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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. Group Health Insurance
Health coverage provided to members of a group.
The transfer of ownership rights of a life insurance policy from one person to another.
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
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.

2. Domestic Insurer
An insurance company that conducts business in the state of incorporation.
A detailed financial report that an insurance company must submit every year to the insurance department of state(s) in which it conducts business.
The accounting measurement of an insurer's future obligations to pay claims to policyowners.
A provision that specifies to whom claims payments are to be made.

3. Recurrent Disability
A document that provides information for underwriting purposes. After the policy is issued - any unanswered questions are considered waived by the insurer.
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.
Insurance that pays over and above or in addition to basic policy limits.
A covered expense under Part A of Medicare in which a licensed home health agency provides home health care to an insured.

4. Policy Loan
The amount to which a policyowner is entitled if the policy is surrendered before maturity.
Ability to perform some - but not all - of the duties of the insured's occupation as a result of injury or sickness.
A clause that defines the insurance company's and the insured's right to cancel or renew coverage.
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.

5. Preferred Provider Organization (PPO)

6. Risk
Uncertainty as to the outcome of an event when two or more possibilities exist.
To reach the maturity date or time at which the face amount equals cash values.
Plans designed to help individuals save for qualified health expenses.
Average number of years remaining for a person of a given age to live - as shown on the mortality table.

7. Permanent Disability
A detailed financial report that an insurance company must submit every year to the insurance department of state(s) in which it conducts business.
Insurance that pays benefits for inability to work because of disability resulting from accidental bodily injury or sickness.
The portion of the loss that is to be paid by the insured before any claim benefits may be paid by the insurer.
Disability from which the insured does not recover.

8. Substandard Risk
The amount of time an employee has to sign up for a contributory group health plan.
An applicant or insured who has a higher than normal probability of loss - and who may be subject to an increased premium.
The tendency or likelihood of insurance policies not lapsing or being replaced with insurance from another insurer.
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.

9. Skilled Nursing Care
The accounting measurement of an insurer's future obligations to pay claims to policyowners.
An insurance sales office or company.
A booklet that describes insurance policies and concepts - and provides general information to help an applicant make an informed decision.
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.

10. Provider
Any group or individual who provides health care services.
A salary reduction cafeteria plan that uses employee funds to provide various types of health care benefits.
The act of signing an insurance policy by a licensed resident agent.
A condition which does not allow a person to perform the duties of any occupation for payment as a result of injury or sickness.

11. Endow
To reach the maturity date or time at which the face amount equals cash values.
Insurance that pays dividends to policyholders.
An entity certified by the insured's health plan that provides health care services under contract.
The tendency of risks with higher probability of loss to purchase and maintain insurance more often than the risks who present lower probability.

12. Cease and Desist Order
A demand of a person to stop committing an action that is in violation of a provision.
Similar to consumer reports in that they also provide information on the consumer's character - reputation - and habits.
An entity that indemnifies against losses - provides benefits - or renders services (also known as "company" or "insurance company").
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.

13. Misrepresentation
The third in line to receive the benefits of a life insurance policy.
A special area of dentistry that involves the replacement of missing teeth with artificial devices like bridgework or dentures.
A false statement or lie that can render the contract void.
A disease that causes the victim to become dysfunctional due to degeneration of brain cells causing severe memory loss.

14. Expiration
A principle stating that the larger the number of similar exposure units considered - the more closely the losses reported will equal the underlying probability of loss.
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 date specified in the policy as the date of termination.
The head of the state department of insurance.

15. Errors and Omissions Policy (E&O)
The person who receives the proceeds from the policy when the insured dies.
Insurance agent or broker.
A professional liability insurance that protects the insurer from claims by the insured for errors or oversights on the part of the insurer.
A ledger or proposal used in the sale of a life insurance policy that shows both guaranteed and nonguaranteed elements.

16. Pre-Existing Condition
A booklet that describes insurance policies and concepts - and provides general information to help an applicant make an informed decision.
Insurance agent or broker.
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 physical condition that existed before the effective date of the policy - usually excluded from coverage.

17. Application
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
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.
A document that provides information for underwriting purposes. After the policy is issued - any unanswered questions are considered waived by the insurer.
A statement sent to a Medicare patient indicating how the Medicare claim will be settled.

18. Morbidity Rate
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.
An individual appointed by a court as a fiduciary to settle the financial affairs and estate of a deceased person.
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
Similar to consumer reports in that they also provide information on the consumer's character - reputation - and habits.

19. Free Look
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 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.
The authority granted to an agent by means of the agent's written contract.
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

20. Lapse
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.
A specialty of dentistry that involves treatment of the surrounding and supporting tissue of the teeth such as treatment for gum disease.
Termination of a policy because the premium has not been paid by the end of the grace period.

21. Custodial Car
An area of dentistry that involves treatments that restore functional use to natural teeth such as fillings or crowns.
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.
Care that is rendered to help an insured complete his/her activities of daily living.
Termination of an insurance policy - with an adjustment of the premium charge in proportion to the exact coverage that has been in force.

22. Adult Day Care
A selection of health care benefits from which an employee may choose the ones that he/she needs.
A program for impaired adults that attempts to meet their health - social - and functional needs in a setting away from their homes.
Policies which replace a certain percentage of the insured's pure loss of income due to a covered accident or sickness.
An unplanned - unforeseen event which occurs suddenly and at an unspecified place.

23. 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.
Termination of a policy because the premium has not been paid by the end of the grace period.
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 choice of ways of receiving policy dividends - nonforfeiture values - death benefits - or cash values.

24. Effective Date
The voluntary abandonment of a known or legal right or advantage.
A plan that provides a package of health care services - including preventive care - routine physicals - immunization - outpatient services and hospitalization.
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.
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.

25. Nonadmitted (Nonauthorized)
The inclusion of causes of loss (perils) which are covered within a scope of a policy.
A plan that provides a package of health care services - including preventive care - routine physicals - immunization - outpatient services and hospitalization.
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 cause of a possible loss.

26. Proof of Loss
Coverage that provides benefits for room - board and miscellaneous hospital expenses for a certain number of days during a hospital stay.
A claim form that a claimant must submit after a loss occurs.
Intentional misrepresentation or deceit with the intent to induce a person to part with something of value.
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.

27. Hazard
Choices available to the insured/owner for distribution of insurance proceeds.
A physical condition that existed before the effective date of the policy - usually excluded from coverage.
A circumstance that increases the likelihood of a loss.
The date when the face amount of the life insurance becomes payable.

28. Avoidance
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.
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 optional disability income rider that waives the elimination period when an insured is hospitalized as an inpatient.

29. Limited-Pay Whole Life

30. Accident
An unplanned - unforeseen event which occurs suddenly and at an unspecified place.
The amount to which a policyowner is entitled if the policy is surrendered before maturity.
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.
A claim form that a claimant must submit after a loss occurs.

31. Non-participating Policies (Non-par)
The portion of the loss that is to be paid by the insured before any claim benefits may be paid by the insurer.
A plan that provides a package of health care services - including preventive care - routine physicals - immunization - outpatient services and hospitalization.
Insurance that does not pay dividends.
An agent licensed in a state in which he or she is not a resident.

32. Deductible
An optional disability income rider that waives the elimination period when an insured is hospitalized as an inpatient.
A program for impaired adults that attempts to meet their health - social - and functional needs in a setting away from their homes.
The date specified in the policy as the date of termination.
The portion of the loss that is to be paid by the insured before any claim benefits may be paid by the insurer.

33. Actual Charge
The amount a physician or supplier actually bills for a particular service or supply.
The amount Medicare determines to be reasonable for a service that is covered under part B of Medicare.
Coverage that provides benefits for room - board and miscellaneous hospital expenses for a certain number of days during a hospital stay.
Organizations that provide support facilities for underwriters or groups of individuals that accept insurance risk.

34. Partial Disability

35. Viatical Settlement
Termination of an insurance policy - with an adjustment of the premium charge in proportion to the exact coverage that has been in force.
An entity that indemnifies against losses - provides benefits - or renders services (also known as "company" or "insurance company").
A group insurance plan that requires the employees to pay part of the premium.
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.

36. Controlled Business
The cause of a possible loss.
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 basic policy that charges a level annual premium for the lifetime of the insured and provides a level - guaranteed death benefit.
An entity that obtains and possesses a license solely for the purpose of writing business on the owner - immediate family - relatives - employer and employees.

37. Risk Retention Group
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 policy that provides payment if the insured's death is the result of an accident.
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.
Choices available to the insured/owner for distribution of insurance proceeds.

38. Assignment (Life)
A special type of coverage written to pay off the balance of a loan in the event of the death of the debtor.
Uncertainty as to the outcome of an event when two or more possibilities exist.
The transfer of ownership rights of a life insurance policy from one person to another.
Average number of years remaining for a person of a given age to live - as shown on the mortality table.

39. Long-Term Care (LTC)
A statement that outlines what services were rendered - how much the insurer paid - and how much the insured was billed.
An insurance sales office or company.
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 ledger or proposal used in the sale of a life insurance policy that shows both guaranteed and nonguaranteed elements.

40. Nonauthorized (Nonadmitted)
A level of care that is one step down from skilled nursing care; provided under the supervision of physicians or registered nurses.
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.
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.
Ability to perform some - but not all - of the duties of the insured's occupation as a result of injury or sickness.

41. Administrator
Insurance furnished by nongovernmental insuring organizations.
An entity that obtains and possesses a license solely for the purpose of writing business on the owner - immediate family - relatives - employer and employees.
Care that is rendered to help an insured complete his/her activities of daily living.
An individual appointed by a court as a fiduciary to settle the financial affairs and estate of a deceased person.

42. Life Expectancy
Lessening the possibility or severity of a loss.
Average number of years remaining for a person of a given age to live - as shown on the mortality table.
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.
Intentional misrepresentation or deceit with the intent to induce a person to part with something of value.

43. Hazard - Physical
An excessive amount of insurance that would result in overpayment to the insured in the event of a loss.
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.
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.

44. Alien Insurer
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 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 that is incorporated outside the United States.
Any life insurance written on the life of a minor.

45. Underwriting
Any inducement offered in the sale of insurance products that is not specified in the policy.
The process of reviewing - accepting or rejecting applications for insurance.
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 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.

46. Physical Exam and Autopsy
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.
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.
To restore the insured to the same condition as prior to loss with no intent of loss or gain.
The person or organization that is protected by insurance; the party to be indemnified.

47. Out-of-Pocket Costs
The inclusion of causes of loss (perils) which are covered within a scope of a policy.
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.
Amounts an insured must pay for coinsurance and deductibles before the insurer will pay its portion.
Intentional misrepresentation or deceit with the intent to induce a person to part with something of value.

48. Reduction
Insurance that pays dividends to policyholders.
Selling assets as a method of raising capital.
Lessening the possibility or severity of a loss.
The person who is named as first to receive benefits from a policy.

49. Investigative Consumer Report

50. Oral Surgery
The effect a person's indifference concerning loss has on the risk to be insured.
An individual who represents an insured in the process of purchasing and negotiating a contract of insurance.
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.
Operative treatment of the mouth such as extractions of teeth and related surgical treatment.