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Accident and Health Insurance Agent - Broker Practice Exam (ACTUAL EXAM ) Questions and Answers (Solved)
- Sally is considering her Medicare options. She understands that to enroll in
- Yes, she can enroll at anytime in the future
- Yes, however; she would have a permanent premium penalty when she does enroll
- No, this is a take or leave it situation
- Yes, but she would have to show evidence of good health.
Medicare Part B, she will have to pay a monthly premium. Since she is healthy, she is considering delaying her enrollment until later. Will she be able to enroll at a later date?
Answer: Yes, however; she would have a permanent premium penalty when she
does enroll
- Under Medicare Part A, a spell of illness begins again and is subject to a new
deductible for another admission when:
- The patient has been discharged from a prior stay and 45 days have elapsed
- The patient has been discharged from a prior stay and 30 days have elapsed
- The patient has been discharged from a prior stay and 60 days have elapsed
- The patient has been discharged from a prior stay and 90 days have elapsed-
Answer: The patient has been discharged from a prior stay and 60 days have elapsed
- What type of insurer retains risk?
1.Government insurance.
2.Reinsurers.
3.Self insurers.
4.Assessment insurers.
Answer: Self insurers.
- A variety of types of care are provided under a long-term care policy. All of the
following are types of care generally provided EXCEPT:
1.Home health care 2.Intensive care 3.Custodial care
- Skilled care
Answer: Intensive care
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- Melvin has a long-term care policy with a 30-day elimination period. The policy
has a daily benefit of $100/day. The policy has a 3-year benefit period. If Melvin is confined to a nursing home for 9 months, how much in benefits will his policy pay?
1. $27,000
2. $18,000
3. $24,000
4. $17,000
Answer: $24,000
- Martin and his friends were at a local tavern celebrating his birthday. Martin left
the bar to drive home, but unfortunately, he was involved in a fatal accident, killing himself and two other individuals. An autopsy reveals that Martin was well above the legal limit on his blood alcohol test. Martin's family will receive the following
from his Accidental Death and Dismemberment policy:
- His family will receive reduced benefits since other deaths were involved.
- His family will receive the principal sum since this was death
- His family will receive no benefits, since he was in the act of committing a felony
- His family will receive no benefits since there was no dismemberment involved.
Answer: His family will receive no benefits, since he was in the act of committing a felony
7. An exclusion that always appears in a health policy is:
- No coverage for drug or alcohol related illness
- Hernia from an accident
- Travel outside of the USA
- Injury in the act of committing a felony
Answer: Injury in the act of committing a felony
- Bruce owns a plan that pays $100 daily benefit for a hospital stay with no
deductible. This kind of policy is known as a (an):
- Major medical plan
- Basic plan 3.Indemnity plan
4.Reimbursement plan
Answer: Indemnity plan
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- Under what conditions is the death benefit (principal sum) payable under an
- The insured dies from a grave illness
- The insured dies from natural causes
- The insured dies from an accident
- All of the above
Accidental Death and Dismemberment (AD&D) policy?
Answer: The insured dies from an accident
- An insurance agent told a member of his church who had recently experienced
- The agent was breaking the law.
- The agent is compassionate.
- The agent was engaging in unfair discrimination.
- The agent was engaging in twisting.
several personal and financial losses that he could see that she got a more favorable rate on her insurance policies than her health and general circumstances would warrant. The woman had been his kindergarten teacher and was a pillar in the community's life. He wanted to help her. Which of the following is FALSE?
Answer: The agent was engaging in twisting.
- Which of the following is NOT considered to be an unfair claims settlement
practice?
1.Knowingly misrepresenting policy provisions. 2.Replacing one insurance policy with another.
3.Failing to promptly acknowledge pertinent communications.
4.Refusing to pay claimants without conducting a reasonable investigation.
Answer: - Replacing one insurance policy with another.
- The practice of using misrepresentation to induce a policyholder to re- place a
policy issued by the insurer the producer represents is called:
- twisting. 2.churning. 3.intimidation.
4.misrepresentation.
Answer: churning.
13. All of the following acts are considered unfair trade practices EXCEPT:
- replacement. 2.misrepresentation 3.coercion. 3 / 4
4.rebating.
Answer: replacement.
- What gives the insurance company the right to assume rights of the insured in
order to sue a responsible third party when damages are inflicted on the insured?
1.Warranties 2.Subrogation 3.Concealment 4.Utmost good faith
Answer: Subrogation
- Insurance contracts sometimes contain ambiguities. Which of the following has
not been taken to court for further interpretation?
1.Reasonable expectations 2.Subrogation 3.Ambiguities in a contract of adhesion 4.Utmost good faith
Answer: Subrogation
- There are various optional provision for health policies. Which of the following
is not an optional provision?
1.Intoxicants and narcotics 2.Conformity with state statutes 3.Reinstatement 4.Illegal occupation
Answer: Reinstatement
- Tony (the insured) cancelled his health policy by submitting a written notice to
- Returned to the insured using a pro-rata basis
- They are returned to the agent
- The insurer gets to keep them
- Returned to the insured using a short-rate basis
the insurer. How are unearned premiums handled?
Answer: Returned to the insured using a short-rate basis
- The Patient Protection and Affordable Care Act allows states to combine their
- Commercial insurance companies
- Their Medicaid recipients
- Their exchange for individual consumers
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SHOP exchange with -
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