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Download North Carolina Health Insurance State Exam Prep Updated Questions And All Correct Answers and more Exams Insurance law in PDF only on Docsity!
Which type of policy pays benefits to a policyholder covered under a Hospital Expense policy? - Correct Answer Reimbursement J has an Accidental Death and Dismemberment policy with a principal sum of $50,000. While trimming the hedges, J cuts off one of his fingers. What is the MAXIMUM J will receive from his policy? - Correct Answer $25,000 The benefits under a Disability Buy-Out policy are: - Correct Answer payable to the company or another shareholder An accident policy will most likely pay a benefit for a(n) - Correct Answer off-the - job accident a payment for damage or loss - Correct Answer indemnity If the insured and primary beneficiary are both killed in the same accident and it cannot be determined who died first, where are the death proceeds to be directed under the uniform Simultaneous Death Act? - Correct Answer Insured Contingent Beneficiary The COBRA gives workers whose employment has been terminated the right to - Correct Answer continue group health benefits The percentage of as individual's Primary Insurance Amount determines the benefits paid in which of the following programs. - Correct Answer Social Security Disability Income What is the maximum Social Security Disability benefit amount an insured can receive? - Correct Answer 100% of the insured’s Primary Insurance Amount (PIA) Which of these statements is INCORRECT regarding a PPO? - Correct Answer PPO's are NOT a type of managed care system What does Medicare Parts A and B cover? - Correct Answer Part A covers hospitalization; Part B covers doctor's services been in effect for a particular period of time? - Correct Answer Restoration of used benefit If several family members are injured in the same accident, only one deductible is applied. - Correct Answer Common Accident Deductible M has a Major Medical Insurance policy with a $200 flat deductible and an 80% Coinsurance clause. If M incurs a $2,200 claim for an eligible medical expense, how much will M receive in payment for this claim? - Correct Answer $1,600 This type of deductible provision waives the deductible for all family members after some of them have satisfied individual deductibles within the same year - Correct Answer Family maximum deductable Basic Hospital and Surgical policy benefits are - Correct Answer lower than the actual expenses incurred Which of the following BEST describes a Hospital Indemnity policy? - Correct Answer Coverage that pays a stated amount per day of a covered hospitalization Which of the following costs would a Basic Hospital/Surgical policy likely cover? - Correct Answer Surgically removing a facial birthmark Which of the following policy features allows an insured to defer current health charges to the following year's deductible instead of the current year's deductible? - Correct Answer carryover provision R had received full disability income benefits for 6 months. When he returns to work, he is only able to resume half his normal daily workload. Which provision pays reduced benefits to R while he is not working at full capacity? - Correct Answer Residual Disability A disability elimination period is best described as - Correct Answer time deductible What is the elimination period of an individual disability policy? - Correct Answer Time period a disabled person must wait before benefits are paid What is considered to be a characteristic of a conditionally Renewable Health Insurance policy? - Correct Answer Premiums may increase at time of renewal The policy provision that entitles the insurer to establish conditions the insured must meet while a claim is pending is - Correct Answer Time limit on certain defenses what is the purpose of the time of payment of claims provision? - Correct Answer prevents delayed claim payments made by the insurer what type of renewability guarantees premium rates and renewability? - Correct Answer non-cancelable K has a health policy that must be renewed by the insurer and the premiums can only be increased if applied to the entire class of insureds. This type of policy is considered - Correct Answer guaranteed renewable how many days must an insurer provide an insured with claim forms after receiving notice of a loss? - Correct Answer 15 with optionally renewable Health policies, the insurer may - Correct Answer review the policy annually and determine whether or not to renew it the notice of claims provision requires a policyowner to - Correct Answer notify an insurer of a claim within a specified time which of the following involves analyzing a case before admission to determine what type of treatment is necessary? - Correct Answer prospective review an incomplete health insurance application submitted to an insurer will result in which of these actions? - Correct Answer application will be returned to the writing producer which of these actions should a producer take when submitting an insurance application to an insurer? - Correct Answer inform the insurer of relevant information not included on the application an applicant's medical information received by the medical information Bureau may be furnished to the - Correct Answer applicants physician what is being delivered during a policy delivery? - Correct Answer insurance contract to the proposed insured a prepaid application for individual disability income insurance was recently submitted to an insurer. When the insurer received the MIB report, the report showed that the applicant had suffered a stroke 18 months ago, something that was not disclosed on the application. Which of the following actions would the insurance company not take? - Correct Answer send a notice to the MIB that the applicant was declined how long is the free look. For accident and health policies sold in North Carolina? - Correct Answer 10 days what is the standard grace period for premium payments on all individual life insurance policies issued in North Carolina? - Correct Answer 31 days 
