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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. Rescission
A medical benefits program jointly administered by the individual states and the federal government.
The termination of an insurance contract due either to material misrepresentation by the insured or by fraud - misrepresentation - or duress on the part of the agent/insurer.
A patient who is expected to die within an amount of time specified in the 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.

2. Approved Amount
A statement usually obtained from the applicant's doctor.
The amount Medicare determines to be reasonable for a service that is covered under part B of Medicare.
A policy provision that specifies the period of time during which the recurrence of an injury or illness will be considered a continuation of a prior period of disability.
The amount of the premium for which the policy protection has been given.

3. Concealment
The withholding of known facts which - if material - can void a contract.
Health insurance that provides periodic payments to replace an insured's income when he/she is injured or ill.
A policy that provides benefits for all medical costs - including doctor visits - hospitalization - and drugs.
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.

4. Integrated LTC Rider

5. Risk - Pure
The uncertainty or chance of a loss occurring in a situation that can only result in a loss or no change.
An individual appointed by a court as a fiduciary to settle the financial affairs and estate of a deceased person.
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 difference between the Medicare approved amount for a service or supply and the actual charge.

6. Underwriter
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.
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 person who evaluates and classifies risks to accept or reject them on behalf of the insurer.
A type of insurance that protects the insured against loss due to accidental bodily injury.

7. Misrepresentation
A retirement plan that meets the IRS guidelines for receiving favorable tax treatment.
A false statement or lie that can render the contract void.
The portion of the loss that is to be paid by the insured before any claim benefits may be paid by the insurer.
The payment made by insurers to agents or brokers for the sale and service of policies.

8. Certificate of Insurance
An agent licensed in a state in which he or she is not a resident.
A statement usually obtained from the applicant's doctor.
A legal document that indicates that an insurance policy has been issued - and that states both the amounts and types of insurance provided.
A statement (or booklet) that confirms that a policy has been written and that describes the coverage in general.

9. Rollover
A practice in which a person in a fiduciary capacity illegally mixes his/her personal funds with funds he/she is holding in trust.
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 type of temporary health or medical care provided either by paid workers who come to the home or by a nursing facility where a patient stays to give a caregiver a short rest.
Withdrawing the money from a qualified plan and placing it into another qualified plan.

10. Standard Provisions
A selection of health care benefits from which an employee may choose the ones that he/she needs.
The amount of money an insured can borrow using the cash value of his/her life insurance policy as collateral.
Requirements approved by state law that must appear in all insurance policies.
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.

11. Surrender
An arrangement that allows someone living with a life threatening condition to sell their existing life insurance policy and use the proceeds when and where they are most needed - before death.
An act of giving up a life policy - in which the insurer will pay the insured the cash value the policy has built up.
Coverage for doctor visits - x-rays - lab tests - and emergency room visits; benefits - however - are limited to specified dollar amounts.
The individual's age when a policy is issued.

12. Carriers
An area of dentistry that involves treatments that restore functional use to natural teeth such as fillings or crowns.
A basic principle of insurance under which the risk of financial loss is assigned to another party.
Organizations that process claims and pay benefits in an insurance policy
An area of dentistry that deals with diagnosis - prevention and treatment of the dental pulp within natural teeth at the root canal.

13. Major Medical Insurance
The act that stipulates federal standards for private pension plans.
Period of time after the premium due date during which premiums may still be paid - and the policy and its riders remain in force.
The withholding of known facts which - if material - can void a contract.
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.

14. Medicaid
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 medical benefits program jointly administered by the individual states and the federal government.
Organizations that provide support facilities for underwriters or groups of individuals that accept insurance risk.
An insurance company that is incorporated outside the United States.

15. Renewability Clause

16. Twisting

17. Group Life
Life insurance provided for members of a group.
Time between the beginning of a disability and the start of disability insurance benefits.
A provision that is found in most disability income policies which specifies the conditions that will automatically qualify the insured for full disability benefits.
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.

18. Personal Contract

19. Qualified Plan
Special powers granted to an agent by his or her agency contract.
A retirement plan that meets the IRS guidelines for receiving favorable tax treatment.
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.
An organization of medical professionals and hospitals who provide services to an insurance company's clients for a set fee.

20. Flexible Spending Account (FSA)
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.
Legal term that distinguishes oral statements from written statements.
A contract which has not yet been fulfilled by one or both parties that promises action in the event of a specified future occurrence.
A salary reduction cafeteria plan that uses employee funds to provide various types of health care benefits.

21. Comprehensive Major Medical
Insurer's location of incorporation and the legal ability to write business in a state.
A combination of basic coverage and major medical coverage that features low deductibles - high maximum benefits - and coinsurance.
A part of the insurance contract that states that both parties must give something of value for the transfer of risk - and specifies the conditions of the exchange.
Withdrawing the money from a qualified plan and placing it into another qualified plan.

22. Basic Illustration
Organizations that process claims and pay benefits in an insurance policy
A disease that causes the victim to become dysfunctional due to degeneration of brain cells causing severe memory loss.
A ledger or proposal used in the sale of a life insurance policy that shows both guaranteed and nonguaranteed elements.
A statement that outlines what services were rendered - how much the insurer paid - and how much the insured was billed.

23. Alien Insurer
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.
An insurance company that is incorporated outside the United States.
An unfair trade practice in which an insurer uses physical or mental force to persuade an applicant to buy insurance.
Those guaranteed values in a life insurance policy that cannot be taken from the insured - even if he or she ceases to pay premiums.

24. Adult Day Care
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.
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.
The effect of a person's reputation - character - living habits - etc. on his/her insurability.
A program for impaired adults that attempts to meet their health - social - and functional needs in a setting away from their homes.

25. Risk - Substandard
An applicant or insured who has a higher than normal probability of loss - and who may be subject to an increased premium.
An excessive amount of insurance that would result in overpayment to the insured in the event of a loss.
An agent licensed in a state in which he or she is not a resident.
A rider attached to a life insurance policy that provides LTC benefits or benefits for the terminally ill by using available life insurance benefits.

26. Proceeds

27. Risk - Speculative
Insurance furnished by nongovernmental insuring organizations.
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.
The uncertainty or chance of a loss occurring in a situation that involves the opportunity for either loss or gain.
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.

28. Hospital Confinement Rider
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.
Care that is rendered to help an insured complete his/her activities of daily living.
An optional disability income rider that waives the elimination period when an insured is hospitalized as an inpatient.
The acceptability of an applicant who meets an insurance company's underwriting requirements for insurance.

29. Transfer
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 basic principle of insurance under which the risk of financial loss is assigned to another party.
A disease that causes the victim to become dysfunctional due to degeneration of brain cells causing severe memory loss.
A legal document that indicates that an insurance policy has been issued - and that states both the amounts and types of insurance provided.

30. Director (Commissioner - Superintendent)
The head of the state department of insurance.
A fee or commission charged at the time of purchase of an annuity or a security.
The amount of money an insured can borrow using the cash value of his/her life insurance policy as collateral.
An individual who represents an insured in the process of purchasing and negotiating a contract of insurance.

31. Tertiary Beneficiary
Special powers granted to an agent by his or her agency contract.
A type of temporary health or medical care provided either by paid workers who come to the home or by a nursing facility where a patient stays to give a caregiver a short rest.
Those guaranteed values in a life insurance policy that cannot be taken from the insured - even if he or she ceases to pay premiums.
The third in line to receive the benefits of a life insurance policy.

32. Representations
The amount of the premium for which the policy protection has been given.
The law that provides for the continuation of group health care benefits for the insured for up to 18 months if he/she terminates employment or is no longer eligible - and for the insured's dependents for up to 36 months in cases of loss of eligibili
Statements made by the applicant on the insurance application that are believed to be true - but are not guaranteed to be true.
A statement sent to a Medicare patient indicating how the Medicare claim will be settled.

33. Insuring Clause
A general statement that identifies the basic agreement between the insurance company and the insured - usually located on the first page of the policy.
A policy feature that allows the policyholder to vary premium payments in the amount and/or timing.
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.
A physical condition that existed before the effective date of the policy - usually excluded from coverage.

34. Avoidance
An applicant or insured who has a higher than normal probability of loss - and who may be subject to an increased premium.
Time between the beginning of a disability and the start of disability insurance benefits.
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).
Life or health insurance companies formed to provide insurance for members of an affiliated lodge - religious organization - or fraternal organization with a representative form of government.

35. Life Expectancy
A specialty of dentistry that involves treatment of the surrounding and supporting tissue of the teeth such as treatment for gum disease.
A part of the insurance contract that states that both parties must give something of value for the transfer of risk - and specifies the conditions of the exchange.
Average number of years remaining for a person of a given age to live - as shown on the mortality table.
An injury or disease which occurs suddenly and requires treatment within 24 hours.

36. Provider
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.
A statement usually obtained from the applicant's doctor.
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.
Any group or individual who provides health care services.

37. Spendthrift Clause
An insurance company that conducts business in the state of incorporation.
An organization of medical professionals and hospitals who provide services to an insurance company's clients for a set fee.
The date when the face amount of the life insurance becomes payable.
A clause that prevents the debtors of a beneficiary from collecting the benefits before he/she receives them.

38. Cash Value
An insurance policy that provides payment if the insured's death is the result of an accident.
Plans that allow employers to set aside funds for reimbursing employees for qualified medical expenses.
The payment made by insurers to agents or brokers for the sale and service of policies.
The amount to which a policyowner is entitled if the policy is surrendered before maturity.

39. Payor Benefit
The United States federal government plan for paying certain hospital and medical expenses for persons who qualify.
An applicant or insured who has a higher than normal probability of loss - and who may be subject to an increased premium.
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.
The full face value of a policy.

40. Reinsurance
An agreement between two or more parties enforceable by law.
Any group or individual who provides health care services.
Activities individuals must do every day such as moving about - getting dressed - eating - bathing - etc.
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.

41. Home Health Services
An organization of medical professionals and hospitals who provide services to an insurance company's clients for a set fee.
A choice of ways of receiving policy dividends - nonforfeiture values - death benefits - or cash values.
A covered expense under Part A of Medicare in which a licensed home health agency provides home health care to an insured.
An insurance company that conducts business in the state of incorporation.

42. Physical Exam and Autopsy
Similar to consumer reports in that they also provide information on the consumer's character - reputation - and habits.
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 legal document that indicates that an insurance policy has been issued - and that states both the amounts and types of insurance provided.
A policy that may be exchanged for another type of policy by contractual provision - at the option of the policyowner - and without evidence of insurability (i.e. term life changed to a form of permanent life).

43. Hazard
A circumstance that increases the likelihood of a loss.
The uncertainty or chance of a loss occurring in a situation that can only result in a loss or no change.
A policy on which all premiums have been paid but which has not matured due either to death or endowment.
The method of premium payment - whether annually - semiannually - quarterly - or monthly.

44. Mode of Payment
An individual who represents an insured in the process of purchasing and negotiating a contract of insurance.
An area of dentistry that deals with diagnosis - prevention and treatment of the dental pulp within natural teeth at the root canal.
The method of premium payment - whether annually - semiannually - quarterly - or monthly.
A waiting period that is imposed on the insured from the onset of disability until benefit payments begin.

45. Commission
The payment made by insurers to agents or brokers for the sale and service of policies.
A type of insurance that pays benefits for medical - surgical - and hospital costs.
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.
Withdrawing the money from a qualified plan and placing it into another qualified plan.

46. Juvenile Life
Any life insurance written on the life of a minor.
A waiting period that is imposed on the insured from the onset of disability until benefit payments begin.
An individual who represents an insured in the process of purchasing and negotiating a contract of insurance.
The date specified in the policy as the date of termination.

47. Contributory
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.
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.
Similar to consumer reports in that they also provide information on the consumer's character - reputation - and habits.
A group insurance plan that requires the employees to pay part of the premium.

48. Exposure
A facility which is licensed by the state to provide 24 hour nursing care.
Insurance that pays over and above or in addition to basic policy limits.
A unit of measure used to determine rates charged for insurance coverage.
Medicare supplement plans issued by private insurance companies that are designed to fill some of the gaps in Medicare.

49. Waiting Period
A retirement plan that meets the IRS guidelines for receiving favorable tax treatment.
Time between the beginning of a disability and the start of disability insurance benefits.
A ledger or proposal used in the sale of a life insurance policy that shows both guaranteed and nonguaranteed elements.
An infectious and incurable disease caused by the human immunodeficiency virus (HIV).

50. Coverage
A booklet that describes insurance policies and concepts - and provides general information to help an applicant make an informed decision.
A material stipulation in the policy that if breached may void coverage.
The inclusion of causes of loss (perils) which are covered within a scope of a policy.
The required amount to pay damages or for property loss - which is calculated based on the property's current replacement value minus depreciation.