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Test your basic knowledge |
Life And Health Insurance Exam
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Study First
Subject
:
certifications
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. Risk - Pure
Causes of loss - exposures - conditions - etc. listed in the policy for which the benefits will not be paid.
A request for payment of the benefits provided by an insurance contract.
The uncertainty or chance of a loss occurring in a situation that can only result in a loss or no change.
A periodic payment to the insurance company to keep the policy in force.
2. Deductible
The portion of the loss that is to be paid by the insured before any claim benefits may be paid by the insurer.
Organizations that process inpatient and outpatient claims on individuals by hospitals - skilled nursing facilities - home health agencies - hospices and certain other providers of health services.
An insurance company authorized and licensed to transact business in a particular state.
The full face value of a policy.
3. Application
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.
A document that provides information for underwriting purposes. After the policy is issued - any unanswered questions are considered waived by 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.
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.
4. Policyowner
A fee or commission charged at the time of purchase of an annuity or a security.
A ledger or proposal used in the sale of a life insurance policy that shows both guaranteed and nonguaranteed elements.
The person who is entitled to exercise the rights and privileges in the policy. This person may or may not be the insured.
A type of life insurance that features a level premium and a death benefit that decreases each year over the duration of the policy.
5. Straight Life
A basic policy that charges a level annual premium for the lifetime of the insured and provides a level - guaranteed death benefit.
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.
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.
A fee charged at the time of a sale - transfer or withdrawal from an annuity or a life insurance policy.
6. Risk - Speculative
A provision that allows coverage to continue beyond the policy's expiration date for employees who are not actively at work due to disability or who have dependents hospitalized on that date. This coverage continues only until the employee returns to
Written and /or oral statements regarding a consumer's credit - character - reputation - or habits collected by a reporting agency from employment records - credit reports - and other public sources.
The uncertainty or chance of a loss occurring in a situation that involves the opportunity for either loss or gain.
A legal document that indicates that an insurance policy has been issued - and that states both the amounts and types of insurance provided.
7. Short-Rate Cancellation
Canceling the policy with a less than proportionate return of premium.
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.
Any life insurance written on the life of a minor.
A special field in dentistry which involves treatment of natural teeth to prevent and/or correct dental anomalies with braces or appliances.
8. Mode of Payment
To restore the insured to the same condition as prior to loss with no intent of loss or gain.
The method of premium payment - whether annually - semiannually - quarterly - or monthly.
An entity that indemnifies against losses - provides benefits - or renders services (also known as "company" or "insurance company").
An insurance policy which pays a specified amount or a specified multiple of the insured's benefit if the insured dies - loses his/her sight - or loses two limbs due to an accident.
9. Aleatory
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.
Legal term that distinguishes oral statements from written statements.
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 temporary contract that puts an insurance policy into force before the premium has been paid.
10. Presumptive Disability
A provision that is found in most disability income policies which specifies the conditions that will automatically qualify the insured for full disability benefits.
Ability to perform some - but not all - of the duties of the insured's occupation as a result of injury or sickness.
An unfair trade practice in which one person refuses to do business with another until he or she agrees to certain conditions.
A basic principle of insurance under which the risk of financial loss is assigned to another party.
11. Assignment (Health)
A policy with a high maximum limit that covers certain diseases named in the contract (such as polio and meningitis).
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.
A claim to a provider or medical supplier to receive payments directly from Medicare.
An optional disability income rider that waives the elimination period when an insured is hospitalized as an inpatient.
12. Sharing
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
Any life insurance written on the life of a minor.
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 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.
13. Health Savings Accounts (HSAs)
Plans designed to help individuals save for qualified health expenses.
A selection of health care benefits from which an employee may choose the ones that he/she needs.
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 form of misrepresentation in which an agent persuades an insured/owner to cancel - lapse - or switch policies - even when it's to the insured's disadvantage.
14. Qualified Plan
The time over which the annuitant makes paymenrs or investments in an annuity - and when those payments earn interest tax deferred.
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 statement usually obtained from the applicant's doctor.
A retirement plan that meets the IRS guidelines for receiving favorable tax treatment.
15. Payment of Claims
A provision that specifies to whom claims payments are to be made.
Insurance that does not pay dividends.
The payment made by insurers to agents or brokers for the sale and service of policies.
A combination of a flexible premium and adjustable life insurance.
16. Group Health Insurance
A practice in which a person in a fiduciary capacity illegally mixes his/her personal funds with funds he/she is holding in trust.
Legal term that distinguishes oral statements from written statements.
Health coverage provided to members of a group.
Insurance furnished by nongovernmental insuring organizations.
17. Reciprocal Exchange
A claim to a provider or medical supplier to receive payments directly from Medicare.
An unincorporated group of individuals who mutually insure one another - each separately assuming a share of each risk.
Unplanned - unforeseen traumatic injury to the body.
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.
18. Viatical Settlement
Additional - miscellaneous services provided by a hospital - such as x-rays - anesthesia - and lab work - but not hospital room and board expenses.
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 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.
A covered expense under Part A of Medicare in which a licensed home health agency provides home health care to an insured.
19. Disclosure
A ledger or proposal used in the sale of a life insurance policy that shows both guaranteed and nonguaranteed elements.
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.
An act of identifying the name of the producer - representative or firm - limited insurance representative - or temporary insurance producer on any policy solicitation.
To reach the maturity date or time at which the face amount equals cash values.
20. Unilateral Contract
Life insurance provided for members of a group.
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.
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.
A contract that legally binds only one party to contractual obligations after the premium is paid.
21. Benefit Period
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 provision that spells out an insured's duty to provide the insurer with reasonable notice in the event of a loss.
The length of time over which the insurance benefits will be paid for each illness - disability or hospital stay.
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'
22. Unearned Premium
The portion of premium for which policy protection has not yet been given.
The uncertainty or chance of a loss occurring in a situation that can only result in a loss or no change.
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 policy rider that states that the cause of death will be analyzed to determine if it complies with the policy description of accidental death.
23. Adjustable Life
A termination of a policy by an insurer on the anniversary or renewal date.
The effect of a person's reputation - character - living habits - etc. on his/her insurability.
The head of the state department of insurance.
Life insurance which permits changes in the face amount - premium amount - period of protection - and the duration of the premium payment period.
24. Alzheimer's Disease
Special powers granted to an agent by his or her agency contract.
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 disease that causes the victim to become dysfunctional due to degeneration of brain cells causing severe memory loss.
A request for payment of the benefits provided by an insurance contract.
25. Hospice
The transfer of ownership rights of a life insurance policy from one person to another.
An individual who is licensed to sell - negotiate - or effect insurance contracts on behalf of an insurer.
The appearance or the assumption of authority based on the actions - words - or deeds of the principal or because of circumstances the principal created.
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.
26. Actual Cash Value (ACV)
27. Probationary Period
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 period of time between the effective date of a health insurance policy and the date coverage for all or certain conditions begins.
Ability to perform some - but not all - of the duties of the insured's occupation as a result of injury or sickness.
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.
28. Indemnify
To restore the insured to the same condition as prior to loss with no intent of loss or gain.
A person making application for - or offering him/herself or another to be insured under an insurance contract.
A contract which has not yet been fulfilled by one or both parties that promises action in the event of a specified future occurrence.
A mortality table used in life insurance that mathematically predicts the likelihood of death.
29. Certificate
A statement (or booklet) that confirms that a policy has been written and that describes the coverage in general.
Health insurance policies that cover only specific accidents or diseases.
An act of giving up a life policy - in which the insurer will pay the insured the cash value the policy has built up.
A legal contract that determines what will be done with a business in the event that an owner dies or becomes disabled.
30. Risk - Standard
A periodic payment to the insurance company to keep the policy in force.
An insurance company that is incorporated outside the United States.
An applicant or insured who is considered to have an average probability of a loss based on health - vocation and lifestyle.
A provision that helps determine the primary provider in situations where an insured is covered by more than one policy - thus avoiding claims overpayments.
31. Coinsurance Clause
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 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 percentage of the principal amount of a policy paid to the insured if he/she suffered the loss of an appendage.
The date when the face amount of the life insurance becomes payable.
32. Claim
Activities individuals must do every day such as moving about - getting dressed - eating - bathing - etc.
Organizations that provide support facilities for underwriters or groups of individuals that accept insurance risk.
A request for payment of the benefits provided by an insurance contract.
Insurance agent or broker.
33. Accidental Death and Dismemberment (AD&D)
34. Carriers
The person or organization that is protected by insurance; the party to be indemnified.
An insurance policy that provides payment if the insured's death is the result of an accident.
The amount of money an insured can borrow using the cash value of his/her life insurance policy as collateral.
Organizations that process claims and pay benefits in an insurance policy
35. Medical Expense Insurance
A life or health insurance policy that is underwritten based on the insured's statement of health rather than a medical examination.
The cause of a possible loss.
A life insurance policy designed to provide a level death benefit to the insured's age 100 for a one-time - lump sum payment.
A type of insurance that pays benefits for medical - surgical - and hospital costs.
36. Beneficiary
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 person who receives the proceeds from the policy when the insured dies.
A covered expense under Part A of Medicare in which a licensed home health agency provides home health care to an insured.
A clause that defines the insurance company's and the insured's right to cancel or renew coverage.
37. Primary Beneficiary
The act of signing an insurance policy by a licensed resident agent.
A fee charged at the time of a sale - transfer or withdrawal from an annuity or a life insurance 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
The person who is named as first to receive benefits from a policy.
38. Dependent
Termination of a policy because the premium has not been paid by the end of the grace period.
A person who relies on another for support and maintenance.
Continuation of life insurance coverage if the insured becomes totally disabled and is unable to pay the premiums.
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).
39. Health Reimburse
A type of insurance that protects the insured against loss due to accidental bodily injury.
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.
Plans that allow employers to set aside funds for reimbursing employees for qualified medical expenses.
The cause of a possible loss.
40. Buyer's Guide
A unit of measure used to determine rates charged for insurance coverage.
A booklet that describes insurance policies and concepts - and provides general information to help an applicant make an informed decision.
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 facility which is licensed by the state to provide 24 hour nursing care.
41. Representations
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 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.
Statements made by the applicant on the insurance application that are believed to be true - but are not guaranteed to be true.
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.
42. Authorized (Admitted) Insurer
An insurance company authorized and licensed to transact business in a particular state.
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.
The process of reviewing - accepting or rejecting applications for insurance.
A fee or commission charged at the time of purchase of an annuity or a security.
43. Underwriter
An excessive amount of insurance that would result in overpayment to the insured in the event of a loss.
A life insurance policy designed to provide a level death benefit to the insured's age 100 for a one-time - lump sum payment.
An insurance company authorized and licensed to transact business in a particular state.
A person who evaluates and classifies risks to accept or reject them on behalf of the insurer.
44. Issue Age
45. Nonqualified Pla
To restore the insured to the same condition as prior to loss with no intent of loss or gain.
The United States federal government plan for paying certain hospital and medical expenses for persons who qualify.
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.
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.
46. Buy-Sell Agreement
A choice of ways of receiving policy dividends - nonforfeiture values - death benefits - or cash values.
A legal contract that determines what will be done with a business in the event that an owner dies or becomes disabled.
Organizations that provide support facilities for underwriters or groups of individuals that accept insurance risk.
The person who is named as first to receive benefits from a policy.
47. Medical Information Bureau (MIB)
A periodic payment to the insurance company to keep the policy in force.
The transfer of ownership rights of a life insurance policy from one person to another.
A program for impaired adults that attempts to meet their health - social - and functional needs in a setting away from their homes.
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
48. Permanent Disability
An act of giving up a life policy - in which the insurer will pay the insured the cash value the policy has built up.
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.
Disability from which the insured does not recover.
Statements made by the applicant on the insurance application that are believed to be true - but are not guaranteed to be true.
49. Rescission
A policy feature that allows the policyholder to vary premium payments in the amount and/or timing.
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 authorized and licensed to transact business in a particular state.
Selling assets as a method of raising capital.
50. Policyholder
A legal impediment to denying a fact or restoring a right that has been previously waived.
An unfair trade practice in which one person refuses to do business with another until he or she agrees to certain conditions.
Period of time after the premium due date during which premiums may still be paid - and the policy and its riders remain in force.
The person who has possession of the policy - usually the insured.