PEARSON VUE NATIONAL HEALTH INSURANCE PRACTICE

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PEARSON VUE NATIONAL HEALTH INSURANCE PRACTICE

TEST Actual Qs and Ans - Expert-Verified Explanation -Guaranteed passing score -51 Questions and Answers

-Format: Multiple-choice / Flashcard

Question 1: Which of the following laws requires an insurer to notify an applicant in writing that an investigative consumer report may be made on the applicant?

• Uniform Provisions Law
• Freedom of Information Act
• Medical Information Bureau Disclosure Act
• Fair Credit Reporting Act (Insurance Information and Privacy Protection Act)

Answer:

d Question 2: A Disability Income policy may provide benefits for which of the following losses?

• Residual Disability
• Catastrophic medical expenses
• Long term care
• Supplemental payments to Medicare

Answer:

a

Question 3: Which of the following reports may include information obtained by a telephone call to the proposed insured?

• Medical Information Bureau (MIB) report
• Attending physician's report
• Inspection report
• Precertification Review

Answer:

c Question 4: The Consideration clause in an accident and health policy states the:

• the applicant pays the initial premium
• conditions under which benefits are paid

C.premiums will be refunded during the free look period

• certain claims will be excluded under the policy

Answer:

a Question 5: An insurer must provide claim forms to an insured within a MAXIMUM of how many days after receiving notice of an Accident & Health claim?

• Five
• Fifteen
• Twenty
• Thirty

Answer:

b

Question 6: On June 1, S purchased a Major Medical policy and paid the initial premium to Producer T. On July 1, Producer T received the policy from the insurance company. The policy contained a Ten-Day Free Look provision. On July 3, Producer T attempted to deliver the policy but found that S was not at home. On July 5, Producer T was able to deliver the policy to S. On July 7, S decided he did not want the policy. S had 10 days from which of the following dates to return the policy to the company and obtain a full premium refund?

• July 1
• July 3
• July 5
• July 7

Answer:

c Question 7: Suicide, pre-existing conditions and self-inflicted injuries are dealt with in which of the following policy features?

• Extensions of coverage
• Benefits clause
• Riders
• Exclusions

Answer:

d Question 8: J has a physical impairment, attends school, and is incapable of self-sustaining employment and/ or self care. Which of the following statements is CORRECT about J's medical coverage under J's father's group plan?

• J's coverage ceases, but J may apply for group student coverage.
• J's coverage automatically discontinues at age twenty-six.
• J's coverage continues only as long as J is a full-time student.
• J's coverage continues as long as J is continually incapacitated and is financially dependent

on J's father.

Answer:

d

Question 9: Which of the following statements is CORRECT about coinsurance?

A.It applies to deductibles as well as to claim payments.

• It applies to deductibles as well as to claim payments.

B.It helps control overutilization of benefits.

• It is effective for the first claim payment and waived for future claims.
• Insurance companies may adjust the coinsurance ratio after issuing a policy.

Answer:

b Question 10: Health insurance policies are offered on a "take it or leave it" basis and referred to as which of the following types of contracts?

• Aleatory Contracts
• Valued Contracts
• Unilateral Contracts
• Contracts of Adhesion

Answer:

d Question 11: Under a Guaranteed Renewable Accident & Health policy, an insurer retains the

right to:

A.increase the premium rate for one insured without increasing the rate for others in the same class

• increase the premium rate for one insured without increasing the rate for others in the same

class

• increase the premium rate for an entire class of insureds
• increase the benefits for an individual insured
• decrease benefits for one insured without decreasing benefits for others in the same class

Answer: