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Comprehensive Instructional Review Questions with Solutions
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Comprehensive Instructional Review
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Comprehensive Instructional ReviewPre-hospitalization authorization is considered an example of: - answer Managed Care
M purchases a $70,000 Life Insurance Policy with premium payments of $550/year for
the first 5 years. At the beginning of the 6th year, the premium will increase to $800/year
but will remain level thereafter. The face amount will remain $70,000 throughout the life
of the policy. The type of policy that M has purchased is: - answerModified Premium Life
An insured MUST submit a proof of loss on a health insurance claim within how many
days after the date of loss? - answer180
Flexible Premium - answerWhat kind of special need would a policy owner require with
an Adjustable Life Insurance policy?
How does group insurance differ from individual insurance?insurance? -
answerPremiums are lower
A terminated employee must have been covered for at LEAST __ month(s) under a
Group Health insurance policy immediately prior to termination in order to be eligible for
continuation of coverage. - answer3
An insurance agent is guilty of twisting if the agent: - answerMisrepresents a policy to
induce a policyowner to surrender an existing
Which of these is considered a mandatory provision? - answerPayment of claims
K works for XYZ Clothing Store from September through December each year. K works
45hrs/week for this period of time. The employer's Group Policy would consider K: -
answerNot eligible for the insurance because as a seasonal employee K does not meet
the definition of "employee" under NC law
The situation in which a group of physicians are salaried employees and conduct
business in an HMO facility is called a(n): - answerClosed Panel
XYZ Company pays the entire premium for its group health plan. The MINIMUM
percentage of eligible employees that must be covered is: - answer100%
The policy provision that entitles the insurer to establish conditions the insured must
meet while a claim is pending is: - answerTime Limit on Certain Defenses
,M has a Major Medical Insurance policy with a $200 flat deducible and an 80% Co-
insurance clause. If M incurs a $2,200 claim for an eligible medical expense, how much
will M receive in payment for this claim? - answer$1,600 ($2,200-$200 deductible X
80% = $1,600)
When does a Probationary Period provision become effective in a health insurance
contract? - answerA the policy's inception
K has an Accidental Death and Dismemberment (AD&D) insurance policy where her
husband is beneficiary and her daughter is contingent beneficiary. Under the Common
Disaster clause, if K and her husband are both killed in an automobile accident, where
would the death proceeds be directed? - answerDaughter
An insured owns an Individual Disability Income policy with a 30-day Elimination Period
for sickness and accidents and a monthly indemnity benefit of $500. If the insured is
disabled for 3.5 months, what is the MAXIMUM amount he would receive for an
approved claim? - answer$1,250 (3.5 months - 1 month elimination period = 2.5 months
X $500 monthly indemnity = $1,250)
How long must every insurance agent maintain all records, books, and documents
related to each insurance transaction? - answer5 years
What action can a policyowner take if an application for a bank loan requires collateral?
- answerAssign policy ownership to the bank
Which of these would be considered a Limited-Pay Life policy? - answerLife Paid-Up at
Age 70
A Health Insurance Policy applicant unintentionally fails to list a previous visit to a
neurologist. If the policy is issued and the insurer later decides to contest the policy, it
must do so: - answerWithin 2 years from the date of issue
What is one of the requirements for an applicant to become a licensed as a NC accident
and health insurance agent? - answerComplete at least 20 hours of instruction
approved by the commissioner of Insurance
Non-occupational disability coverage is designed for: - answerEmployees who suffer
non-work related disabilities, since work-related disabilities are covered by Workers'
Compensation
An individual life insurance policy issued in NC MUST have a grace period for premium
payment of how many days? - answer31
Which of the following types of policies BEST identifies one in which the cash value may
fluctuate to reflect changing assumptions regarding mortality cost, interest, and expense
factors? - answerUniversal Life
, K sent a renewal premium payment to her insurer that would extend her coverage
beyond the policy's maximum age limit. If the insurer accepts this payments, it: -
answerMust continue the coverage to the end of the period of time for which the
premium was accepted
Which of the following best describes a contingent beneficiary? - answerPerson
designated by the insured to receive policy proceeds in the event that the primary
beneficiary dies before the insured
Common exclusions to continuation of group coverage include: - answerAll of the above
(Dental Care, Dental Care, Other Rx Drugs)
If the Commissioner of Insurance is no longer able to complete the term of office, who is
REQUIRED to fill this vacancy? - answerGovernor
T is covered by two health insurance plans: a group plan through his employer and his
spouse's plan as a dependent. Under the Model Group coordination of Benefits
provision, when T files a claim, his employer's plain is considered the: - answerPrimary
Carrier
Insurance policies are considered aleatory contracts because: - answerPerformance is
conditioned upon a future occurrence
An individual Disability Income insurance applicant may be required to submit all of the
following information, EXCEPT: - answerSpouse's Occupation
Which of the following types of insurance is exempt form the rules governing Life
Insurance and Annuity Replacements? - answerCredit Life
Which of these types of Life insurance allows the policyowner to have level premiums
and to also choose form a selection of investment options? - answerVariable Life
Which of the following is the reimbursement of benefits for the treatment of a
beneficiary's injuries caused by a third party? - answerSubrogation
Which of the following individuals MUST be licensed as an agent? - answerA person
who places insurance on behalf of anyone seeking insurance
Who does an insurance broker in NC represent? - answerInsured
The annuity that represents the largest possible monthly payment to an individual
annuitant is a(n): - answerStraight Life Annuity
A group health policy's approved premium rate is guaranteed by the insurer for an initial
period of at LEAST __ months? - answer12
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