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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. Administrator
An individual appointed by a court as a fiduciary to settle the financial affairs and estate of a deceased person.
An agent licensed in a state in which he or she is not a resident.
A covered expense under Part A of Medicare in which a licensed home health agency provides home health care to an insured.
A legal contract that determines what will be done with a business in the event that an owner dies or becomes disabled.

2. Face
An amount representing actual or potential liabilities kept by an insurer in a separate account to cover debts to policyholders.
The first page of a policy.
The head of the state department of insurance.
The difference between the Medicare approved amount for a service or supply and the actual charge.

3. Investigative Consumer Report

4. Orthodontics
A special field in dentistry which involves treatment of natural teeth to prevent and/or correct dental anomalies with braces or appliances.
A provision that spells out an insured's duty to provide the insurer with reasonable notice in the event of a loss.
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.
A legal contract that determines what will be done with a business in the event that an owner dies or becomes disabled.

5. Executory Contract
A policy that provides benefits for all medical costs - including doctor visits - hospitalization - and drugs.
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 request for payment of the benefits provided by an insurance contract.
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.

6. Risk Retention Group
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.
A basic policy that charges a level annual premium for the lifetime of the insured and provides a level - guaranteed death benefit.
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 booklet that describes insurance policies and concepts - and provides general information to help an applicant make an informed decision.

7. Beneficiary
The individual's age when a policy is issued.
The person who receives the proceeds from the policy when the insured dies.
A combination of a flexible premium and adjustable life insurance.
A federal law which extends the minimum COBRA continuation of group health care coverage from 18 to 29 months for qualified beneficiaries who are disabled at the time of qualification.

8. Policyholder
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.
The person who has possession of the policy - usually the insured.
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
An applicant or insured who has a higher than normal probability of loss - and who may be subject to an increased premium.

9. Agent's Authority
The voluntary abandonment of a known or legal right or advantage.
Special powers granted to an agent by his or her agency contract.
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.
An injury or disease which occurs suddenly and requires treatment within 24 hours.

10. Endodontics
A provision that helps determine the primary provider in situations where an insured is covered by more than one policy - thus avoiding claims overpayments.
A table showing the probability of death at specified ages.
An area of dentistry that deals with diagnosis - prevention and treatment of the dental pulp within natural teeth at the root canal.
The amount of the premium for which the policy protection has been given.

11. Pre-Existing Condition
The full face value of a policy.
A mortality table used in life insurance that mathematically predicts the likelihood of death.
A physical condition that existed before the effective date of the policy - usually excluded from coverage.
Any group or individual who provides health care services.

12. Payment of Claims
A provision that specifies to whom claims payments are to be made.
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.
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.
Canceling the policy with a less than proportionate return of premium.

13. Long-Term Care (LTC)
An insurance policy which pays a specified amount or a specified multiple of the insured's benefit if the insured dies - loses his/her sight - or loses two limbs due to an accident.
A program for impaired adults that attempts to meet their health - social - and functional needs in a setting away from their homes.
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 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

14. Exclusions
A legal contract that determines what will be done with a business in the event that an owner dies or becomes disabled.
Causes of loss - exposures - conditions - etc. listed in the policy for which the benefits will not be paid.
An entity that obtains and possesses a license solely for the purpose of writing business on the owner - immediate family - relatives - employer and employees.
An insurance company that conducts business in the state of incorporation.

15. Conditional Contract
A retirement plan that meets the IRS guidelines for receiving favorable tax treatment.
Insurance that pays dividends to policyholders.
Unplanned - unforeseen traumatic injury to the body.
A type of an agreement in which both parties must perform certain duties and follow rules of conduct to make the contract enforceable.

16. Claim
A form changing the provisions of and attached to a life insurance policy (also known as a rider).
Insurance organizations that have no capital stock - but are owned by the policyholders.
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 request for payment of the benefits provided by an insurance contract.

17. Cafeteria Plan
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.
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 selection of health care benefits from which an employee may choose the ones that he/she needs.
A basic - fundamental insurance policy which pays first with respect to other outstanding policies.

18. Insurance
A special type of coverage written to pay off the balance of a loan in the event of the death of the debtor.
An individual appointed by a court as a fiduciary to settle the financial affairs and estate of a deceased person.
An excessive amount of insurance that would result in overpayment to the insured in the event of a loss.
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.

19. Contract
A choice of ways of receiving policy dividends - nonforfeiture values - death benefits - or cash values.
Intentional misrepresentation or deceit with the intent to induce a person to part with something of value.
The effect a person's indifference concerning loss has on the risk to be insured.
An agreement between two or more parties enforceable by law.

20. Death Benefit
A covered expense under Part A of Medicare in which a licensed home health agency provides home health care to an insured.
The amount payable upon the death of the person whose life is insured.
Coverage for doctor visits - x-rays - lab tests - and emergency room visits; benefits - however - are limited to specified dollar amounts.
Ability to perform some - but not all - of the duties of the insured's occupation as a result of injury or sickness.

21. Adjuster
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.
The chief executive and administrative officer of a state insurance department.
A provision that specifies to whom claims payments are to be made.
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.

22. Convertible
The person who has possession of the policy - usually the insured.
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.
Health coverage provided to members of a group.
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).

23. Superintendent (Commissioner - Director)
The head of the state department of insurance.
A basic policy that charges a level annual premium for the lifetime of the insured and provides a level - guaranteed death benefit.
The first page of a policy.
Organizations that process claims and pay benefits in an insurance policy

24. Health Maintenance Organization (HMO)
Plans designed to help individuals save for qualified health expenses.
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 act of giving up a life policy - in which the insurer will pay the insured the cash value the policy has built up.
A detailed financial report that an insurance company must submit every year to the insurance department of state(s) in which it conducts business.

25. Periodontics
A specialty of dentistry that involves treatment of the surrounding and supporting tissue of the teeth such as treatment for gum disease.
An unincorporated group of individuals who mutually insure one another - each separately assuming a share of each risk.
An insurance sales office or company.
A type of an agreement in which both parties must perform certain duties and follow rules of conduct to make the contract enforceable.

26. Nonmedical

27. Stock Companies
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.
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.
Companies owned by the stockholders whose investments provide the capital necessary to establish and operate the insurance company.
Legal term that distinguishes oral statements from written statements.

28. Application
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 professional liability insurance that protects the insurer from claims by the insured for errors or oversights on the part of the insurer.
The authority granted to an agent by means of the agent's written contract.
A document that provides information for underwriting purposes. After the policy is issued - any unanswered questions are considered waived by the insurer.

29. Juvenile Life
A statement (or booklet) that confirms that a policy has been written and that describes the coverage in general.
Any life insurance written on the life of a minor.
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.
Statements made by the applicant on the insurance application that are believed to be true - but are not guaranteed to be true.

30. Reciprocal Exchange
A special area of dentistry that involves the replacement of missing teeth with artificial devices like bridgework or dentures.
An unincorporated group of individuals who mutually insure one another - each separately assuming a share of each risk.
An insurance policy which pays a specified amount or a specified multiple of the insured's benefit if the insured dies - loses his/her sight - or loses two limbs due to an accident.
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.

31. Legal Reserve

32. Consideration
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
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
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 process of reviewing - accepting or rejecting applications for insurance.

33. Term Insurance
The tendency of risks with higher probability of loss to purchase and maintain insurance more often than the risks who present lower probability.
Insurance that provides protection for a specific period of time.
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.
Canceling the policy with a less than proportionate return of premium.

34. Apparent Authority
A person trained in the technical aspects of insurance and related fields - particularly in the mathematics of insurance; a person who - on behalf of the company - determines the mathematical probability of loss.
The portion of the loss that is to be paid by the insured before any claim benefits may be paid by the insurer.
The appearance or the assumption of authority based on the actions - words - or deeds of the principal or because of circumstances the principal created.
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).

35. Primary Beneficiary
Any life insurance written on the life of a minor.
A contract that provides income for a specified period of years - or for life.
An entity certified by the insured's health plan that provides health care services under contract.
The person who is named as first to receive benefits from a policy.

36. Coordination of Benefits
An insurance policy which pays a specified amount or a specified multiple of the insured's benefit if the insured dies - loses his/her sight - or loses two limbs due to an accident.
An infectious and incurable disease caused by the human immunodeficiency virus (HIV).
Coverage that provides benefits for room - board and miscellaneous hospital expenses for a certain number of days during a hospital stay.
A provision that helps determine the primary provider in situations where an insured is covered by more than one policy - thus avoiding claims overpayments.

37. Sharing
A clause that prevents the debtors of a beneficiary from collecting the benefits before he/she receives them.
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.
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.
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. Permanent Disability
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.
The process of reviewing - accepting or rejecting applications for insurance.
Disability from which the insured does not recover.

39. Renewable Term
A retirement plan that meets the IRS guidelines for receiving favorable tax treatment.
Insurance which can - at the election of the policyowner - be renewed at the end of a term without evidence of insurability.
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.

40. Annual Statement
A program for impaired adults that attempts to meet their health - social - and functional needs in a setting away from their homes.
The head of the state department of insurance.
A detailed financial report that an insurance company must submit every year to the insurance department of state(s) in which it conducts business.
A legal document that indicates that an insurance policy has been issued - and that states both the amounts and types of insurance provided.

41. Attained Age
The age of the insured at a determined date.
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.
Coverage that provides benefits for room - board and miscellaneous hospital expenses for a certain number of days during a hospital stay.
Insurance agent or broker.

42. Sickness
Insurance that does not pay dividends.
A combination of a flexible premium and adjustable life insurance.
A physical illness - disease - or pregnancy - but not a mental illness.
An unincorporated group of individuals who mutually insure one another - each separately assuming a share of each risk.

43. Issue Age

44. Medicare Supplement Insurance
A program for impaired adults that attempts to meet their health - social - and functional needs in a setting away from their homes.
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 type of individual or group insurance that fills the gaps in the protection provided by Medicare - but that cannot duplicate any Medicare benefits.
A circumstance that increases the likelihood of a loss.

45. Standard Provisions
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.
An agent licensed in a state in which he or she is not a resident.
A table showing the probability of death at specified ages.
Requirements approved by state law that must appear in all insurance policies.

46. Nonauthorized (Nonadmitted)
An agent/broker who handles insurer's funds in a trust capacity.
A policy premium that remains the same over the period of time premiums are paid.
A type of benefit plan that may discriminate - is not required to be filed with the IRS - and does not provide a current tax deduction for contributions.
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.

47. Risk - Standard
The person who receives the proceeds from the policy when the insured dies.
A form changing the provisions of and attached to a life insurance policy (also known as a rider).
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.
An applicant or insured who is considered to have an average probability of a loss based on health - vocation and lifestyle.

48. Binder (Binding Receipt)
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 temporary contract that puts an insurance policy into force before the premium has been paid.
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.
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.

49. Valued Contract
A group of small employers who do not qualify for group insurance individually - formed to establish a group health plan or self-funded plan.
Life insurance which permits changes in the face amount - premium amount - period of protection - and the duration of the premium payment period.
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.
A contract that pays a stated amount in the event of a loss (disability insurance/life insurance).

50. Flexible Spending Account (FSA)
Organizations that provide support facilities for underwriters or groups of individuals that accept insurance risk.
An unfair trade practice in which an insurer uses physical or mental force to persuade an applicant to buy insurance.
A unit of measure used to determine rates charged for insurance coverage.
A salary reduction cafeteria plan that uses employee funds to provide various types of health care benefits.