors - Answer-Age
Gender
Tobacco use
Occupation and hobbies (degree of risk); if more than 1 occupation, the most hazardous
will be used
Physical condition
Moral hazard/financial hazard
Health history
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