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Test your basic knowledge |
Life And Health Insurance Exam
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Study First
Subject
:
certifications
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. Buyer's Guide
A booklet that describes insurance policies and concepts - and provides general information to help an applicant make an informed decision.
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 clause that defines the insurance company's and the insured's right to cancel or renew coverage.
The first page of a policy.
2. Medical Savings Account
The person or organization that is protected by insurance; the party to be indemnified.
An employer-funded account linked to a high deductible medical insurance plan.
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'
The withholding of known facts which - if material - can void a contract.
3. Back-End Load
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
An unplanned - unforeseen event which occurs suddenly and at an unspecified place.
An insurance policy that provides payment if the insured's death is the result of an accident.
A fee charged at the time of a sale - transfer or withdrawal from an annuity or a life insurance policy.
4. Limited Policies
Insurance which can - at the election of the policyowner - be renewed at the end of a term without evidence of insurability.
Insurance that provides protection for a specific period of time.
A policy that provides benefits for all medical costs - including doctor visits - hospitalization - and drugs.
Health insurance policies that cover only specific accidents or diseases.
5. Liquidation
Selling assets as a method of raising capital.
A type of life insurance that features a level premium and a death benefit that decreases each year over the duration of the policy.
A temporary contract that puts an insurance policy into force before the premium has been paid.
An applicant or insured who has a higher than normal probability of loss - and who may be subject to an increased premium.
6. Risk - Pure
An insurance classification for applicants who have a lower expectation of incurring loss - and who - therefore - are covered at a reduced rate.
A request for payment of the benefits provided by an insurance contract.
The uncertainty or chance of a loss occurring in a situation that can only result in a loss or no change.
An agent/broker who handles insurer's funds in a trust capacity.
7. Consumer Reports
8. Respite Care
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.
The difference between the Medicare approved amount for a service or supply and the actual charge.
The person who is entitled to exercise the rights and privileges in the policy. This person may or may not be the insured.
Legal term that distinguishes oral statements from written statements.
9. Unilateral Contract
A contract that legally binds only one party to contractual obligations after the premium is paid.
The amount of time an employee has to sign up for a contributory group health plan.
A provision that helps determine the primary provider in situations where an insured is covered by more than one policy - thus avoiding claims overpayments.
Additional - miscellaneous services provided by a hospital - such as x-rays - anesthesia - and lab work - but not hospital room and board expenses.
10. Employee RetirementIncome Security Act (ERISA)
Amounts an insured must pay for coinsurance and deductibles before the insurer will pay its portion.
A covered expense under Part A of Medicare in which a licensed home health agency provides home health care to an insured.
The person who has possession of the policy - usually the insured.
The act that stipulates federal standards for private pension plans.
11. Implied Authority
A legal contract that determines what will be done with a business in the event that an owner dies or becomes disabled.
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.
A combination of a flexible premium and adjustable life insurance.
An insurance policy that provides payment if the insured's death is the result of an accident.
12. Waiting Period
An applicant or insured who has a higher than normal probability of loss - and who may be subject to an increased premium.
An individual appointed by a court as a fiduciary to settle the financial affairs and estate of a deceased person.
Insurer's location of incorporation and the legal ability to write business in a state.
Time between the beginning of a disability and the start of disability insurance benefits.
13. Binder (Binding Receipt)
A temporary contract that puts an insurance policy into force before the premium has been paid.
An injury or disease which occurs suddenly and requires treatment within 24 hours.
A contract that pays a stated amount in the event of a loss (disability insurance/life insurance).
A ledger or proposal used in the sale of a life insurance policy that shows both guaranteed and nonguaranteed elements.
14. Decreasing Term
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 material stipulation in the policy that if breached may void coverage.
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 life insurance that features a level premium and a death benefit that decreases each year over the duration of the policy.
15. Medical Expense 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.
A type of insurance that pays benefits for medical - surgical - and hospital costs.
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.
The amount a physician or supplier actually bills for a particular service or supply.
16. Policyholder
A clause that defines the insurance company's and the insured's right to cancel or renew coverage.
The person who has possession of the policy - usually the insured.
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 method of premium payment - whether annually - semiannually - quarterly - or monthly.
17. Commissioner (Superintendent - Director)
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.
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 chief executive and administrative officer of a state insurance department.
A special field in dentistry which involves treatment of natural teeth to prevent and/or correct dental anomalies with braces or appliances.
18. Underwriting
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.
Special powers granted to an agent by his or her agency contract.
A program for impaired adults that attempts to meet their health - social - and functional needs in a setting away from their homes.
The process of reviewing - accepting or rejecting applications for insurance.
19. Insured
A termination of a policy by an insurer on the anniversary or renewal date.
The person or organization that is protected by insurance; the party to be indemnified.
Organizations that process claims and pay benefits in an insurance policy
A mortality table used in life insurance that mathematically predicts the likelihood of death.
20. Terminally Ill
A patient who is expected to die within an amount of time specified in the policy.
Causes of loss - exposures - conditions - etc. listed in the policy for which the benefits will not be paid.
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.
The payment made by insurers to agents or brokers for the sale and service of policies.
21. Admitted (Authorized) Insurer
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 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 insurance company authorized and licensed to transact business in a particular state.
A basic policy that charges a level annual premium for the lifetime of the insured and provides a level - guaranteed death benefit.
22. Insurance
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 type of individual or group insurance that fills the gaps in the protection provided by Medicare - but that cannot duplicate any Medicare benefits.
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.
A life insurance policy designed to provide a level death benefit to the insured's age 100 for a one-time - lump sum payment.
23. Aleatory
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 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 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.
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.
24. Insurer
Insurance plans where the health care services rendered are the benefits instead of monetary benefits.
An individual who is licensed to sell - negotiate - or effect insurance contracts on behalf of an insurer.
An entity that indemnifies against losses - provides benefits - or renders services (also known as "company" or "insurance company").
The amount Medicare determines to be reasonable for a service that is covered under part B of Medicare.
25. Disclosure
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
An act of identifying the name of the producer - representative or firm - limited insurance representative - or temporary insurance producer on any policy solicitation.
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 person who evaluates and classifies risks to accept or reject them on behalf of the insurer.
26. Agent
An individual who is licensed to sell - negotiate - or effect insurance contracts on behalf of an insurer.
An applicant or insured who has a higher than normal probability of loss - and who may be subject to an increased premium.
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.
A temporary contract that puts an insurance policy into force before the premium has been paid.
27. Excess Insurance
Insurance that pays over and above or in addition to basic policy limits.
The amount a physician or supplier actually bills for a particular service or supply.
Coverage that provides benefits for room - board and miscellaneous hospital expenses for a certain number of days during a hospital stay.
A contract that provides income for a specified period of years - or for life.
28. Investigative Consumer Report
29. Insurable Interest
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.
An agent/broker who handles insurer's funds in a trust capacity.
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.
30. Right to Return (aka Free Look)
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 insurance that protects the insured against loss due to accidental bodily injury.
The chief executive and administrative officer of a state insurance department.
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.
31. Probationary Period
The period of time between the effective date of a health insurance policy and the date coverage for all or certain conditions begins.
An unincorporated group of individuals who mutually insure one another - each separately assuming a share of each risk.
A request for payment of the benefits provided by an insurance contract.
Amounts an insured must pay for coinsurance and deductibles before the insurer will pay its portion.
32. Hazard
A material stipulation in the policy that if breached may void coverage.
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.
A circumstance that increases the likelihood of a loss.
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.
33. Elimination Period
A waiting period that is imposed on the insured from the onset of disability until benefit payments begin.
The amount a physician or supplier actually bills for a particular service or supply.
Medicare supplement plans issued by private insurance companies that are designed to fill some of the gaps in Medicare.
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.
34. Boycott
An unfair trade practice in which one person refuses to do business with another until he or she agrees to certain conditions.
Insurance that does not pay dividends.
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 tendency or likelihood of insurance policies not lapsing or being replaced with insurance from another insurer.
35. Coverage
The portion of the loss that is to be paid by the insured before any claim benefits may be paid by the insurer.
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.
The inclusion of causes of loss (perils) which are covered within a scope of a policy.
The withholding of known facts which - if material - can void a contract.
36. Multiple Employer Welfare Association (MEWA)
The amount payable by the insurance company - usually in at the insured's death or when the policy matures.
Any inducement offered in the sale of insurance products that is not specified in the policy.
The withholding of known facts which - if material - can void a contract.
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.
37. Administrator
An insurance company that conducts business in the state of incorporation.
An individual appointed by a court as a fiduciary to settle the financial affairs and estate of a deceased person.
A nonforfeiture value in which an insurer loans a part or all of the cash value of the policy assigned as security for the loan to the policyowner.
The accounting measurement of an insurer's future obligations to pay claims to policyowners.
38. Representations
Statements made by the applicant on the insurance application that are believed to be true - but are not guaranteed to be true.
A form changing the provisions of and attached to a life insurance policy (also known as a rider).
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).
The amount Medicare determines to be reasonable for a service that is covered under part B of Medicare.
39. Preferred Provider Organization (PPO)
40. Insurability
41. Viatical Settlement
An unincorporated group of individuals who mutually insure one another - each separately assuming a share of each risk.
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.
To reach the maturity date or time at which the face amount equals cash values.
The reduction - decrease - or disappearance of value of the person or property insured in a policy - by a peril insured against.
42. Principal Amount
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.
The full face value of a policy.
A patient who is expected to die within an amount of time specified in the policy.
A basic - fundamental insurance policy which pays first with respect to other outstanding policies.
43. Accidental Death and Dismemberment (AD&D)
44. Waiver of Premium
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
A mortality table used in life insurance that mathematically predicts the likelihood of death.
Continuation of life insurance coverage if the insured becomes totally disabled and is unable to pay the premiums.
Organizations that process claims and pay benefits in an insurance policy
45. 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.
A person who evaluates and classifies risks to accept or reject them on behalf of the insurer.
The effect a person's indifference concerning loss has on the risk to be insured.
Insurance plans where the health care services rendered are the benefits instead of monetary benefits.
46. Gatekeeper Model
47. Persistency
An area of dentistry that involves treatments that restore functional use to natural teeth such as fillings or crowns.
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.
Time between the beginning of a disability and the start of disability insurance benefits.
The tendency or likelihood of insurance policies not lapsing or being replaced with insurance from another insurer.
48. Group Health Insurance
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 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).
A rider attached to a life insurance policy that provides LTC benefits or benefits for the terminally ill by using available life insurance benefits.
Health coverage provided to members of a group.
49. Producer
An information database that stores the health histories of this database for underwriting purposes.individuals who have applied for insurance in the past. Most insurance companies subscribe to
The amount to which a policyowner is entitled if the policy is surrendered before maturity.
Insurance agent or broker.
A type of individual or group insurance that fills the gaps in the protection provided by Medicare - but that cannot duplicate any Medicare benefits.
50. Long-Term Disability Insurance
An agreement between two or more parties enforceable by law.
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.
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.
The method of premium payment - whether annually - semiannually - quarterly - or monthly.