MAINE LIFE INSURANCE EXAM

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MAINE LIFE INSURANCE EXAM

Qs and Ans - Expert- Explanation - ing score -100 Questions and Answers

-Format: Multiple-choice / Flashcard

Question 1: Notice and hearing

Answer:

Superintendent may call and hold hearings. At least 14 days notice will be given to those affected.

Question 2: 11. Legal Actions (12 Mandatory Policy Provisions)

Answer:

The insured cannot take legal action in a claim dispute until after 60 days from the time the insured submits proof of loss. Time is limited to no more than 5 years.

Question 3: HSAs (Health Saving Organizations)

Answer:

Helps people save for medical expenses, contributions are tax deductible. To be eligible, must have a high deductible health plan

Question 4: Automatic Policy Loan

Answer:

A provision that will keep a whole life policy in force if a required premium payment is not made and there is sufficient cash value

Question 5: Agents may not submit applications to insurance company without the following:

Answer:

The insurance company's name on the first page, the agents license number,

Question 6: 12. Change of Beneficiary (12 Mandatory Policy Provisions)

Answer:

Policy owner may change beneficiary at any time, unless irrevocable

Question 7: Maternity Benefits

Answer:

Any policy of health insurance that provides maternity care must also cover the services of nurses/midwives, and licensed birth centers.

Question 8: Home health care

Answer:

LTC policies must pay for "at home" care at the same daily amount as paid for nursing homes

Question 9: 3. Grace Period (12 Mandatory Policy Provisions)

Answer:

Policy owner given a number of days after the premium due date during which time the premium payment may be delayed without penalty and the policy continues. Minimum grace period for weekly payments are 7 days, 10 days for monthly, 31 for all others.

Question 10: 11. Intoxicants and Narcotics (11 Optional Provisions)

Answer:

Insurer is not liable for any loss attributed to the insured while intoxicated or under the influence of narcotics.

Question 11: Waiting period in a group health policy

Answer:

gives insurance company the right to delay coverage for a covered sickness for a specified number of days after the effective date of the policy

Question 12: Deductible

Answer:

What an insured pays before benefits are paid out. Used to control the cost of premiums and reduce over-utilization of medical services.

Question 13: 3 basic categories of health insurances

Answer:

Medical Expense, Disability Income Insurance, AD&D

Question 14: Noncontributory Health Insurance

Answer:

If the employer pays the entire premium. Most require participation by eligible members.

Question 15: Major medical expense plans

Answer:

Usually carry deductibles, coinsurance requirements, and have large benefit maximums. Coverage provided for inpatient and outpatient hospital expenses.

Question 16: Health Insurance Portability and Accountability Act (HIPAA)

Answer:

Provides the ability to transfer and continue health insurance when someone changes or loses their job

Question 17: Coordination of Benefits provision

Answer:

Prevents an insured covered by two health plans from making a profit on a covered loss

Question 18: 1. Change of Occupation (11 Optional Provisions)

Answer:

Allows the insurer to reduce the maximum benefit payable if the insured switches to a more hazardous job or to reduce the premium rate charged if they switch to a less hazardous job.

Question 19: 3. Other insurance with this insurer (11 Optional Provisions)

Answer:

Designed to protect insurer

Question 20: Medicare Part D

Answer:

Prescription drug plan

Question 21: Examination of Records

Answer:

The Superintendent may perform investigations of any company. A domestic company shall be examined once every 3 years.

Question 22: Twisting

Answer:

Using misrepresentations to induce a person to terminate or borrow against their current insurance policy to take out a policy with another insurer

Question 23: 9. Payment of Claims (12 Mandatory Policy Provisions)

Answer:

How and to whom claim payments are made

Question 24: Incontestability Period

Answer:

A policy is incontestable after 2 years from date of issue (unless fraud)

Question 25: Medicare select (or Part C)

Answer:

Insured agrees to use preferred providers, and pay a lower premium in exchange

Question 26: 10. Physical Exam and Autopsy

Answer:

Entitles a company, at its own expense, to make physical examinations of the insured at reasonable intervals during the period of the claim, unless forbidden by state law.

Question 27: Business overhead expense (business income policy)

Answer:

Sold to small business owners who must continue to meet overhead expenses such as rent, used if owner becomes disabled. Covers fixed business expenses