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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. Peril
An applicant or insured who is considered to have an average probability of a loss based on health - vocation and lifestyle.
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 cause of a possible loss.
An optional disability income rider that waives the elimination period when an insured is hospitalized as an inpatient.

2. Risk - Standard
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.
An applicant or insured who is considered to have an average probability of a loss based on health - vocation and lifestyle.
Life insurance provided for members of a group.

3. Defamation

4. Conditional Contract
A specialty of dentistry that involves treatment of the surrounding and supporting tissue of the teeth such as treatment for gum disease.
Health coverage provided to members of a group.
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 type of an agreement in which both parties must perform certain duties and follow rules of conduct to make the contract enforceable.

5. Qualified Plan
A booklet that describes insurance policies and concepts - and provides general information to help an applicant make an informed decision.
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 retirement plan that meets the IRS guidelines for receiving favorable tax treatment.
Care that is rendered to help an insured complete his/her activities of daily living.

6. Fair Credit Reporting Act
Legal term that distinguishes oral statements from written statements.
An unincorporated group of individuals who mutually insure one another - each separately assuming a share of each risk.
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.
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.

7. 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.
Termination of an insurance policy - with an adjustment of the premium charge in proportion to the exact coverage that has been in force.
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.
Requirements approved by state law that must appear in all insurance policies.

8. Workers Compensation
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 provision that states that the insurer and the insured will share the losses covered by the policy in a proportion agreed upon in advance.
A condition which does not allow a person to perform the duties of any occupation for payment as a result of injury or sickness.
The person who receives the proceeds from the policy when the insured dies.

9. Renewable Term
Insurance which can - at the election of the policyowner - be renewed at the end of a term without evidence of insurability.
The difference between the Medicare approved amount for a service or supply and the actual charge.
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 person who is named as first to receive benefits from a policy.

10. Acquired Immunodeficiency Syndrome (AIDS)
A contract that pays a stated amount in the event of a loss (disability insurance/life insurance).
An infectious and incurable disease caused by the human immunodeficiency virus (HIV).
A person making application for - or offering him/herself or another to be insured under an insurance contract.
Withdrawing the money from a qualified plan and placing it into another qualified plan.

11. Renewability Clause

12. Representations
The voluntary abandonment of a known or legal right or advantage.
The amount of the premium for which the policy protection has been given.
Statements made by the applicant on the insurance application that are believed to be true - but are not guaranteed to be true.
A type of an agreement in which both parties must perform certain duties and follow rules of conduct to make the contract enforceable.

13. Medical Expense Insurance
An infectious and incurable disease caused by the human immunodeficiency virus (HIV).
An agent licensed in a state in which he or she is not a resident.
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 type of insurance that pays benefits for medical - surgical - and hospital costs.

14. Ancillary
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 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).
The effect a person's indifference concerning loss has on the risk to be insured.
Additional - miscellaneous services provided by a hospital - such as x-rays - anesthesia - and lab work - but not hospital room and board expenses.

15. Nonadmitted (Nonauthorized)
Any life insurance written on the life of a minor.
Average number of years remaining for a person of a given age to live - as shown on the mortality table.
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 plans where the health care services rendered are the benefits instead of monetary benefits.

16. Home Health Agency

17. Investigative Consumer Report

18. Utmost Good Faith
The uncertainty or chance of a loss occurring in a situation that involves the opportunity for either loss or gain.
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
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.
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.

19. Basic Illustration
A ledger or proposal used in the sale of a life insurance policy that shows both guaranteed and nonguaranteed elements.
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.
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 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.

20. Disability Income Insurance

21. Waiver
The portion of the loss that is to be paid by the insured before any claim benefits may be paid by the insurer.
The voluntary abandonment of a known or legal right or advantage.
A physical or mental impairment - either congenital or resulting from an injury or sickness.
Life insurance provided for members of a group.

22. Waiting Period
A plan that provides a package of health care services - including preventive care - routine physicals - immunization - outpatient services and hospitalization.
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 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.
Time between the beginning of a disability and the start of disability insurance benefits.

23. Policyowner
The act that stipulates federal standards for private pension plans.
Disability from which the insured does not recover.
A choice of ways of receiving policy dividends - nonforfeiture values - death benefits - or cash values.
The person who is entitled to exercise the rights and privileges in the policy. This person may or may not be the insured.

24. Face
Companies owned by the stockholders whose investments provide the capital necessary to establish and operate the insurance company.
The first page of a policy.
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'
Operative treatment of the mouth such as extractions of teeth and related surgical treatment.

25. Decreasing Term
Activities individuals must do every day such as moving about - getting dressed - eating - bathing - etc.
Health coverage provided to members of a group.
The amount of the premium for which the policy protection has been given.
A type of life insurance that features a level premium and a death benefit that decreases each year over the duration of the policy.

26. Rate Service Organization
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 professional liability insurance that protects the insurer from claims by the insured for errors or oversights on the part of the insurer.
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.
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.

27. Notice of Claim

28. Oral Surgery
Operative treatment of the mouth such as extractions of teeth and related surgical treatment.
A clause that prevents the debtors of a beneficiary from collecting the benefits before he/she receives them.
A provision that specifies to whom claims payments are to be made.
The portion of the loss that is to be paid by the insured before any claim benefits may be paid by the insurer.

29. Viatical Settlement
The United States federal government plan for paying certain hospital and medical expenses for persons who qualify.
A contract that pays a stated amount in the event of a loss (disability insurance/life insurance).
A facility which is licensed by the state to provide 24 hour nursing care.
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.

30. Convertible
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 inclusion of causes of loss (perils) which are covered within a scope of a policy.
A type of insurance that covers a group of individuals against loss of pay due to accident or sickness.
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).

31. Mutual Companies
Insurance organizations that have no capital stock - but are owned by the policyholders.
A policy with a high maximum limit that covers certain diseases named in the contract (such as polio and meningitis).
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.
Insurance furnished by nongovernmental insuring organizations.

32. Exposure
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 inclusion of causes of loss (perils) which are covered within a scope of a policy.
A unit of measure used to determine rates charged for insurance coverage.
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.

33. Director (Commissioner - Superintendent)
Insurance that pays over and above or in addition to basic policy limits.
The head of the state department of insurance.
Insurance whereby premiums are paid for protection in the event of death or disability - not for cash value accumulation.
The act of signing an insurance policy by a licensed resident agent.

34. Comprehensive Major Medical
Any inducement offered in the sale of insurance products that is not specified in the policy.
A combination of basic coverage and major medical coverage that features low deductibles - high maximum benefits - and coinsurance.
To restore the insured to the same condition as prior to loss with no intent of loss or gain.
A type of insurance that covers a group of individuals against loss of pay due to accident or sickness.

35. Intermediate Care
A single policy that is designed to insure two or more lives.
A level of care that is one step down from skilled nursing care; provided under the supervision of physicians or registered nurses.
A statement sent to a Medicare patient indicating how the Medicare claim will be settled.
A person making application for - or offering him/herself or another to be insured under an insurance contract.

36. Extension of Benefits

37. Rescission
The portion of premium for which policy protection has not yet been given.
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.
Selling assets as a method of raising capital.
The termination of an insurance contract due either to material misrepresentation by the insured or by fraud - misrepresentation - or duress on the part of the agent/insurer.

38. Intentional Injury
The time over which the annuitant makes paymenrs or investments in an annuity - and when those payments earn interest tax deferred.
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.
Choices available to the insured/owner for distribution of insurance proceeds.
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.

39. Waiver of Cost
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 basic principle of insurance under which the risk of financial loss is assigned to another party.
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 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

40. Cafeteria Plan
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.
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 program for impaired adults that attempts to meet their health - social - and functional needs in a setting away from their homes.

41. Policyholder
The process of reviewing - accepting or rejecting applications for insurance.
The uncertainty or chance of a loss occurring in a situation that involves the opportunity for either loss or gain.
The person who has possession of the policy - usually the insured.
An insurance company authorized and licensed to transact business in a particular state.

42. Annuity
Insurance agent or broker.
A form changing the provisions of and attached to a life insurance policy (also known as a rider).
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 contract that provides income for a specified period of years - or for life.

43. Health Reimburse
Plans that allow employers to set aside funds for reimbursing employees for qualified medical expenses.
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.
To reach the maturity date or time at which the face amount equals cash values.
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.

44. Applicant
The date when the face amount of the life insurance becomes payable.
A person making application for - or offering him/herself or another to be insured under an insurance contract.
Operative treatment of the mouth such as extractions of teeth and related surgical treatment.
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.

45. Primary Policy
A basic - fundamental insurance policy which pays first with respect to other outstanding policies.
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 required amount to pay damages or for property loss - which is calculated based on the property's current replacement value minus depreciation.
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

46. Mode of Payment
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 policy premium that remains the same over the period of time premiums are paid.
The method of premium payment - whether annually - semiannually - quarterly - or monthly.

47. Certificate of Authority
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 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 group of small employers who do not qualify for group insurance individually - formed to establish a group health plan or self-funded plan.
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.

48. Extended Care Facility
Plans designed to help individuals save for qualified health expenses.
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 rider attached to a life insurance policy that provides LTC benefits or benefits for the terminally ill by using available life insurance benefits.
A facility which is licensed by the state to provide 24 hour nursing care.

49. Home Health Care
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.
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.
An unincorporated group of individuals who mutually insure one another - each separately assuming a share of each risk.
Coverage for doctor visits - x-rays - lab tests - and emergency room visits; benefits - however - are limited to specified dollar amounts.

50. Limited Policies
A type of insurance that protects the insured against loss due to accidental bodily injury.
A contract that legally binds only one party to contractual obligations after the premium is paid.
Health insurance policies that cover only specific accidents or diseases.
Similar to consumer reports in that they also provide information on the consumer's character - reputation - and habits.