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NC Accident & Health Practice Exam Questions and Answers 100% Accurate
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NC Accident & Health Practice Exam
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NC Accident & Health Practice ExamWhich of the following policies would be the most expensive? - answer Noncancellable
The deductible that an insured has to pay before benefits begin to be paid by the insurer
in a major medical policy is know as the: - answer Initial Deductible
When a specialist within the insurance company reviews a file to asses whether an
alternate treatment is available that might be cheaper, this is known as: - answer Case
Management
X has an 80/20 major medical policy with a $250 deductible. Since X has not satisfied
any of the deductible, if X incurs $1500 in medical expenses, how much of the bill will
the INSURER pay? - answer$1000
What is the feature found in a major medical policy that replaces a certain amount of
coverage each year lost as a result of a claim? - answer Restoration of Benefits
In a major medical policy, what limits the amount of total deductible on a per person
deductible policy? - answer Family Deductible Limit
When available Dental & Vision coverage generally are issued in what type of Health
Insurance policy? - answerGroup
Which of the following is not a required uniform provision in individual health insurance
policies? - answerChange of Occupation
If the co-insurance feature in a major medical policy is 75%-25% with a $100 deductible,
how much of a $2,100 bill would the insured have to pay? - answer$600
Regardless of you expenses this policy pays a flat amount per day in the hospital. What
is this called? - answerHospital Indemnity or Hospital Income Plan
Under the proof of loss provision: - answerThe insured has 180 days to file proof of loss
By adding the major medical to the basic, the insured now has the equivalent of
comprehensive major medical coverage. The deductible which is in between the basic
and the major medical coverage is known as the: - answerCorridor Deductible
Which of the following is false regarding the NONCANCELABLE form of renewability? -
answerThe policy can be canceled but only for reasons stated in the contract
, Premiums may not be increased on which of the following health policies? -
answerNoncancelable
The time limit on certain defenses (Incontestable) is: - answer2 years from the date of
issue
Which of the follow is not a feature of a Dental Plan? - answerHigh Policy Limits
The optional provision, OTHER INSURANCE IN THIS INSURER, is specifically
designed to: - answerlimit the risk with any one individual insured with the company
What is the "consideration" given by an insurance company? - answerPromises in the
Policy
Unfortunately, Larry's family was involved in an automobile accident. What is the name
of the health insurance provision which explains how the deduction works in their
situation? - answerCommon Accident
X and Y have twin sons, A and B, who have just turned 18. In the fall A will enter college
and B is going into the Army. Who will X and Y be able to continue to cover under their
health policy? - answerA only
A Comprehensive Medical Expense policy pays 100% of the first $5,000 of expenses,
has a corridor deductible of $100 and 80% / 20% coinsurance. How much of a $6,100
bill will the insurance company pay? - answer$5,800
What is used in major medical policies to limit coverage for a specific disease? -
answerInside Limits
X incurs $1400 in eligible expenses. The policy is 80/20 with a $200 annual deductible.
This is the first claim for the year. What is the maximum amount the insured will be
required to pay on this claim? - answer$440
The Notice of Claim provision requires the insured to notify the insurance company of a
claim within: - answer20 days
What does the term First Dollar mean? - answerThe policy has no deductible
After the basic benefits are exhausted, the corridor deductible must be paid before the
benefits of what coverage becomes payable? - answerMajor Medical
The words "reasonable & customary" found in a health policy mean: - answerThe policy
will pay what most Dr's & Hospitals charge for similar services in the same geographic
area
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