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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. Subrogation
Lessening the possibility or severity of a loss.
A level of care that is one step down from skilled nursing care; provided under the supervision of physicians or registered nurses.
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 unplanned - unforeseen event which occurs suddenly and at an unspecified place.

2. Rebating
A request for payment of the benefits provided by an insurance contract.
A clause that prevents the debtors of a beneficiary from collecting the benefits before he/she receives them.
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.
Any inducement offered in the sale of insurance products that is not specified in the policy.

3. Fiduciary

4. Reserve
An amount representing actual or potential liabilities kept by an insurer in a separate account to cover debts to policyholders.
Choices available to the insured/owner for distribution of insurance proceeds.
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 date when the face amount of the life insurance becomes payable.

5. Hazard - Physical
Health insurance policies that cover only specific accidents or diseases.
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 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.
Termination of an insurance policy - with an adjustment of the premium charge in proportion to the exact coverage that has been in force.

6. Waiver
A contract that pays a stated amount in the event of a loss (disability insurance/life insurance).
An unincorporated group of individuals who mutually insure one another - each separately assuming a share of each risk.
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.
The voluntary abandonment of a known or legal right or advantage.

7. Commingling
Written and /or oral statements regarding a consumer's credit - character - reputation - or habits collected by a reporting agency from employment records - credit reports - and other public sources.
A practice in which a person in a fiduciary capacity illegally mixes his/her personal funds with funds he/she is holding in trust.
A selection of health care benefits from which an employee may choose the ones that he/she needs.
The acceptability of an applicant who meets an insurance company's underwriting requirements for insurance.

8. Long-Term Disability Insurance
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.
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 accounting measurement of an insurer's future obligations to pay claims to policyowners.
A retirement plan that meets the IRS guidelines for receiving favorable tax treatment.

9. Intermediate Care
Amounts an insured must pay for coinsurance and deductibles before the insurer will pay its portion.
Settlement method that pays the beneficiary the entire proceeds of a life insurance policy in one payment rather than in installments.
A level of care that is one step down from skilled nursing care; provided under the supervision of physicians or registered nurses.
A type of individual or group insurance that fills the gaps in the protection provided by Medicare - but that cannot duplicate any Medicare benefits.

10. Credit Life Insurance
Insurer's location of incorporation and the legal ability to write business in a state.
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 policy that provides benefits for all medical costs - including doctor visits - hospitalization - and drugs.
A special type of coverage written to pay off the balance of a loan in the event of the death of the debtor.

11. Preferred Risk
A special field in dentistry which involves treatment of natural teeth to prevent and/or correct dental anomalies with braces or appliances.
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.
Causes of loss - exposures - conditions - etc. listed in the policy for which the benefits will not be paid.
An insurance classification for applicants who have a lower expectation of incurring loss - and who - therefore - are covered at a reduced rate.

12. Out-of-Pocket Costs
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 unincorporated group of individuals who mutually insure one another - each separately assuming a share of each risk.
Legal term that distinguishes oral statements from written statements.
Amounts an insured must pay for coinsurance and deductibles before the insurer will pay its portion.

13. Excess Charge
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 fee or commission charged at the time of purchase of an annuity or a security.
Canceling the policy with a less than proportionate return of premium.
The difference between the Medicare approved amount for a service or supply and the actual charge.

14. Mortality Table
The accounting measurement of an insurer's future obligations to pay claims to policyowners.
A demand of a person to stop committing an action that is in violation of a provision.
A table showing the probability of death at specified ages.
Organizations that process claims and pay benefits in an insurance policy

15. Investigative Consumer Report

16. Medicare
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 United States federal government plan for paying certain hospital and medical expenses for persons who qualify.
A policy provision that specifies the period of time during which the recurrence of an injury or illness will be considered a continuation of a prior period of disability.
The method of premium payment - whether annually - semiannually - quarterly - or monthly.

17. 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.
Amounts an insured must pay for coinsurance and deductibles before the insurer will pay its portion.
A termination of a policy by an insurer on the anniversary or renewal date.
The date specified in the policy as the date of termination.

18. Terminally Ill
A disease that causes the victim to become dysfunctional due to degeneration of brain cells causing severe memory loss.
A patient who is expected to die within an amount of time specified in the policy.
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 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.

19. Valued Contract
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.
Termination of an insurance policy - with an adjustment of the premium charge in proportion to the exact coverage that has been in force.
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.
A contract that pays a stated amount in the event of a loss (disability insurance/life insurance).

20. Co-Pay
An arrangement in which an insured must pay a specified amount for services "up front" and the provider pays the remainder of the cost.
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 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 circumstance that increases the likelihood of a loss.

21. Group Health Insurance
Intentional misrepresentation or deceit with the intent to induce a person to part with something of value.
An act of giving up a life policy - in which the insurer will pay the insured the cash value the policy has built up.
Health coverage provided to members of a group.
Organizations that provide support facilities for underwriters or groups of individuals that accept insurance risk.

22. Preferred Provider Organization (PPO)

23. Legal Reserve

24. Risk - Pure
The person who is named as first to receive benefits from a policy.
A contract that legally binds only one party to contractual obligations after the premium is paid.
The uncertainty or chance of a loss occurring in a situation that can only result in a loss or no change.
A mortality table used in life insurance that mathematically predicts the likelihood of death.

25. Probationary Period
Health coverage provided to members of a group.
The period of time between the effective date of a health insurance policy and the date coverage for all or certain conditions begins.
The method of premium payment - whether annually - semiannually - quarterly - or monthly.
The difference between the Medicare approved amount for a service or supply and the actual charge.

26. Stock Companies
Termination of a policy because the premium has not been paid by the end of the grace period.
Companies owned by the stockholders whose investments provide the capital necessary to establish and operate the insurance company.
A termination of a policy by an insurer on the anniversary or renewal date.
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.

27. Dual Choice
The United States federal government plan for paying certain hospital and medical expenses for persons who qualify.
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 arrangement in which an insured must pay a specified amount for services "up front" and the provider pays the remainder of the cost.
A statement that outlines what services were rendered - how much the insurer paid - and how much the insured was billed.

28. Accident
An unplanned - unforeseen event which occurs suddenly and at an unspecified place.
A policy rider that states that the cause of death will be analyzed to determine if it complies with the policy description of accidental death.
A level of care that is one step down from skilled nursing care; provided under the supervision of physicians or registered nurses.
A statement usually obtained from the applicant's doctor.

29. Benefit Period
A provision that helps determine the primary provider in situations where an insured is covered by more than one policy - thus avoiding claims overpayments.
The length of time over which the insurance benefits will be paid for each illness - disability or hospital stay.
The head of the state department of insurance.
A claim to a provider or medical supplier to receive payments directly from Medicare.

30. Juvenile Life
Any life insurance written on the life of a minor.
An insurance company that is incorporated in another state.
Organizations that provide support facilities for underwriters or groups of individuals that accept insurance risk.
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.

31. Limited-Pay Whole Life

32. Secondary Beneficiary
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 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.
Time between the beginning of a disability and the start of disability insurance benefits.
An applicant or insured who has a higher than normal probability of loss - and who may be subject to an increased premium.

33. Rollover
A choice of ways of receiving policy dividends - nonforfeiture values - death benefits - or cash values.
The time over which the annuitant makes paymenrs or investments in an annuity - and when those payments earn interest tax deferred.
Withdrawing the money from a qualified plan and placing it into another qualified plan.
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.

34. Implied Authority
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.
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 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.
A fee or commission charged at the time of purchase of an annuity or a security.

35. Insurer
Organizations that provide support facilities for underwriters or groups of individuals that accept insurance risk.
The portion of premium for which policy protection has not yet been given.
An entity that indemnifies against losses - provides benefits - or renders services (also known as "company" or "insurance company").
Settlement method that pays the beneficiary the entire proceeds of a life insurance policy in one payment rather than in installments.

36. Express Authority

37. Home Health Services
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.
Special powers granted to an agent by his or her agency contract.
A covered expense under Part A of Medicare in which a licensed home health agency provides home health care to an insured.
A provision that states that the insurer and the insured will share the losses covered by the policy in a proportion agreed upon in advance.

38. Controlled Business
An insurance company that is incorporated outside the United States.
An entity that obtains and possesses a license solely for the purpose of writing business on the owner - immediate family - relatives - employer and employees.
A covered expense under Part A of Medicare in which a licensed home health agency provides home health care to an insured.
A life or health insurance policy that is underwritten based on the insured's statement of health rather than a medical examination.

39. Administrator
An applicant or insured who is considered to have an average probability of a loss based on health - vocation and lifestyle.
An individual appointed by a court as a fiduciary to settle the financial affairs and estate of a deceased person.
An insurance company authorized and licensed to transact business in a particular state.
Health coverage provided to members of a group.

40. Coordination of Benefits
A covered expense under Part A of Medicare in which a licensed home health agency provides home health care to an insured.
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 choice of ways of receiving policy dividends - nonforfeiture values - death benefits - or cash values.
The amount payable upon the death of the person whose life is insured.

41. Residual Disability
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 pays over and above or in addition to basic policy limits.
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.
Type of disability income policy that provides benefits for loss of income when a person returns to work after a total disability - but is still not able to perform at the same level as before becoming disabled.

42. Hazard - Morale

43. Limited Policies
An insurance sales office or company.
Health insurance policies that cover only specific accidents or diseases.
A claim form that a claimant must submit after a loss occurs.
The amount payable upon the death of the person whose life is insured.

44. Estoppel
A material stipulation in the policy that if breached may void coverage.
A statement sent to a Medicare patient indicating how the Medicare claim will be settled.
A legal impediment to denying a fact or restoring a right that has been previously waived.
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.

45. Limiting Charge
A type of life insurance that features a level premium and a death benefit that decreases each year over the duration of the policy.
Insurance whereby premiums are paid for protection in the event of death or disability - not for cash value accumulation.
A specialty of dentistry that involves treatment of the surrounding and supporting tissue of the teeth such as treatment for gum disease.
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.

46. Approved Amount
The amount payable by the insurance company - usually in at the insured's death or when the policy matures.
The age of the insured at a determined date.
The amount Medicare determines to be reasonable for a service that is covered under part B of Medicare.
Protection against loss due to sickness or bodily injury.

47. Activities of Daily Living (ADLs)
Activities individuals must do every day such as moving about - getting dressed - eating - bathing - etc.
Life insurance provided for members of a group.
The authority granted to an agent by means of the agent's written contract.
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.

48. Comprehensive Policy
The United States federal government plan for paying certain hospital and medical expenses for persons who qualify.
The head of the state department of insurance.
A plan that provides a package of health care services - including preventive care - routine physicals - immunization - outpatient services and hospitalization.
Health insurance policies that cover only specific accidents or diseases.

49. Extended Care Facility
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.
A policy premium that remains the same over the period of time premiums are paid.
A facility which is licensed by the state to provide 24 hour nursing care.
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).

50. Transfer
A type of insurance that protects the insured against loss due to accidental bodily injury.
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 document that authorizes a company to start conducting business and specifies the kind(s) of insurance a company can transact. It is illegal for an insurance company to transact insurance without this certificate.
A basic principle of insurance under which the risk of financial loss is assigned to another party.