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Life And Health Insurance Exam

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. Activities of Daily Living (ADLs)
Activities individuals must do every day such as moving about - getting dressed - eating - bathing - etc.
The portion of premium for which policy protection has not yet been given.
Termination of an insurance policy - with an adjustment of the premium charge in proportion to the exact coverage that has been in force.
A type of insurance that protects the insured against loss due to accidental bodily injury.

2. Participating Policies (Par)
A method of dealing with risk by intentionally or unintentionally keeping a portion of it for the insured's account; the amount of responsibility assumed but not reinsured by the insurance company.
Insurance that pays dividends to policyholders.
A contract that legally binds only one party to contractual obligations after the premium is paid.
A provision that allows an insurer - at its own expense - to have an insured physically examined when a claim is pending or to have an autopsy performed where not prohibited by law.

3. Preferred Provider Organization (PPO)

4. Comprehensive Policy
A plan that provides a package of health care services - including preventive care - routine physicals - immunization - outpatient services and hospitalization.
The amount of premium that must be collected from each member of a group composed of the same age - sex and risk in order to pay $1 -000 for each death that will occur in the group each year.
A disease that causes the victim to become dysfunctional due to degeneration of brain cells causing severe memory loss.
A life or health insurance policy that is underwritten based on the insured's statement of health rather than a medical examination.

5. Alien Insurer
The third in line to receive the benefits of a life insurance policy.
An insurance company that is incorporated outside the United States.
The date when an insurance policy begins (also known as the inception date). The period of time in which an employee may enroll in a group health care plan without having to provide evidence of insurability.
The authority granted to an agent by means of the agent's written contract.

6. Coordination of Benefits
The reduction - decrease - or disappearance of value of the person or property insured in a policy - by a peril insured against.
A period of time - usually required by law - during which a policyowner may inspect a newly issued individual life or health insurance policy for a stated number of days and surrender it in exchange for a full refund of premium if not satisfied for a
A provision that helps determine the primary provider in situations where an insured is covered by more than one policy - thus avoiding claims overpayments.
Health insurance that provides periodic payments to replace an insured's income when he/she is injured or ill.

7. Loss of Income Insurance
A fee or commission charged at the time of purchase of an annuity or a security.
A provision that allows an insurer - at its own expense - to have an insured physically examined when a claim is pending or to have an autopsy performed where not prohibited by law.
A combination of a flexible premium and adjustable life insurance.
Insurance that pays benefits for inability to work because of disability resulting from accidental bodily injury or sickness.

8. Apparent Authority
A retirement plan that meets the IRS guidelines for receiving favorable tax treatment.
A form of insurance whereby one insurance company (the reinsurer) in consideration of a premium paid to it - agrees to indemnify another insurance company (the ceding company) for part or all of its liabilities from insurance policies it has issued.
The appearance or the assumption of authority based on the actions - words - or deeds of the principal or because of circumstances the principal created.
The effect a person's indifference concerning loss has on the risk to be insured.

9. Service Plans
Insurance that pays dividends to policyholders.
A ledger or proposal used in the sale of a life insurance policy that shows both guaranteed and nonguaranteed elements.
A type of individual or group insurance that fills the gaps in the protection provided by Medicare - but that cannot duplicate any Medicare benefits.
Insurance plans where the health care services rendered are the benefits instead of monetary benefits.

10. Credit Life Insurance
An act of giving up a life policy - in which the insurer will pay the insured the cash value the policy has built up.
Daily nursing care or skilled care - such as administration of medication - diagnosis - or minor surgery that is performed by or under the supervision of a skilled professional.
A special type of coverage written to pay off the balance of a loan in the event of the death of the debtor.
Settlement method that pays the beneficiary the entire proceeds of a life insurance policy in one payment rather than in installments.

11. Commingling
A statement sent to a Medicare patient indicating how the Medicare claim will be settled.
The inclusion of causes of loss (perils) which are covered within a scope of a policy.
A practice in which a person in a fiduciary capacity illegally mixes his/her personal funds with funds he/she is holding in trust.
Selling assets as a method of raising capital.

12. Basic Illustration
A ledger or proposal used in the sale of a life insurance policy that shows both guaranteed and nonguaranteed elements.
A model of HMO and PPO organizations that uses the insured's primary care physician (the gatekeeper) as the initial contact for the patient for medical care and for referrals.
A fee or commission charged at the time of purchase of an annuity or a security.
Continuation of life insurance coverage if the insured becomes totally disabled and is unable to pay the premiums.

13. Risk - Substandard
A rider found in juvenile policies which waives the premiums if the person paying them (often the parent) is disabled or dies while the child is still a minor.
A provision that allows coverage to continue beyond the policy's expiration date for employees who are not actively at work due to disability or who have dependents hospitalized on that date. This coverage continues only until the employee returns to
An applicant or insured who has a higher than normal probability of loss - and who may be subject to an increased premium.
A type of insurance that pays benefits for medical - surgical - and hospital costs.

14. Hazard - Moral

15. Natural Premium
The amount of premium that must be collected from each member of a group composed of the same age - sex and risk in order to pay $1 -000 for each death that will occur in the group each year.
The acceptability of an applicant who meets an insurance company's underwriting requirements for insurance.
A person who relies on another for support and maintenance.
Health insurance policies that cover only specific accidents or diseases.

16. Hazard - Physical
An agent/broker who handles insurer's funds in a trust capacity.
A type of hazard that arises from the physical characteristics of an individual - such as a physical disability due to either current circumstance or a condition present at birth.
A type of insurance that covers a group of individuals against loss of pay due to accident or sickness.
A legal contract that determines what will be done with a business in the event that an owner dies or becomes disabled.

17. Prosthodontics
The individual's age when a policy is issued.
A special area of dentistry that involves the replacement of missing teeth with artificial devices like bridgework or dentures.
An applicant or insured who has a higher than normal probability of loss - and who may be subject to an increased premium.
The United States federal government plan for paying certain hospital and medical expenses for persons who qualify.

18. Endorsement
The time over which the annuitant makes paymenrs or investments in an annuity - and when those payments earn interest tax deferred.
A federal requirement that employers who have 25 or more employees - who are within the service area of a qualified HMO - who pay minimum wage - and offer a health plan - must offer HMO coverage as well as an indemnity plan.
A form changing the provisions of and attached to a life insurance policy (also known as a rider).
A model of HMO and PPO organizations that uses the insured's primary care physician (the gatekeeper) as the initial contact for the patient for medical care and for referrals.

19. Certificate
A professional liability insurance that protects the insurer from claims by the insured for errors or oversights on the part of the insurer.
A form changing the provisions of and attached to a life insurance policy (also known as a rider).
A statement (or booklet) that confirms that a policy has been written and that describes the coverage in general.
Organizations that provide support facilities for underwriters or groups of individuals that accept insurance risk.

20. Fair Credit Reporting Act
The legal process by which an insurance company seeks recovery of the amount paid to the insured from a third party who may have caused the loss.
A person who relies on another for support and maintenance.
A federal law that established procedures that consumer-reporting agencies must follow in order to ensure that records are confidential - accurate - relevant and properly used.
An employer-funded account linked to a high deductible medical insurance plan.

21. Domestic Insurer
A professional liability insurance that protects the insurer from claims by the insured for errors or oversights on the part of the insurer.
An insurance company that conducts business in the state of incorporation.
A life insurance policy designed to provide a level death benefit to the insured's age 100 for a one-time - lump sum payment.
Any life insurance written on the life of a minor.

22. Noncancelable
An insurance contract that the insured has a right to continue in force by payment of premiums that remain the same for a substantial period of time.
A level of care that is one step down from skilled nursing care; provided under the supervision of physicians or registered nurses.
An individual who represents an insured in the process of purchasing and negotiating a contract of insurance.
Type of care in which part-time nursing or home health aide services - speech therapy - physical or occupational therapy services are given in the home of the insured.

23. Admitted (Authorized) Insurer
An insurance company authorized and licensed to transact business in a particular state.
An applicant or insured who has a higher than normal probability of loss - and who may be subject to an increased premium.
A percentage of the principal amount of a policy paid to the insured if he/she suffered the loss of an appendage.
An insurance company that is incorporated in another state.

24. Straight Life
An unincorporated group of individuals who mutually insure one another - each separately assuming a share of each risk.
The time over which the annuitant makes paymenrs or investments in an annuity - and when those payments earn interest tax deferred.
A contract offered on a "take-it-or-leave-it" basis by an insurer - in which the insured's only option is to accept or reject the contract. Any ambiguities in the contract will be settled in favor of the insured.
A basic policy that charges a level annual premium for the lifetime of the insured and provides a level - guaranteed death benefit.

25. Physical Exam and Autopsy
A covered expense under Part A of Medicare in which a licensed home health agency provides home health care to an insured.
A document that provides information for underwriting purposes. After the policy is issued - any unanswered questions are considered waived by the insurer.
Written and /or oral statements regarding a consumer's credit - character - reputation - or habits collected by a reporting agency from employment records - credit reports - and other public sources.
A provision that allows an insurer - at its own expense - to have an insured physically examined when a claim is pending or to have an autopsy performed where not prohibited by law.

26. Limited-Pay Whole Life

27. Pro Rata Cancellation
A facility for the terminally ill that provides supportive care such as pain relief and symptom management to the patient and his/her family. Hospice care is covered under Part A of Medicare.
A combination of a flexible premium and adjustable life insurance.
Termination of an insurance policy - with an adjustment of the premium charge in proportion to the exact coverage that has been in force.
A clause that prevents the debtors of a beneficiary from collecting the benefits before he/she receives them.

28. Presumptive Disability
Health insurance policies that cover only specific accidents or diseases.
An insurance company that is incorporated in another state.
Canceling the policy with a less than proportionate return of premium.
A provision that is found in most disability income policies which specifies the conditions that will automatically qualify the insured for full disability benefits.

29. Legal Reserve

30. Co-Pay
An arrangement in which an insured must pay a specified amount for services "up front" and the provider pays the remainder of the cost.
A combination of a flexible premium and adjustable life insurance.
A request for payment of the benefits provided by an insurance contract.
Any life insurance written on the life of a minor.

31. Commission
A policy premium that remains the same over the period of time premiums are paid.
The payment made by insurers to agents or brokers for the sale and service of policies.
Life insurance provided for members of a group.
Insurer's location of incorporation and the legal ability to write business in a state.

32. Fraud
Insurance that is kept in force for a person's entire life and pays a benefit upon the person's death - whenever that may be.
A legal impediment to denying a fact or restoring a right that has been previously waived.
Intentional misrepresentation or deceit with the intent to induce a person to part with something of value.
Termination of an insurance policy - with an adjustment of the premium charge in proportion to the exact coverage that has been in force.

33. Hospital Confinement Rider
An optional disability income rider that waives the elimination period when an insured is hospitalized as an inpatient.
A policy with a high maximum limit that covers certain diseases named in the contract (such as polio and meningitis).
Organizations that provide support facilities for underwriters or groups of individuals that accept insurance risk.
A selection of health care benefits from which an employee may choose the ones that he/she needs.

34. Application
A federal law that established procedures that consumer-reporting agencies must follow in order to ensure that records are confidential - accurate - relevant and properly used.
Insurance which can - at the election of the policyowner - be renewed at the end of a term without evidence of insurability.
A document that provides information for underwriting purposes. After the policy is issued - any unanswered questions are considered waived by the insurer.
An insurance company that has not applied for - or has applied and been denied a Certificate of Authority and may not transact insurance in a particular state.

35. Insolvent organization
A facility which is licensed by the state to provide 24 hour nursing care.
An agreement between two or more parties enforceable by law.
A disease that causes the victim to become dysfunctional due to degeneration of brain cells causing severe memory loss.
A member organization which is unable to pay its contractual obligations and is placed under a final order of liquidation or rehabilitation by a court of competent jurisdiction.

36. Ancillary
A type of an agreement in which both parties must perform certain duties and follow rules of conduct to make the contract enforceable.
A fee charged at the time of a sale - transfer or withdrawal from an annuity or a life insurance policy.
A type of life insurance that features a level premium and a death benefit that decreases each year over the duration of the policy.
Additional - miscellaneous services provided by a hospital - such as x-rays - anesthesia - and lab work - but not hospital room and board expenses.

37. Subrogation
An applicant or insured who has a higher than normal probability of loss - and who may be subject to an increased premium.
A general term used to refer to various forms of whole life insurance policies that remain in effect to age 100 so long as the premium is paid.
A statement (or booklet) that confirms that a policy has been written and that describes the coverage in general.
The legal process by which an insurance company seeks recovery of the amount paid to the insured from a third party who may have caused the loss.

38. Reduction
The binding force in a contract that requires something of value to be exchanged for the transfer of risk. The consideration on the part of the insured is the representations made in the application and the payment of premium; the consideration on th
Lessening the possibility or severity of a loss.
A financial interest in the life of another person; a possibility of losing something of value if the insured should die. In life and health insurance - insurable interest must be stated at the time of policy issue.
Organizations that process inpatient and outpatient claims on individuals by hospitals - skilled nursing facilities - home health agencies - hospices and certain other providers of health services.

39. Employee RetirementIncome Security Act (ERISA)
The act that stipulates federal standards for private pension plans.
Insurance that pays benefits for inability to work because of disability resulting from accidental bodily injury or sickness.
The method of determining primary coverage for a dependent child - under which the plan of the parent whose birthday occurs first in the calendar year is designated as primary.
The payment made by insurers to agents or brokers for the sale and service of policies.

40. Unilateral Contract
A basic policy that charges a level annual premium for the lifetime of the insured and provides a level - guaranteed death benefit.
A statement sent to a Medicare patient indicating how the Medicare claim will be settled.
A contract offered on a "take-it-or-leave-it" basis by an insurer - in which the insured's only option is to accept or reject the contract. Any ambiguities in the contract will be settled in favor of the insured.
A contract that legally binds only one party to contractual obligations after the premium is paid.

41. Accidental Death Insurance

42. Periodontics
The transfer of ownership rights of a life insurance policy from one person to another.
Insurance that pays benefits for inability to work because of disability resulting from accidental bodily injury or sickness.
A specialty of dentistry that involves treatment of the surrounding and supporting tissue of the teeth such as treatment for gum disease.
The person who is named to receive benefits upon the death of the insured if the (primary) first-named beneficiary is no longer alive or does not collect all the benefits due to his/her own death.

43. Spendthrift Clause
A salary reduction cafeteria plan that uses employee funds to provide various types of health care benefits.
A clause that prevents the debtors of a beneficiary from collecting the benefits before he/she receives them.
An agreement between two or more parties enforceable by law.
An unfair trade practice in which one agent or insurer makes an injurious statement about another with the intent of harming the person's or company's reputation.

44. CSO Table (The Commissioner's Standard Ordinary Table)
A mortality table used in life insurance that mathematically predicts the likelihood of death.
Unplanned - unforeseen traumatic injury to the body.
An individual who represents an insured in the process of purchasing and negotiating a contract of insurance.
An insurance sales office or company.

45. Earned Premium
The amount of the premium for which the policy protection has been given.
A level of care that is one step down from skilled nursing care; provided under the supervision of physicians or registered nurses.
Insurance that pays benefits for inability to work because of disability resulting from accidental bodily injury or sickness.
The United States federal government plan for paying certain hospital and medical expenses for persons who qualify.

46. Nonadmitted (Nonauthorized)
A termination of a policy by an insurer on the anniversary or renewal date.
An insurance company that has not applied for - or has applied and been denied a Certificate of Authority and may not transact insurance in a particular state.
A rider attached to a life insurance policy that provides LTC benefits or benefits for the terminally ill by using available life insurance benefits.
The amount payable upon the death of the person whose life is insured.

47. Skilled Nursing Care
An illustration furnished in addition to a basic illustration that may be presented in a different format than the basic illustration - but may only depict a scale of nonguaranteed elements that is permitted in a basic illustration.
Coverage for doctor visits - x-rays - lab tests - and emergency room visits; benefits - however - are limited to specified dollar amounts.
Daily nursing care or skilled care - such as administration of medication - diagnosis - or minor surgery that is performed by or under the supervision of a skilled professional.
A specialty of dentistry that involves treatment of the surrounding and supporting tissue of the teeth such as treatment for gum disease.

48. Administrator
The person who has possession of the policy - usually the insured.
The ratio of the incidence of sickness to the number of well persons in a given group of people over a given period of time.
A general statement that identifies the basic agreement between the insurance company and the insured - usually located on the first page of the policy.
An individual appointed by a court as a fiduciary to settle the financial affairs and estate of a deceased person.

49. Major Medical Insurance
Uncertainty as to the outcome of an event when two or more possibilities exist.
A type of health insurance that usually carries a large deductible and pays covered expenses up to a high limit whether the insured is in or out of the hospital.
Companies owned by the stockholders whose investments provide the capital necessary to establish and operate the insurance company.
Insurance organizations that have no capital stock - but are owned by the policyholders.

50. Accidental Bodily Injury
Unplanned - unforeseen traumatic injury to the body.
An insurance policy that provides payment if the insured's death is the result of an accident.
Any supplemental agreement attached to and made a part of the policy indicating the policy expansion by additional coverage - or a waiver of a coverage or condition.
A medical benefits program jointly administered by the individual states and the federal government.