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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. Reciprocity

2. Substandard Risk
A specialty of dentistry that involves treatment of the surrounding and supporting tissue of the teeth such as treatment for gum disease.
An insurance company that conducts business in the state of incorporation.
An applicant or insured who has a higher than normal probability of loss - and who may be subject to an increased premium.
Organizations that provide support facilities for underwriters or groups of individuals that accept insurance risk.

3. Underwriter
Insurer's location of incorporation and the legal ability to write business in a state.
A group of small employers who do not qualify for group insurance individually - formed to establish a group health plan or self-funded plan.
A person who evaluates and classifies risks to accept or reject them on behalf of the insurer.
The process of reviewing - accepting or rejecting applications for insurance.

4. Coinsurance
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 portion of premium for which policy protection has not yet been given.
The first page of a policy.
A table showing the incidence of sickness at specified ages.

5. Accumulation Period
A covered expense under Part A of Medicare in which a licensed home health agency provides home health care to an insured.
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.
The time over which the annuitant makes paymenrs or investments in an annuity - and when those payments earn interest tax deferred.
A group of small employers who do not qualify for group insurance individually - formed to establish a group health plan or self-funded plan.

6. Retention

7. Private Insurance
A plan that provides a package of health care services - including preventive care - routine physicals - immunization - outpatient services and hospitalization.
Insurance furnished by nongovernmental insuring organizations.
Statements made by the applicant on the insurance application that are believed to be true - but are not guaranteed to be true.
Insurance plans where the health care services rendered are the benefits instead of monetary benefits.

8. Commission
A waiting period that is imposed on the insured from the onset of disability until benefit payments begin.
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.
The payment made by insurers to agents or brokers for the sale and service of policies.
The accounting measurement of an insurer's future obligations to pay claims to policyowners.

9. Skilled Nursing Care
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.
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 statement sent to a Medicare patient indicating how the Medicare claim will be settled.
The tendency or likelihood of insurance policies not lapsing or being replaced with insurance from another insurer.

10. Flexible Premium
Amounts an insured must pay for coinsurance and deductibles before the insurer will pay its portion.
Average number of years remaining for a person of a given age to live - as shown on the mortality table.
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.

11. Parol
A patient who is expected to die within an amount of time specified in the policy.
A statement (or booklet) that confirms that a policy has been written and that describes the coverage in general.
Legal term that distinguishes oral statements from written statements.
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.

12. Noncancelable
Withdrawing the money from a qualified plan and placing it into another qualified plan.
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.
Health insurance policies that cover only specific accidents or diseases.
A contract in which participating parties exchange unequal amounts. Insurance contracts are aleatory in that the amount the insured will pay in premiums is unequal to the amount the insurer will pay in the event of a loss.

13. Concealment
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 is incorporated outside the United States.
The withholding of known facts which - if material - can void a contract.
Life insurance provided for members of a group.

14. Acquired Immunodeficiency Syndrome (AIDS)
An infectious and incurable disease caused by the human immunodeficiency virus (HIV).
Health and social services provided under the supervision of physicians and medical health professionals for persons with chronic diseases or disabilities. Care is usually provided in a Long-Term Care Facility which is a state licensed facility that
A specialty of dentistry that involves treatment of the surrounding and supporting tissue of the teeth such as treatment for gum disease.
An insurance company that is incorporated outside the United States.

15. Apparent Authority
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.
The appearance or the assumption of authority based on the actions - words - or deeds of the principal or because of circumstances the principal created.
Health and social services provided under the supervision of physicians and medical health professionals for persons with chronic diseases or disabilities. Care is usually provided in a Long-Term Care Facility which is a state licensed facility that
A policy with a high maximum limit that covers certain diseases named in the contract (such as polio and meningitis).

16. Reserve
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.
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.
An amount representing actual or potential liabilities kept by an insurer in a separate account to cover debts to policyholders.
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

17. Workers Compensation
The full face value of a policy.
A person who evaluates and classifies risks to accept or reject them on behalf of the insurer.
Benefits required by state law to be paid to an employee by an employer in the case of injury - disability - or death as the result of an on-the-job hazard.
A booklet that describes insurance policies and concepts - and provides general information to help an applicant make an informed decision.

18. Insuring Clause
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.
The maximum amount a physician may charge a Medicare beneficiary for a covered service if the physician does not accept assignment of the Medicare approved amount.
A group insurance plan that requires the employees to pay part of the premium.
A general statement that identifies the basic agreement between the insurance company and the insured - usually located on the first page of the policy.

19. Accidental Death and Dismemberment (AD&D)

20. Nonauthorized (Nonadmitted)
The full face value of a policy.
A demand of a person to stop committing an action that is in violation of a provision.
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.
Insurance that provides protection for a specific period of time.

21. CSO Table (The Commissioner's Standard Ordinary Table)
A mortality table used in life insurance that mathematically predicts the likelihood of death.
A single policy that is designed to insure two or more lives.
Requirements approved by state law that must appear in all insurance policies.
An organization of medical professionals and hospitals who provide services to an insurance company's clients for a set fee.

22. Renewability Clause

23. Risk Retention Group
A basic - fundamental insurance policy which pays first with respect to other outstanding policies.
A liability insurance company owned by its members - which are exposed to similar liability risks by virtue of being in the same business or industry.
The head of the state department of insurance.
A clause that prevents the debtors of a beneficiary from collecting the benefits before he/she receives them.

24. Executory Contract
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.
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 contract that legally binds only one party to contractual obligations after the premium is paid.
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.

25. Subrogation
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.
The method of premium payment - whether annually - semiannually - quarterly - or monthly.
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 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.

26. Alzheimer's Disease
The time over which the annuitant makes paymenrs or investments in an annuity - and when those payments earn interest tax deferred.
Health coverage provided to members of a group.
A disease that causes the victim to become dysfunctional due to degeneration of brain cells causing severe memory loss.
Insurance organizations that have no capital stock - but are owned by the policyholders.

27. Standard Risk
Canceling the policy with a less than proportionate return of premium.
The appearance or the assumption of authority based on the actions - words - or deeds of the principal or because of circumstances the principal created.
An applicant or insured who is considered to have an average probability of a loss based on health - vocation and lifestyle.
Organizations that process claims and pay benefits in an insurance policy

28. Rollover
Withdrawing the money from a qualified plan and placing it into another qualified plan.
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.
Those guaranteed values in a life insurance policy that cannot be taken from the insured - even if he or she ceases to pay premiums.
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.

29. Express Authority

30. Basic Medical Expense Insurance
Coverage for doctor visits - x-rays - lab tests - and emergency room visits; benefits - however - are limited to specified dollar amounts.
Choices available to the insured/owner for distribution of insurance proceeds.
Organizations that process claims and pay benefits in an insurance policy
A policy that provides benefits for all medical costs - including doctor visits - hospitalization - and drugs.

31. Surrender
An amount representing actual or potential liabilities kept by an insurer in a separate account to cover debts to policyholders.
A basic policy that charges a level annual premium for the lifetime of the insured and provides a level - guaranteed death benefit.
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.
An act of giving up a life policy - in which the insurer will pay the insured the cash value the policy has built up.

32. Convertible
The person who receives the proceeds from the policy when the insured dies.
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 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.
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).

33. Straight Life
A basic policy that charges a level annual premium for the lifetime of the insured and provides a level - guaranteed death benefit.
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.
An individual appointed by a court as a fiduciary to settle the financial affairs and estate of a deceased person.
A provision that specifies to whom claims payments are to be made.

34. Living Benefits Rider
Insurer's location of incorporation and the legal ability to write business in a 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.
An insurance company that is incorporated in another state.
The first page of a policy.

35. Buyer's Guide
The head of the state department of insurance.
A booklet that describes insurance policies and concepts - and provides general information to help an applicant make an informed decision.
An excessive amount of insurance that would result in overpayment to the insured in the event of a loss.
A person who evaluates and classifies risks to accept or reject them on behalf of the insurer.

36. Coercion
An unfair trade practice in which an insurer uses physical or mental force to persuade an applicant to buy insurance.
A termination of a policy by an insurer on the anniversary or renewal date.
A life insurance policy designed to provide a level death benefit to the insured's age 100 for a one-time - lump sum payment.
Benefits required by state law to be paid to an employee by an employer in the case of injury - disability - or death as the result of an on-the-job hazard.

37. Medigap
Medicare supplement plans issued by private insurance companies that are designed to fill some of the gaps in Medicare.
A type of individual or group insurance that fills the gaps in the protection provided by Medicare - but that cannot duplicate any Medicare benefits.
The payment made by insurers to agents or brokers for the sale and service of policies.
A fee or commission charged at the time of purchase of an annuity or a security.

38. Insurability

39. Unilateral Contract
A legal document that indicates that an insurance policy has been issued - and that states both the amounts and types of insurance provided.
A demand of a person to stop committing an action that is in violation of a provision.
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.
A contract that legally binds only one party to contractual obligations after the premium is paid.

40. Long-Term Care (LTC)
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.
Health and social services provided under the supervision of physicians and medical health professionals for persons with chronic diseases or disabilities. Care is usually provided in a Long-Term Care Facility which is a state licensed facility that
A person who evaluates and classifies risks to accept or reject them on behalf of the insurer.
A claim to a provider or medical supplier to receive payments directly from Medicare.

41. Fraternal Benefit Societies
Legal term that distinguishes oral statements from written statements.
A provision that spells out an insured's duty to provide the insurer with reasonable notice in the event of a loss.
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).
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.

42. Principal Amount
Organizations that process claims and pay benefits in an insurance policy
The effect a person's indifference concerning loss has on the risk to be insured.
An insurance sales office or company.
The full face value of a policy.

43. Accidental Bodily Injury
Unplanned - unforeseen traumatic injury to the body.
The transfer of ownership rights of a life insurance policy from one person to another.
A document that provides information for underwriting purposes. After the policy is issued - any unanswered questions are considered waived by the insurer.
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

44. Activities of Daily Living (ADLs)
The tendency or likelihood of insurance policies not lapsing or being replaced with insurance from another insurer.
Activities individuals must do every day such as moving about - getting dressed - eating - bathing - etc.
A disability rider - found in Universal Life Insurance - that waives the cost of the insurance but does not waive the cost of premiums necessary to accumulate cash values.
The tendency of risks with higher probability of loss to purchase and maintain insurance more often than the risks who present lower probability.

45. Persistency
Continuation of life insurance coverage if the insured becomes totally disabled and is unable to pay the premiums.
A legal impediment to denying a fact or restoring a right that has been previously waived.
The tendency or likelihood of insurance policies not lapsing or being replaced with insurance from another insurer.
A disease that causes the victim to become dysfunctional due to degeneration of brain cells causing severe memory loss.

46. Risk - Speculative
Protection against loss due to sickness or bodily injury.
A liability insurance company owned by its members - which are exposed to similar liability risks by virtue of being in the same business or industry.
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 uncertainty or chance of a loss occurring in a situation that involves the opportunity for either loss or gain.

47. Home Health Services
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.
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 covered expense under Part A of Medicare in which a licensed home health agency provides home health care to an insured.
An act of identifying the name of the producer - representative or firm - limited insurance representative - or temporary insurance producer on any policy solicitation.

48. Primary Beneficiary
A fee charged at the time of a sale - transfer or withdrawal from an annuity or a life insurance policy.
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.
The amount of time an employee has to sign up for a contributory group health plan.
The person who is named as first to receive benefits from a policy.

49. Preferred Provider Organization (PPO)

50. Long-Term Disability Insurance
A type of individual or group insurance that provides coverage for illness until the insured reaches age 65 and for life in the case of an accident.
The fair and equal bargaining by both parties in forming the contract - where the applicant must make full disclosure of risk to the company - and the insurance company must be fair in underwriting the risk.
A policy with a high maximum limit that covers certain diseases named in the contract (such as polio and meningitis).
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.