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. Preferred Provider Organization (PPO)

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2. Contributory
A type of insurance that protects the insured against loss due to accidental bodily injury.
The time over which the annuitant makes paymenrs or investments in an annuity - and when those payments earn interest tax deferred.
A group insurance plan that requires the employees to pay part of the premium.
A provision that helps determine the primary provider in situations where an insured is covered by more than one policy - thus avoiding claims overpayments.


3. Integrated LTC Rider

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4. Accidental Death and Dismemberment (AD&D)

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5. Cafeteria Plan
The method of premium payment - whether annually - semiannually - quarterly - or monthly.
A policy rider that states that the cause of death will be analyzed to determine if it complies with the policy description of accidental death.
A selection of health care benefits from which an employee may choose the ones that he/she needs.
The amount Medicare determines to be reasonable for a service that is covered under part B of Medicare.


6. Substandard Risk
A prepaid medical service plan in which specified medical service providers contract with the HMO to provide services. The focus of the HMO is preventive medicine.
An applicant or insured who has a higher than normal probability of loss - and who may be subject to an increased premium.
An agreement between an insurer and insured in which both parties are expected to pay a certain portion of the potential loss and other expenses.
The cause of a possible loss.


7. Accidental Death Insurance

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8. Intermediate Care
An act of identifying the name of the producer - representative or firm - limited insurance representative - or temporary insurance producer on any policy solicitation.
A statement (or booklet) that confirms that a policy has been written and that describes the coverage in general.
A level of care that is one step down from skilled nursing care; provided under the supervision of physicians or registered nurses.
Additional - miscellaneous services provided by a hospital - such as x-rays - anesthesia - and lab work - but not hospital room and board expenses.


9. Enrollment Period
The full face value of a policy.
A booklet that describes insurance policies and concepts - and provides general information to help an applicant make an informed decision.
The amount of time an employee has to sign up for a contributory group health plan.
A type of insurance that covers a group of individuals against loss of pay due to accident or sickness.


10. Tertiary Beneficiary
A type of life insurance that features a level premium and a death benefit that decreases each year over the duration of the policy.
Intentional misrepresentation or deceit with the intent to induce a person to part with something of value.
The third in line to receive the benefits of a life insurance policy.
The transfer of ownership rights of a life insurance policy from one person to another.


11. Prosthodontics
A basic principle of insurance under which the risk of financial loss is assigned to another party.
A special area of dentistry that involves the replacement of missing teeth with artificial devices like bridgework or dentures.
Type of disability income policy that provides benefits for loss of income when a person returns to work after a total disability - but is still not able to perform at the same level as before becoming disabled.
Those guaranteed values in a life insurance policy that cannot be taken from the insured - even if he or she ceases to pay premiums.


12. Pro Rata Cancellation
The chief executive and administrative officer of a state insurance department.
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.
Termination of an insurance policy - with an adjustment of the premium charge in proportion to the exact coverage that has been in force.
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.


13. Lump Sum
Any entity of at least two employers - other than a duly admitted insurer - that establishes an employee benefit plan for the purpose of offering or providing accident and sickness or death benefits to the employees.
Average number of years remaining for a person of a given age to live - as shown on the mortality table.
The period of time between the effective date of a health insurance policy and the date coverage for all or certain conditions begins.
Settlement method that pays the beneficiary the entire proceeds of a life insurance policy in one payment rather than in installments.


14. Health Savings Accounts (HSAs)
Disability from which the insured does not recover.
The first page of a policy.
Insurance that pays dividends to policyholders.
Plans designed to help individuals save for qualified health expenses.


15. Maturity Date
The date when the face amount of the life insurance becomes payable.
A type of an agreement in which both parties must perform certain duties and follow rules of conduct to make the contract enforceable.
Causes of loss - exposures - conditions - etc. listed in the policy for which the benefits will not be paid.
Uncertainty as to the outcome of an event when two or more possibilities exist.


16. Investigative Consumer Report

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17. Actual Cash Value (ACV)

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18. Domicile of Insurer

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19. Annuity
A document that provides information for underwriting purposes. After the policy is issued - any unanswered questions are considered waived by the insurer.
The voluntary abandonment of a known or legal right or advantage.
A contract that provides income for a specified period of years - or for life.
A waiting period that is imposed on the insured from the onset of disability until benefit payments begin.


20. Blanket Medical Insurance
The portion of premium for which policy protection has not yet been given.
A policy that provides benefits for all medical costs - including doctor visits - hospitalization - and drugs.
A policy on which all premiums have been paid but which has not matured due either to death or endowment.
The amount payable by the insurance company - usually in at the insured's death or when the policy matures.


21. Life Expectancy
A unit of measure used to determine rates charged for insurance coverage.
A contract which has not yet been fulfilled by one or both parties that promises action in the event of a specified future occurrence.
Average number of years remaining for a person of a given age to live - as shown on the mortality table.
Causes of loss - exposures - conditions - etc. listed in the policy for which the benefits will not be paid.


22. Legal Reserve

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23. Fraud
Intentional misrepresentation or deceit with the intent to induce a person to part with something of value.
A percentage of the principal amount of a policy paid to the insured if he/she suffered the loss of an appendage.
Organizations that provide support facilities for underwriters or groups of individuals that accept insurance risk.
A type of an agreement in which both parties must perform certain duties and follow rules of conduct to make the contract enforceable.


24. Insurer
A single policy that is designed to insure two or more lives.
The payment made by insurers to agents or brokers for the sale and service of policies.
An infectious and incurable disease caused by the human immunodeficiency virus (HIV).
An entity that indemnifies against losses - provides benefits - or renders services (also known as "company" or "insurance company").


25. Multiple Employer Welfare Association (MEWA)
Any entity of at least two employers - other than a duly admitted insurer - that establishes an employee benefit plan for the purpose of offering or providing accident and sickness or death benefits to the employees.
Requirements approved by state law that must appear in all insurance policies.
An act of giving up a life policy - in which the insurer will pay the insured the cash value the policy has built up.
A form of misrepresentation in which an agent persuades an insured/owner to cancel - lapse - or switch policies - even when it's to the insured's disadvantage.


26. Group Health Insurance
Health coverage provided to members of a group.
The age of the insured at a determined date.
A rider that is added to a life insurance policy to pay log-term care benefits. The amount of benefits available for LTC depends upon the life insurance benefits available; however - the benefits paid toward LTC will reduce the life insurance policy'
A physical illness - disease - or pregnancy - but not a mental illness.


27. Natural Premium
An excessive amount of insurance that would result in overpayment to the insured in the event of a loss.
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 request for payment of the benefits provided by an insurance contract.
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.


28. Renewability Clause

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29. Authorized (Admitted) Insurer
A contract that pays a stated amount in the event of a loss (disability insurance/life insurance).
An insurance company authorized and licensed to transact business in a particular state.
A person making application for - or offering him/herself or another to be insured under an insurance contract.
The amount of the premium for which the policy protection has been given.


30. Agency
An area of dentistry that involves treatments that restore functional use to natural teeth such as fillings or crowns.
A program for impaired adults that attempts to meet their health - social - and functional needs in a setting away from their homes.
A method of dealing with risk by deliberately keeping away from it (e.g. if a person wanted to avoid the risk of being killed in an airplane crash - he/she might choose never to fly in a plane).
An insurance sales office or company.


31. Medicare
An insurance sales office or company.
The United States federal government plan for paying certain hospital and medical expenses for persons who qualify.
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.
An individual appointed by a court as a fiduciary to settle the financial affairs and estate of a deceased person.


32. Cash Value
An insurance company authorized and licensed to transact business in a particular state.
The amount to which a policyowner is entitled if the policy is surrendered before maturity.
A claim to a provider or medical supplier to receive payments directly from Medicare.
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.


33. Rollover
Lessening the possibility or severity of a loss.
Coverage for doctor visits - x-rays - lab tests - and emergency room visits; benefits - however - are limited to specified dollar amounts.
Withdrawing the money from a qualified plan and placing it into another qualified plan.
A method of dealing with risk for a group of individual persons or businesses with the same or similar exposure to loss who share the losses that occur within that group.


34. Actual Charge
The amount a physician or supplier actually bills for a particular service or supply.
To restore the insured to the same condition as prior to loss with no intent of loss or gain.
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.
Authority that is not expressed or written into the contract - but which the agent is assumed to have in order to transact the business of insurance for the principal.


35. Waiting Period
A clause that prevents the debtors of a beneficiary from collecting the benefits before he/she receives them.
Time between the beginning of a disability and the start of disability insurance benefits.
An employer-funded account linked to a high deductible medical insurance plan.
Insurance whereby premiums are paid for protection in the event of death or disability - not for cash value accumulation.


36. Home Health Care
An insurance classification for applicants who have a lower expectation of incurring loss - and who - therefore - are covered at a reduced rate.
A statement that outlines what services were rendered - how much the insurer paid - and how much the insured was billed.
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.
Plans that allow employers to set aside funds for reimbursing employees for qualified medical expenses.


37. Expiration
The withholding of known facts which - if material - can void a contract.
The date specified in the policy as the date of termination.
An agent/broker who handles insurer's funds in a trust capacity.
A group or individual policy that covers disabilities of 13 to 26 weeks - and in some cases for a period of up to two years.


38. Binder (Binding Receipt)
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.
The length of time over which the insurance benefits will be paid for each illness - disability or hospital stay.
Termination of a policy because the premium has not been paid by the end of the grace period.
A temporary contract that puts an insurance policy into force before the premium has been paid.


39. Valued Contract
To restore the insured to the same condition as prior to loss with no intent of loss or gain.
A contract that pays a stated amount in the event of a loss (disability insurance/life insurance).
A person making application for - or offering him/herself or another to be insured under an insurance contract.
A contract whereby one party (insurer) agrees to indemnify or guarantee another party (insured) against a loss by a specified future contingency or peril in return for payment of a premium.


40. Errors and Omissions Policy (E&O)
The required amount to pay damages or for property loss - which is calculated based on the property's current replacement value minus depreciation.
A group or individual policy that covers disabilities of 13 to 26 weeks - and in some cases for a period of up to two years.
An area of dentistry that involves treatments that restore functional use to natural teeth such as fillings or crowns.
A professional liability insurance that protects the insurer from claims by the insured for errors or oversights on the part of the insurer.


41. Mortality Table
A condition which does not allow a person to perform the duties of any occupation for payment as a result of injury or sickness.
A table showing the probability of death at specified ages.
A contract that pays a stated amount in the event of a loss (disability insurance/life insurance).
Companies owned by the stockholders whose investments provide the capital necessary to establish and operate the insurance company.


42. Notice of Claim

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43. Concealment
A representative of an insurance company who investigates and acts on the behalf of the company to obtain agreements for the amount of the insurance claim.
The withholding of known facts which - if material - can void a contract.
A type of an agreement in which both parties must perform certain duties and follow rules of conduct to make the contract enforceable.
The method of premium payment - whether annually - semiannually - quarterly - or monthly.


44. Intentional Injury
An act that is intended to cause injury. Self- inflicted injuries are not covered under accident insurance; intentional injuries inflicted on the insured by another are covered.
The required amount to pay damages or for property loss - which is calculated based on the property's current replacement value minus depreciation.
Insurance that pays over and above or in addition to basic policy limits.
A principle stating that the larger the number of similar exposure units considered - the more closely the losses reported will equal the underlying probability of loss.


45. Issue Age

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46. Skilled Nursing Care
Life insurance provided for members of a group.
A condition which does not allow a person to perform the duties of any occupation for payment as a result of injury or sickness.
The period of time between the effective date of a health insurance policy and the date coverage for all or certain conditions begins.
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.


47. Pre-Existing Condition
The amount payable by the insurance company - usually in at the insured's death or when the policy matures.
A physical condition that existed before the effective date of the policy - usually excluded from coverage.
An excessive amount of insurance that would result in overpayment to the insured in the event of a loss.
A waiting period that is imposed on the insured from the onset of disability until benefit payments begin.


48. Director (Commissioner - Superintendent)
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 head of the state department of insurance.
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.
Life insurance provided for members of a group.


49. Participating Policies (Par)
A covered expense under Part A of Medicare in which a licensed home health agency provides home health care to an insured.
A request for payment of the benefits provided by an insurance contract.
Insurance that pays dividends to policyholders.
Operative treatment of the mouth such as extractions of teeth and related surgical treatment.


50. Pure Protection
Insurance whereby premiums are paid for protection in the event of death or disability - not for cash value accumulation.
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.
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.
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.