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. Excess Insurance
The portion of premium for which policy protection has not yet been given.
Insurance that pays over and above or in addition to basic policy limits.
Insurance whereby premiums are paid for protection in the event of death or disability - not for cash value accumulation.
A special field in dentistry which involves treatment of natural teeth to prevent and/or correct dental anomalies with braces or appliances.


2. Risk
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.
An insurance company authorized and licensed to transact business in a particular state.
An entity certified by the insured's health plan that provides health care services under contract.
Uncertainty as to the outcome of an event when two or more possibilities exist.


3. Implied Authority
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 applicant or insured who is considered to have an average probability of a loss based on health - vocation and lifestyle.
The first page of a policy.
An entity that obtains and possesses a license solely for the purpose of writing business on the owner - immediate family - relatives - employer and employees.


4. Waiver of Premium
The authority granted to an agent by means of the agent's written contract.
Continuation of life insurance coverage if the insured becomes totally disabled and is unable to pay the premiums.
Additional - miscellaneous services provided by a hospital - such as x-rays - anesthesia - and lab work - but not hospital room and board expenses.
A contract which has not yet been fulfilled by one or both parties that promises action in the event of a specified future occurrence.


5. Accidental Death Insurance

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6. Commissioner (Superintendent - Director)
The chief executive and administrative officer of a state insurance department.
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 applicant or insured who is considered to have an average probability of a loss based on health - vocation and lifestyle.
An optional disability income rider that waives the elimination period when an insured is hospitalized as an inpatient.


7. Noncancelable
Plans that allow employers to set aside funds for reimbursing employees for qualified medical expenses.
A provision that is found in most disability income policies which specifies the conditions that will automatically qualify the insured for full disability benefits.
A policy feature that allows the policyholder to vary premium payments in the amount and/or timing.
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.


8. Pre-Existing Condition
An unincorporated group of individuals who mutually insure one another - each separately assuming a share of each risk.
A general statement that identifies the basic agreement between the insurance company and the insured - usually located on the first page of the policy.
Riders attached to life insurance policies which allow death benefits to be used to cover nursing or convalescent home expenses.
A physical condition that existed before the effective date of the policy - usually excluded from coverage.


9. Excess Charge
A legal impediment to denying a fact or restoring a right that has been previously waived.
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 fee or commission charged at the time of purchase of an annuity or a security.
The difference between the Medicare approved amount for a service or supply and the actual charge.


10. Universal Life
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 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.
A combination of a flexible premium and adjustable life insurance.
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.


11. Major Medical Insurance
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 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.
The accounting measurement of an insurer's future obligations to pay claims to policyowners.
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.


12. Warranty
A disease that causes the victim to become dysfunctional due to degeneration of brain cells causing severe memory loss.
A material stipulation in the policy that if breached may void coverage.
Care that is rendered to help an insured complete his/her activities of daily living.
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.


13. Issue Age

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14. Explanation of Medicare Benefits
A table showing the incidence of sickness at specified ages.
A statement sent to a Medicare patient indicating how the Medicare claim will be settled.
The amount of money an insured can borrow using the cash value of his/her life insurance policy as collateral.
A form changing the provisions of and attached to a life insurance policy (also known as a rider).


15. Subrogation
A covered expense under Part A of Medicare in which a licensed home health agency provides home health care to an insured.
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 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.
Unplanned - unforeseen traumatic injury to the body.


16. Gatekeeper Model

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17. Accidental Death Benefits
Insurance organizations that have no capital stock - but are owned by the policyholders.
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
The acceptability of an applicant who meets an insurance company's underwriting requirements for insurance.
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.


18. Custodial Car
A false statement or lie that can render the contract void.
Care that is rendered to help an insured complete his/her activities of daily living.
Settlement method that pays the beneficiary the entire proceeds of a life insurance policy in one payment rather than in installments.
A provision that spells out an insured's duty to provide the insurer with reasonable notice in the event of a loss.


19. Multiple-Employer Trust (MET)
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.
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 rider attached to a life insurance policy that provides LTC benefits or benefits for the terminally ill by using available life insurance benefits.
An annuity that offers fixed payments and guarantees a minimum rate of interest to be credited to the purchase payment or payments.


20. Adverse Selection
The tendency of risks with higher probability of loss to purchase and maintain insurance more often than the risks who present lower probability.
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.
A table showing the incidence of sickness at specified ages.
A statement that outlines what services were rendered - how much the insurer paid - and how much the insured was billed.


21. Adult Day Care
Coverage for doctor visits - x-rays - lab tests - and emergency room visits; benefits - however - are limited to specified dollar amounts.
The withholding of known facts which - if material - can void a contract.
Companies owned by the stockholders whose investments provide the capital necessary to establish and operate the insurance company.
A program for impaired adults that attempts to meet their health - social - and functional needs in a setting away from their homes.


22. Extension of Benefits

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23. Binder (Binding Receipt)
An unplanned - unforeseen event which occurs suddenly and at an unspecified place.
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 temporary contract that puts an insurance policy into force before the premium has been paid.
An individual who is licensed to sell - negotiate - or effect insurance contracts on behalf of an insurer.


24. Disclosure
The person who receives the proceeds from the policy when the insured dies.
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 act of identifying the name of the producer - representative or firm - limited insurance representative - or temporary insurance producer on any policy solicitation.
Insurance plans where the health care services rendered are the benefits instead of monetary benefits.


25. Disability
Termination of an insurance policy - with an adjustment of the premium charge in proportion to the exact coverage that has been in force.
The time over which the annuitant makes paymenrs or investments in an annuity - and when those payments earn interest tax deferred.
The amount Medicare determines to be reasonable for a service that is covered under part B of Medicare.
A physical or mental impairment - either congenital or resulting from an injury or sickness.


26. Pro Rata Cancellation
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 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.
Those guaranteed values in a life insurance policy that cannot be taken from the insured - even if he or she ceases to pay premiums.
Insurance agent or broker.


27. Omnibus Budget Reconciliation Act
The date when the face amount of the life insurance becomes payable.
Period of time after the premium due date during which premiums may still be paid - and the policy and its riders remain in force.
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 type of life insurance that features a level premium and a death benefit that decreases each year over the duration of the policy.


28. Basic Medical Expense Insurance
A temporary contract that puts an insurance policy into force before the premium has been paid.
A physical condition that existed before the effective date of the policy - usually excluded from coverage.
Coverage for doctor visits - x-rays - lab tests - and emergency room visits; benefits - however - are limited to specified dollar amounts.
The acceptability of an applicant who meets an insurance company's underwriting requirements for insurance.


29. Nonmedical

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30. Coinsurance Clause
The payment made by insurers to agents or brokers for the sale and service of policies.
A unit of measure used to determine rates charged for insurance coverage.
The portion of premium for which policy protection has not yet been given.
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.


31. Presumptive Disability
The acceptability of an applicant who meets an insurance company's underwriting requirements for insurance.
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 provision that is found in most disability income policies which specifies the conditions that will automatically qualify the insured for full disability benefits.
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.


32. Whole Life Insurance

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33. Employee RetirementIncome Security Act (ERISA)
A periodic payment to the insurance company to keep the policy in force.
The act that stipulates federal standards for private pension plans.
Choices available to the insured/owner for distribution of insurance proceeds.
Intentional misrepresentation or deceit with the intent to induce a person to part with something of value.


34. Application
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.
A document that provides information for underwriting purposes. After the policy is issued - any unanswered questions are considered waived by the insurer.
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'
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).


35. Medical Savings Account
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.
A special field in dentistry which involves treatment of natural teeth to prevent and/or correct dental anomalies with braces or appliances.
Insurance that pays dividends to policyholders.
An employer-funded account linked to a high deductible medical insurance plan.


36. Agency
An insurance sales office or company.
The age of the insured at a determined date.
Continuation of life insurance coverage if the insured becomes totally disabled and is unable to pay the premiums.
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.


37. Provider
An insurance company authorized and licensed to transact business in a particular state.
Any group or individual who provides health care services.
A person making application for - or offering him/herself or another to be insured under an insurance contract.
An organization of medical professionals and hospitals who provide services to an insurance company's clients for a set fee.


38. Alien Insurer
An insurance company that is incorporated in another state.
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 insurance company that is incorporated outside the United States.
Canceling the policy with a less than proportionate return of premium.


39. Grace Period
The payment made by insurers to agents or brokers for the sale and service of policies.
Period of time after the premium due date during which premiums may still be paid - and the policy and its riders remain 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.
The acceptability of an applicant who meets an insurance company's underwriting requirements for insurance.


40. Policyowner
Plans that allow employers to set aside funds for reimbursing employees for qualified medical expenses.
Operative treatment of the mouth such as extractions of teeth and related surgical treatment.
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 person who is entitled to exercise the rights and privileges in the policy. This person may or may not be the insured.


41. Commission
Withdrawing the money from a qualified plan and placing it into another qualified plan.
The payment made by insurers to agents or brokers for the sale and service of policies.
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).
An area of dentistry that deals with diagnosis - prevention and treatment of the dental pulp within natural teeth at the root canal.


42. Morbidity Table
A table showing the incidence of sickness at specified ages.
A group of small employers who do not qualify for group insurance individually - formed to establish a group health plan or self-funded plan.
Causes of loss - exposures - conditions - etc. listed in the policy for which the benefits will not be paid.
A basic policy that charges a level annual premium for the lifetime of the insured and provides a level - guaranteed death benefit.


43. Superintendent (Commissioner - Director)
An individual who is licensed to sell - negotiate - or effect insurance contracts on behalf of an insurer.
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.
The head of the state department of insurance.
A waiting period that is imposed on the insured from the onset of disability until benefit payments begin.


44. Non-participating Policies (Non-par)
The time over which the annuitant makes paymenrs or investments in an annuity - and when those payments earn interest tax deferred.
Insurance that does not pay dividends.
The person who has possession of the policy - usually the insured.
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.


45. Assignment (Life)
The third in line to receive the benefits of a life insurance policy.
Organizations that process claims and pay benefits in an insurance policy
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.
The transfer of ownership rights of a life insurance policy from one person to another.


46. Annual Statement
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 who is licensed to sell - negotiate - or effect insurance contracts on behalf of an insurer.
An excessive amount of insurance that would result in overpayment to the insured in the event of a loss.
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.


47. Convertible
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).
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
Organizations that process claims and pay benefits in an insurance policy
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.


48. Standard Provisions
Requirements approved by state law that must appear in all insurance policies.
A policy on which all premiums have been paid but which has not matured due either to death or endowment.
The appearance or the assumption of authority based on the actions - words - or deeds of the principal or because of circumstances the principal created.
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


49. Joint Life
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.
Insurance plans where the health care services rendered are the benefits instead of monetary benefits.
A life or health insurance policy that is underwritten based on the insured's statement of health rather than a medical examination.
A single policy that is designed to insure two or more lives.


50. Proof of Loss
A claim form that a claimant must submit after a loss occurs.
An entity that indemnifies against losses - provides benefits - or renders services (also known as "company" or "insurance company").
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 life insurance policy designed to provide a level death benefit to the insured's age 100 for a one-time - lump sum payment.