PSI : LIFE ,ACCIDENT,AND HEALTH EXAM LATEST 2023-2024 REAL
EXAM 250 QUESTIONS AND CORRECT ANSWERS(VERIFIED
ANSWERS)|ALREADY GRADED A+
which oft he following is a characteristic of preferred provider org (PPO)
A: prearranged costs for services rendered
B: providers receive a flat montlyh amount for each user
C: ability to receive care at the same cost from any provider
D: emergency treatment is restricted to pre-select hospitals – ANSWER- A:
prearranged costs for services rendered
how do most disability policies handle the case of a recurrent disability at least 90
days after the first claim:
A: it is handled as a continuation of existing claim
B: it is excluded from coverage because the benefits have already been paid out
C: it must be handled as a new claim for a new period of disability, requiring a new
elimination period
D: it must be handles as a new claim for a new period of disability, without
requiring a new elimination period. – ANSWER- D: it must be handles as a new
claim for a new period of disability, without requiring a new elimination period.
how are issues of amigity usually resolved because insurance contracts are
contracts of adhesion:
A: in favor of the insured because the insurance company drafts language in the
contract
B: in favor of the insured bec insurance companies often do not adhere to the more
specific contract principles
C: in favor of the insurer because most issues arise from misrepresentation on the
part of the insured
D: in favor of the insurer bec the insured frequently does not adhere to the
requirements of the contract – ANSWER- C: in favor of the insurer because most
issues arise from misrepresentation on the part of the insured
what is the difference between copayment and coinsurance:
A: a copayment is a set percentage, while coin insurance is a set dollar amount
B: a copayment is a set dollar amount, while coininsurance is a percentage
C: a copayment is an amount of money that must be paid up front anually before
benefits begin
D: coin insurance is an amount of money that must be paid up front anually before
benefits begin – ANSWER- B: a copayment is a set dollar amount, while
coininsurance is a percentage
which policy provision permits the policyowner to take a specified number of days
to examine the contract, and all the cancellation and a full refund if the
policyowner rejects the terms or costs:
A: exclusions
B: free look
C: grace period
D: insuring clause – ANSWER- B: free look
According to the time of payment of claims provision, the insurer must make the
payment immediately after receiving proof of loss EXCEPT:
A: for claims involving periodic payments
B: if the death is a suicide or due to pre existing conditions
C: when the policy is in the incontestability period
D: if the insured is able to eventually return to work – ANSWER- C: when the
policy is in the incontestability period
A group conversion option may be used in all the following instances EXCEPT
- the termination of the master policy
- loss of coverage due to loss of employment.
- loss of eligibility on the part of a class of insureds.
- a life-changing event, such as marriage, divorce, or childbirth. – ANSWER- 1.
the termination of the master policy
How do warranties differ from representations? - a warranty is guaranteed to be true, a representation is believed to be true to the
best of one’s knowledge. - a representation is guaranteed to be true, a waranty is believed to be true to the
best of one’s knowledge. - a warranty is issued by the insurer, a representation is a statement provided by
the applicant. - an incorrect representation automatically voids a contract, whereas an incorrect
waranty must be proven. – ANSWER- 1. a warranty is guaranteed to be true, a
representation is believed to be true to the best of one’s knowledge.
Which of the following is considered the major advantage of HIPAA?
- portability
- increased coverage
- qualified beneficiaries
- tax deductibility of certain medical expenses – ANSWER- 4. tax deductibility of
certain medical expenses
During which period of a Disability Income Policy is coverage effective but during
which no benefits will be paid under the policy? - benefit period
- elimination period
- grace period
- probationary period – ANSWER- 2. elimination period
Which of the following may be thought of as a time deductible rather a dollar
deductible in a disability income policy because benefits are not payable during
that time? - elimination period
- probationary period
- benefit period
- grace period – ANSWER- 1. elimination period
What is an impairment rider? - It indefinitely extends the time to provide the proof of loss until after an
impairment is resolved. - It allows the reinstatement of a policy when an impairment is deemed to have
caused the policy lapse. - It lists specific conditions in the contract that are excluded from the contract
- It states that a contract can be cancelled and premiums refunded if the
policyholder was mentally impaired at time of issue. – ANSWER- 3. It lists
specific conditions in the contract that are excluded from the contract
What is it called when an insurance company tries to recover from a different
insurance policy all or part of its losses resulting from a claim? - secondary beneficiary
- subrogation
- coordination of benefits
- conversion – ANSWER- conversion
Which of the following amends the Social Security Act to make Medicare
secondary to group health plans?
- ADEA
- ERISA
- OBRA
- TEFRA – ANSWER- 1. ADEA
What is the major reason that insurance regulators are often critical of dread
disease insurance policies?
1.
The plans tend to be much more expensive than major medical alternatives.
2.
They exclude illnesses that are related to pre-existing conditions.
3.
It is hard to predict which illness a person is likely to contract.
4.
Buyers often think they are getting broader coverage than they actually purchase. –
ANSWER- 3.
It is hard to predict which illness a person is likely to contract.
What does first dollar coverage mean?
1.
The policy is primary to a secondary insurance policy.
2.
The insured pays the deductible first before coverage begins.
3.
As soon as covered medical expenses are incurred, the policy begins to pay.
4.
The insurer pays the insured first and then the insured pays the provider directly. –
ANSWER- 2.
The insured pays the deductible first before coverage begins.
Obtaining consumer information reports under false pretenses is prosecutable by
which of the following? - USA Patriot Act
- Fair Credit Reporting Act
- State laws where the applicant resides
- Securities and Exchange Commission – ANSWER- 2. Fair Credit Reporting Act