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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. Limiting Charge
A percentage of the principal amount of a policy paid to the insured if he/she suffered the loss of an appendage.
A policy with a high maximum limit that covers certain diseases named in the contract (such as polio and meningitis).
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.
An agreement between two or more parties enforceable by law.

2. Restorative Care
Settlement method that pays the beneficiary the entire proceeds of a life insurance policy in one payment rather than in installments.
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.
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 area of dentistry that involves treatments that restore functional use to natural teeth such as fillings or crowns.

3. Intermediaries
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.
An entity certified by the insured's health plan that provides health care services under contract.
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.
An agent/broker who handles insurer's funds in a trust capacity.

4. Spendthrift Clause
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 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 insurance classification for applicants who have a lower expectation of incurring loss - and who - therefore - are covered at a reduced rate.
A clause that prevents the debtors of a beneficiary from collecting the benefits before he/she receives them.

5. Risk - Speculative
The uncertainty or chance of a loss occurring in a situation that involves the opportunity for either loss or gain.
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.
A unit of measure used to determine rates charged for insurance coverage.
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.

6. Concealment
A special field in dentistry which involves treatment of natural teeth to prevent and/or correct dental anomalies with braces or appliances.
The person who has possession of the policy - usually the insured.
An organization of medical professionals and hospitals who provide services to an insurance company's clients for a set fee.
The withholding of known facts which - if material - can void a contract.

7. Beneficiary
Continuation of life insurance coverage if the insured becomes totally disabled and is unable to pay the premiums.
The person who receives the proceeds from the policy when the insured dies.
The reduction - decrease - or disappearance of value of the person or property insured in a policy - by a peril insured against.
A group insurance plan that requires the employees to pay part of the premium.

8. Emergency
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 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 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 injury or disease which occurs suddenly and requires treatment within 24 hours.

9. Intermediate Care
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 level of care that is one step down from skilled nursing care; provided under the supervision of physicians or registered nurses.
An employer-funded account linked to a high deductible medical insurance plan.
A type of insurance that protects the insured against loss due to accidental bodily injury.

10. Medical Information Bureau (MIB)
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
A provision that spells out an insured's duty to provide the insurer with reasonable notice in the event of a loss.
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 general term used to refer to various forms of whole life insurance policies that remain in effect to age 100 so long as the premium is paid.

11. Oral Surgery
Operative treatment of the mouth such as extractions of teeth and related surgical treatment.
An applicant or insured who is considered to have an average probability of a loss based on health - vocation and lifestyle.
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 situation in which two parties provide the same help or advantages to each other (for example - Producer A living in State A can transact business as a nonresident in State B if State B's resident producers can transact business in State A).

12. Actuary
An unfair trade practice in which an insurer uses physical or mental force to persuade an applicant to buy insurance.
An organization that is formed by - or on behalf of - a group of insurers to develop rates for those insurers - and to file the rates with the insurance department on behalf of its members. They may also act as a collection point for actuarial data.
The person who receives the proceeds from the policy when the insured dies.
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.

13. Nonauthorized (Nonadmitted)
An entity that indemnifies against losses - provides benefits - or renders services (also known as "company" or "insurance company").
Time between the beginning of a disability and the start of disability insurance benefits.
A physical illness - disease - or pregnancy - but not a mental illness.
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.

14. Primary Beneficiary
The person who is named as first to receive benefits from a policy.
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.
Life insurance which permits changes in the face amount - premium amount - period of protection - and the duration of the premium payment period.
A life or health insurance policy that is underwritten based on the insured's statement of health rather than a medical examination.

15. Policy Loan
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.
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 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 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.

16. Home Health Services
A covered expense under Part A of Medicare in which a licensed home health agency provides home health care to an insured.
Insurance that pays over and above or in addition to basic policy limits.
A physical condition that existed before the effective date of the policy - usually excluded from coverage.
A form changing the provisions of and attached to a life insurance policy (also known as a rider).

17. Insurance
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.
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 provision that specifies to whom claims payments are to be made.
An applicant or insured who is considered to have an average probability of a loss based on health - vocation and lifestyle.

18. Coverage
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 periodic payment to the insurance company to keep the policy in force.
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 inclusion of causes of loss (perils) which are covered within a scope of a policy.

19. Lapse
Any supplemental agreement attached to and made a part of the policy indicating the policy expansion by additional coverage - or a waiver of a coverage or condition.
A person who relies on another for support and maintenance.
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.
Termination of a policy because the premium has not been paid by the end of the grace period.

20. Dread (Specified) Disease Policy
A contract that pays a stated amount in the event of a loss (disability insurance/life insurance).
A policy with a high maximum limit that covers certain diseases named in the contract (such as polio and meningitis).
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 policy premium that remains the same over the period of time premiums are paid.

21. Buy-Sell Agreement
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.
The acceptability of an applicant who meets an insurance company's underwriting requirements for insurance.
A legal contract that determines what will be done with a business in the event that an owner dies or becomes disabled.
A basic principle of insurance under which the risk of financial loss is assigned to another party.

22. Settlement Options
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.
Choices available to the insured/owner for distribution of insurance proceeds.
A combination of a flexible premium and adjustable life insurance.
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.

23. Reinsurance
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 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.
The person who is entitled to exercise the rights and privileges in the policy. This person may or may not be the insured.
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.

24. Reciprocity

25. Executory Contract
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 circumstance that increases the likelihood of a loss.
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 person who is named as first to receive benefits from a policy.

26. Personal Contract

27. Premium
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 physical illness - disease - or pregnancy - but not a mental illness.
A periodic payment to the insurance company to keep the policy in force.
Unplanned - unforeseen traumatic injury to the body.

28. Major Medical Insurance
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.
An unplanned - unforeseen event which occurs suddenly and at an unspecified place.
A detailed financial report that an insurance company must submit every year to the insurance department of state(s) in which it conducts business.
An individual appointed by a court as a fiduciary to settle the financial affairs and estate of a deceased person.

29. 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 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
The portion of premium for which policy protection has not yet been given.
The person or organization that is protected by insurance; the party to be indemnified.

30. Retention

31. CSO Table (The Commissioner's Standard Ordinary Table)
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.
Any supplemental agreement attached to and made a part of the policy indicating the policy expansion by additional coverage - or a waiver of a coverage or condition.
A mortality table used in life insurance that mathematically predicts the likelihood of death.

32. Nonmedical

33. Coordination of Benefits
A provision that helps determine the primary provider in situations where an insured is covered by more than one policy - thus avoiding claims overpayments.
Continuation of life insurance coverage if the insured becomes totally disabled and is unable to pay the premiums.
Amounts an insured must pay for coinsurance and deductibles before the insurer will pay its portion.
A provision that is found in most disability income policies which specifies the conditions that will automatically qualify the insured for full disability benefits.

34. Contributory
A clause that prevents the debtors of a beneficiary from collecting the benefits before he/she receives them.
A group insurance plan that requires the employees to pay part of the premium.
An unfair trade practice in which one person refuses to do business with another until he or she agrees to certain conditions.
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).

35. Natural Premium
An infectious and incurable disease caused by the human immunodeficiency virus (HIV).
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 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.
The withholding of known facts which - if material - can void a contract.

36. Investigative Consumer Report

37. Proceeds

38. Integrated LTC Rider

39. Underwriter
Insurance that provides protection for a specific period of time.
The withholding of known facts which - if material - can void a contract.
A person who evaluates and classifies risks to accept or reject them on behalf of the insurer.
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.

40. Approved Amount
A disease that causes the victim to become dysfunctional due to degeneration of brain cells causing severe memory loss.
A life or health insurance policy that is underwritten based on the insured's statement of health rather than a medical examination.
A statement (or booklet) that confirms that a policy has been written and that describes the coverage in general.
The amount Medicare determines to be reasonable for a service that is covered under part B of Medicare.

41. Comprehensive Major Medical
The first page of a policy.
A combination of basic coverage and major medical coverage that features low deductibles - high maximum benefits - and coinsurance.
A policy on which all premiums have been paid but which has not matured due either to death or endowment.
A material stipulation in the policy that if breached may void coverage.

42. Death Benefit
Life insurance provided for members of a group.
Special powers granted to an agent by his or her agency contract.
The amount payable upon the death of the person whose life is insured.
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.

43. Agent
An individual who is licensed to sell - negotiate - or effect insurance contracts on behalf of an insurer.
A general term used to refer to various forms of whole life insurance policies that remain in effect to age 100 so long as the premium is paid.
A person who evaluates and classifies risks to accept or reject them on behalf of the insurer.
A specialty of dentistry that involves treatment of the surrounding and supporting tissue of the teeth such as treatment for gum disease.

44. Medicare Supplement Insurance
Health insurance policies that cover only specific accidents or diseases.
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.
A combination of a flexible premium and adjustable life insurance.
A type of individual or group insurance that fills the gaps in the protection provided by Medicare - but that cannot duplicate any Medicare benefits.

45. Insurer
An entity that indemnifies against losses - provides benefits - or renders services (also known as "company" or "insurance company").
An insurance classification for applicants who have a lower expectation of incurring loss - and who - therefore - are covered at a reduced rate.
Termination of an insurance policy - with an adjustment of the premium charge in proportion to the exact coverage that has been in force.
A person making application for - or offering him/herself or another to be insured under an insurance contract.

46. Policyowner
A policy on which all premiums have been paid but which has not matured due either to death or endowment.
The transfer of ownership rights of a life insurance policy from one person to another.
The person who is entitled to exercise the rights and privileges in the policy. This person may or may not be the insured.
Operative treatment of the mouth such as extractions of teeth and related surgical treatment.

47. Basic Illustration
Any life insurance written on the life of a minor.
Lessening the possibility or severity of a loss.
A ledger or proposal used in the sale of a life insurance policy that shows both guaranteed and nonguaranteed elements.
The act of signing an insurance policy by a licensed resident agent.

48. Limited-Pay Whole Life

49. Adjustable Life
A type of an agreement in which both parties must perform certain duties and follow rules of conduct to make the contract enforceable.
A group or individual policy that covers disabilities of 13 to 26 weeks - and in some cases for a period of up to two years.
Life insurance which permits changes in the face amount - premium amount - period of protection - and the duration of the premium payment period.
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.

50. Risk Retention Group
Coverage that provides benefits for room - board and miscellaneous hospital expenses for a certain number of days during a hospital stay.
A provision that spells out an insured's duty to provide the insurer with reasonable notice in the event of a loss.
A group or individual policy that covers disabilities of 13 to 26 weeks - and in some cases for a period of up to two years.
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.