Florida Life and Health Practice Test – Flashcards
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T and S are named co-primary beneficiaries on a $500,000 Accidental Death and Dismemberment policy insuring their father. Their mother was named contingent beneficiary. Five years later, S dies of natural causes and the father is killed in a scuba accident shortly afterwards. How much of the death benefit will the mother receive?
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$0
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Which statement regarding the Change of Beneficiary provision is true?
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The policyowner can change the beneficiary
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What is the underlying concept regarding level premiums?
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The early years are charged more than what is needed
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C is trying to determine whether to convert her convertible term life policy to whole life insurance using her original age or attained age. What factor would affect her decision the most?
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The cost
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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?
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Insured's contingent beneficiary
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On a life insurance policy, who is qualified to change the beneficiary designation?
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Policyowner
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A policyowner is allowed to pay premiums more than once a year under which provision?
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Mode of Premium
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A life insurance application must be signed by all of these EXCEPT
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Beneficiary
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Any changes made on an insurance application requires the initials of whom?
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Applicant
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Which Federal law allows an insurer to obtain an inspection report on a potential insured?
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Fair Credit Reporting Act
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All of these are considered sources of underwriting information about an applicant EXCEPT
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Rating Services
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K applies for a life insurance policy on herself and submits the initial premium with the application. She is given a receipt by the agent stating that coverage begins immediately if the application is approved. What kind of receipt was used?
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Conditional
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P is a producer who notices 5 questions on a life application were not answered. What actions should P take?
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Set up a meeting with the applicant to answer the remaining questions
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An underwriter determines that an applicant's risk should be recategorized due to a health issue. This life insurance policy may be issued with a(n)
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extra premium
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In order for coverage on a non-medical insurance application to take effect the same day, the producer must collect a signed application and
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the initial premium
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When does a life insurance contract become effective if the initial premium is not collected during the application process?
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When producer delivers policy and collects initial premium
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Why is an applicant's signature required on a life insurance application?
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To attest that the statements on the application are accurate to the best of the applicant's knowledge
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A Disability Income policyowner suffers a disability which was due to the same cause as a previous disability. Both disabilities occurred within a five-month period. The insurer may cover the second disability without a new elimination period under the
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Recurrent Disability provision
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Which of these statements is INCORRECT regarding the federal income tax treatment of life insurance?
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Entire cash surrender value is taxable
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Q would like to purchase $100,000 of permanent protection on his wife and $50,000 of Term coverage on himself under the same policy. What kind of policy should Q purchase?
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Whole life policy with other insured rider
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What action should a producer take if the initial premium is NOT submitted with the application?
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Forward the application to the insurer without the initial premium
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What is being delivered during a policy delivery?
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Insurance contract to the proposed insured
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Which of these actions should a producer take when submitting an insurance application to an insurer?
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Inform insurer of relevant information not included on the application
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Before a life insurance policy is issued, which of these components of the contract is required?
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Applicant's signature on application
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Which requirement must be met for an association to be eligible for a group life plan?
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Group was formed for a purpose other than acquiring insurance
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G purchased a Family Income policy at age 40, The policy has a 20-year rider period. If G were to die at age 50, how long would G's family receive an income?
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10 years
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What group term life feature permits an individual to depart from the group and continue to be covered without providing evidence of insurability?
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Conversion
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S recently received a $500,000 lump sum retirement buyout from her employer. She would like to buy an annuity that will immediately furnish her with a guaranteed income for life. What type of annuity is best suited for her situation?
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Single Premium
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The annuity that represents the largest possible monthly payment to an individual annuitant is a(n)
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Straight Life annuity
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An individual who purchases a Life annuity is given protection against
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the risk of living longer than expected
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What is considered to be a characteristic of an immediate annuity?
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Benefit payments start within one payment period of purchase
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An immediate annuity consists of a
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single premium
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What determines the full amount of Social Security retirement benefits a qualified individual is entitled to receive?
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Primary Insurance Amount (PIA)
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Which of these retirement plans can be started by an employee, even if another plan is in existence?
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Individual Retirement Account (IRA)
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Which of these is NOT a type of agent authority?
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Principal
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Which of the following statements is true about most Blue Cross/Blue Shield organizations?
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They are nonprofit organizations
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When a person returns to work after a period of total disability but cannot earn as much as he or she did before the disability, this situation is called which of the following?
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Residual disability
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An individual Disability Income insurance applicant may be required to submit all of the following information EXCEPT
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spouse's occupation
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B is a teacher who was injured in a car accident and cannot work. She is now receiving monthly benefits as a result of this accident. Which type of policy does B have?
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Disability Income
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Disability policies do NOT normally pay for disabilities arising from which of the following?
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War
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T has Disability Income policy that pays a monthly benefit of $5000. If T becomes partially disabled, what can he likely expect?
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Less than $5,000 per month benefit regardless of the cause
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With Disability Income insurance, an insurance company may limit the monthly benefit amount a prospective policy holder may obtain because of the insured's
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gross income at the time of purchase
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K becomes ill after traveling overseas and is unable to work for 3 months. What kind of policy would cover her loss of income?
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Disability Income
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When determining the monthly benefit amount for a Disability Income policy, the factor that limits the amount a prospective insured may purchase is
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Income
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What does a Guaranteed Insurability rider provide a Disability Income policyowner?
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The ability to periodically increase the amount of coverage without evidence of insurability
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P, age 50, purchased an annuity that P will fund with $500/ month for 15 years. The annuity will then pay P retirement payments after the 15 years. Which type of annuity did P purchase?
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Deferred
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The underwriting process involves all of these EXCEPT for
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Policy loan
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Which parts of a life insurance policy are guaranteed to be true?
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Warranty
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P and Q are married and have three children. P is the primary beneficiary on Q's Accidental Death and Dismemberment (AD) policy and Q's sister R is the contingent beneficiary. P, Q, and R are involved in a car accident and Q and R are killed instantly. The Accidental Death benefits will be paid to
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P only
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An insured covered by life insurance has just died. What will happen if the primary beneficiary had already died before the insured and contingent beneficiary?
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Proceeds will go to the contingent beneficiary
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What type of renewability guarantees premium rates and renewability?
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Guaranteed renewable
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When does a Probationary Period provision become effective in a health insurance contract?
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At the policy's inception
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The clause in an Accident and Health policy which defines the benefit amounts the insurer will pay is called the
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Insuring clause
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A Disability Income policyowner recently submitted a claim for a chronic neck problem that has now resulted in total disability. The original neck injury occurred before the application was taken 5 years prior. The neck injury was never disclosed to the insurer at the time of application. How will the insurer handle this claim?
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Claim will be paid and coverage will remain in force
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T files a claim on his Accident and Health policy after being treated for an illness. The insurance company believes that T misrepresented his actual health on the initial insurance application and is, therefore, disputing the claim's validity. The provision that limits the period during which the company may dispute a claim's validity is called
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Time Limit on Certain Defenses
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K failed to pay a renewal premium within the time granted by the insurer. K then sends in a payment which the insurer subsequently accepts. Which policy provision specifies that coverage may be restored in this situation?
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Reinstatement
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Which of these statements accurately describes the Waiver of Premium provision in an Accident and Health policy?
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Premiums are waived after the insured has been totally disabled for a specified time period
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Pre-hospitalization authorization is considered an example of
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managed care
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An agent takes an individual Disability Income application, collects the appropriate premium, and issues the prospective insured a conditional receipt. The next step the insurance company will take is to
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determine if the applicant is an acceptable risk by completing standard underwriting procedures
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Which of the following statements about the classification of applicants is INCORRECT?
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Substandard applicants are never declined by underwriters
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A prepaid application for individual Disability Income insurance was recently submitted to an insurer. When the insurer received the Medical Information Bureau (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?
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Send a notice to the MIB that the applicant was declined
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Health insurance benefits NOT covered due to an act of war are
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excluded by the insurer in the contract provisions
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Which Accident and Health policy provision addresses preexisting conditions?
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Time Limit on Certain Defenses
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The Notice of Claims provision requires a policyowner to
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notify their physician of a claim within a specified time
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According to the Time Payment of Claims provision, the insurer must pay Disability Income benefits no less frequently than which of the following options?
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Monthly
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What should an insured do if the insurer does not send claims forms within the time period set forth in a health policy's Claims Forms provision?
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Submit the claim in any form
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The policy provision that entitles the insurer to establish conditions the insured must meet while a claim is pending is
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Time Limit on Certain Defenses
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When an insurance company sends a policy to the insured with an attached application, the element that makes the application part of the contract between the insured and the insurer is called the
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Entire Contract provision
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Which statement regarding third-party ownership of a life insurance policy is true?
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It is used extensively in estate-planning as well as business circumstances
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At what point must a life insurance applicant be informed of their rights that fall under the Fair Credit Reporting Act?
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Upon completion of the application
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Who elects the governing body of a mutual insurance company?
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Policyholders
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S would like to use dividends from her life insurance policy to purchase paid-up additions. All of these would be factors that determine how much coverage can be purchased EXCEPT
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beneficiary's age
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When an insurer issues a policy that refuses to cover certain risks, this is referred to as a(n)
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Exclusion
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Which provision prevents an insurer from changing the terms of the contract with the policyowner by referring to documents not found within the policy itself?
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Entire Contract
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What is the Suicide provision designed to do?
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safeguard the insurer from an applicant who is contemplating suicide
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The provision that can be used to put an insurance policy back in force after it has lapsed due to nonpayment is called
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Reinstatement
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What must the policyowner provide to the insurer for validation that a loss has occurred?
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Proof of Loss
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Which of these is considered a mandatory provision?
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Payment of Claims
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What provision in a life insurance policy states that the application is considered part of the contract?
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Entire Contract provision
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What is considered to be a characteristic of a Conditionally Renewable Health Insurance policy?
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Premiums may increase at time of renewal
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J, an Accidental Death and Dismemberment (AD) policy holder, dies after injuries sustained in an accident. J's age as stated on the application five years ago was found to be understated by ten years. Which of the following actions will the insurance company take?
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The insurer will adjust the benefit to what the premiums paid would have purchased at the insured's actual age
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The incontestable clause allows an insurer to
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contest a claim during the contestable period
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M's insurance company denied a reinstatement application for her lapsed health insurance policy. The company did not notify M of this denial. How many days from the reinstatement application date does the insurance company have to notify M of the denial before the policy will be automatically placed back in force?
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45 days
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Which of the following statements is CORRECT about accelerated death benefits?
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Must have a terminal illness to qualify
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With Optionally Renewable Health policies, the insurer may
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review the policy annually and determine whether or not to renew it
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Which of the following services is NOT covered under a hospitalization expense policy?
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surgeon's fees
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For which of the following expenses does a Basic Hospital policy pay?
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Hospital room and board
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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?
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$1,600
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How do life insurance companies handle cases where the insured commits suicide within the contract's stated Contestable period?
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Claims are denied under the Suicide clause of the policy
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N is a student pilot with a large life insurance policy. Which of these features would limit the insurer's obligation in the event N was killed while flying as a student pilot?
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Exclusion
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B owns a Whole Life policy with a guaranteed insurability option that allows him to purchase, without evidence of insurability, stated amounts of
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additional Whole Life coverage at specified times
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Deductibles are used in health policies to lower
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overuse of medical services
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Whose life is covered on a life insurance policy that contains a payor benefit clause?
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Child
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Basic Hospital and Surgical policy benefits are
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lower than the actual expenses incurred
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A characteristic of Preferred Provider Organizations (PPOs) would be:
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Discounted fees for the patient
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The individual most likely to buy a Medicare Supplement policy would be a(n)
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68-year old male covered by Medicare
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An insured pays premiums on an annual basis for an individual health insurance policy. What is the MINIMUM number of days for the Grace Period provision?
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31
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Which of the following provisions specifies how long a policyowner's health coverage will remain in effect if the policyowner does not pay the premium when it is due?
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Grace Period
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Which of the following statements BEST defines usual, customary, and reasonable (UCR) charges?
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The maximum amount considered eligible for reimbursement by an insurance company under a health plan
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How are surrender charges deducted in a life policy with a rear-end loaded provision?
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Deducted when the policy is discontinued
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S wants to open a tax-exempt Health Savings Account. To qualify for this type of account, Federal law dictates that S must be enrolled in a
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High-deductible health plan
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Which of these options can an individual use their medical flexible spending account to pay for?
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Prescription drugs
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Which of the following situations does a Critical Illness plan cover?
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Leukemia
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Major Medical policies typically
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contain a deductible and coinsurance
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What does the ownership clause in a life insurance policy state?
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Who the policyowner is and what rights the policyowner is entitled to
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Comprehensive Major Medical policies usually combine
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Major Medical with Basic Hospital/Surgical coverage
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A life insurance policy which ensures that the premium will be paid if the insured becomes disabled has what kind of rider attached?
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Waiver of Premium
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Which of these statements about a Guaranteed Insurability Option rider is NOT TRUE?
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Evidence of insurability is required when the option is exercised
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S buys a $50,000 whole life policy with a $50,000 Accidental Death and Dismemberment rider. S dies 1 year later of natural causes. How much will the insurer pay the beneficiary?
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$50,000
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An insured is past due on his life insurance premium, but is still within the Grace Period. What will the beneficiary receive if the insured dies during this Grace Period?
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Full face amount minus any past due premiums
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D is the policyowner and insured for a $50,000 life insurance policy. The beneficiary is D's wife. D and his wife divorce and D remarries, transferring ownership of his policy to his new wife. If D dies without making any further changes, to whom will the policy proceeds be paid to?
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Ex-wife
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Which of these are NOT an example of a Nonforfeiture option?
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Life Income
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An individual has a Major Medical policy with a $5,000 deductible and an 80/20 Coinsurance clause. How much will the INSURED have to pay if a total of $15,000 in covered medical expenses are incurred?
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$7,000
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A provision in a life insurance policy that pays the policyowner an amount that does not surpass the guaranteed cash value is called the
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Policy Loan provision
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When a misrepresentation on a life insurance policy application is discovered, what action may an insurance company take?
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Void the policy only if it is discovered during the Contestable period and proven to be material
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P is the insured on a participating life policy. Which statement is true if P's premiums are waived due to a disability?
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P will still receive declared dividends
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T was treated for an ailment 2 months prior to applying for a health insurance policy. This condition was noted on the application and the policy was issued shortly afterwards.How will the insurer likely consider this condition?
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Insurer will likely treat as a pre-existing condition which may not be covered for one year
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The Consideration clause in a life insurance contract contains what pertinent information?
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Amount of premium payments and when they are due
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Which contract permits the remaining partners to buy-out the interest of a disabled business partner?
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Disability Buy-Sell
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Which of the following statements does NOT accurately describe the tax treatment of premiums and benefits of individual Accident and Health insurance?
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Disability income policy premiums are tax-deductible
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A medical care provider which typically delivers health services at its own local medical facility is known as a
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Health Maintenance Organization
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The individual who provides general medical care for a patient as well as the referral for specialized care is known as a
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Primary Care Physician
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J is a subscriber to a plan which contracts with doctors and hospitals to provide medical benefits at a preset price. What type of plan does J belong to?
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Health Maintenance Organization
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C was injured while deep sea diving and requires a hospital stay. C has a Major Medical policy with a 80/20 coinsurance clause and a $400 deductible. What is the MAXIMUM C will pay if the covered medical expenses are $2000?
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$720
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Which of these is NOT considered to be an element of an insurance contract?
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Negotiating
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Who makes the legally enforceable promises in a unilateral contract?
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Insurer
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The part of a life insurance policy guaranteed to be true is called a(n)
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Warranty
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A Business Overhead Expense policy would cover which of the following if a business owner becomes disabled?
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Utilities and office rent
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Under which of the following circumstances do the benefits under COBRA continuation coverage expire?
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All group health plans are eliminated by the employer
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Which statement is TRUE regarding a group accident & health policy issued to an employer?
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The employer is the policyowner and each employee receives a certificate of coverage
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Many small business owners worry how their business would survive financially if the owner becomes disabled. The policy which BEST addresses this concern is
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Business Overhead Expense
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What kind of special need would a policyowner require with an Adjustable Life insurance policy?
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flexible premiums
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Which of the following actions require a policyowner to provide proof of insurability in an Adjustable Life policy?
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increase face amount
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When a policyowner exchanges a term policy for a whole life policy without providing proof of good health, which of these apply?
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Conversion provision
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How long does the coverage normally remain on a limited-pay life policy?
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age 100
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Which of these statements describe a Modified Endowment Contract (MEC)?
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Exceeds the maximum amount of premium that can be paid into a policy and still have it recognized as a life insurance contract
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A variable insurance policy
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does not guarantee a return on its investment accounts
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Term insurance has which of the following characteristics?
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Expires at the end of the policy period
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Which of the following features of a group Term Life policy enables an individual to leave the group and continue his or her insurance without providing evidence of insurability?
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Conversion privilege
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When an employee is required to pay a portion of the premium for an employer/employee group health plan, the employee is covered under which of the following plans?
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Contributory
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The federal income tax treatment of employer-provided group health insurance can be accurately described as
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Employee's coverage paid for by the employer is tax-deductible to the employer as a business expenditure
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The reason for a business having a Business Overhead Expense Disability Plan is to cover
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fixed business expenses
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What type of policy would offer a 40-year old the quickest accumulation of cash value?
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20-pay life
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A life insurance policy that provides a policyowner with cash value along with a level face amount is called
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Whole life
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Which of these characteristics is consistent with a Straight Life policy?
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Premiums are payable for as long as there is insurance coverage in force
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Which of these require an offer, acceptance, and consideration?
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Contract
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Which of these arrangements allows one to bypass insurable interest laws?
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Investor-Originated Life Insurance
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What is the consideration given by an insurer in the Consideration clause of a life policy?
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Promise to pay a death benefit
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When must insurable interest be present in order for a life insurance policy to be valid?
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At the time of application
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Insurance policies offered on a "take it or leave it" basis are considered what?
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Contracts of Adhesion
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Which statement about a whole life policy is correct?
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Cash value may be borrowed against
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Which statement is correct regarding the premium payment schedule for whole life policies?
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Premiums are payable throughout the insured's lifetime/ coverage lasts until death of the insured
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T would like to be assured $10,000 is available in 10 years to replace a roof on his house. What kind of $10,000 policy should T purchase?
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Ten-Year Endowment
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What type of life policy has a death benefit that adjusts periodically and is written for a specific period of time?
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Decreasing term
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What kind of insurance policy supplies an income stream over a set period of time that starts when the insured dies?
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Family Maintenance Policy
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What kind of premium does a Whole Life policy have?
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Level
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An insurance company licensed in Florida and domiciled in Pennsylvania is known as
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a foreign company
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A creditor who requires a debtor to obtain insurance from a particular company or agent as a condition for a loan is guilty of
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Coercion
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According to Florida law, how often must a variable annuity policyholder be informed of the accumulated value of the contract during the premium payment period?
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At least once each year
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In Florida, a foreign insurance company is a company that
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is formed under the laws of a state other than Florida
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Agents marketing variable life insurance must be licensed and appointed as a life and variable contract agent, and a
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broker dealer
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In the Outline of Coverage for a health policy, which of the following is NOT required?
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Table indicating the policy's projected future costs
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A newly licensed agent MUST satisfy a continuing education requirement of how many hours every two years?
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24
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Which type of insurance company is domiciled and incorporated under the laws of the state in which its home office is located?
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Domestic
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An agent who makes a statement that is maliciously critical of another person's financial condition is guilty of
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Defamation
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Which of the following is a nonprofit provider of life insurance that is covered by a special section of the Florida insurance code?
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Fraternal life insurance organizations
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What is the primary difference between a mutual insurance company and a stock insurance company?
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A stock company is owned by shareholders and a mutual is owned by its policyholders
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Under Florida law, adjustable rates for life insurance policy loans are based on
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Moody's corporate bond index
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Florida law requires an agent who is recommending to a person the purchase of an annuity to obtain information regarding all of the following EXCEPT the person's
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marital status
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What statement about conversion privileges in Group Life policies sold is CORRECT?
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Conversion at regular rates on an attained-age basis without a medical exam is a standard provision
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Which statement is CORRECT about an admitted mail order insurance company in Florida?
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It may solicit and accept business by mail without the aid of a licensed agent
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Under a Medicare Supplement policy, the waiting period for pre-existing conditions may not EXCEED
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6 months
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What is the maximum contestability period for most life insurance policies?
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2 years
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An agent's license will terminate if the agent allows what period of time to elapse without being appointed for the class or classes of insurance listed on the license?
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48 months
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Florida's Replacement Rule applies to all of the following situations EXCEPT
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the existing policy is kept in force and an additional policy is purchased from the same company
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Agents can help prospective insureds understand and purchase the most appropriate product by delivering
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a buyer's guide
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According to the insurance code, an agent's controlled business may NOT exceed a maximum of
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50%
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Under certain circumstances, in addition to treatment by medical doctors, health insurance policies in Florida must also cover payment to all of the following practitioners EXCEPT
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Naturopaths
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The Life and Health Insurance Guaranty Association is
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an association that protects policyowners against the insolvency of an insurance company
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Florida insurance law requires that if a Medicare Supplement policy is sold, the agent must deliver an Outline of Coverage to the applicant no later than
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when the application is taken
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All of the following are possible consequences for placing with an unauthorized insurer EXCEPT
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conviction of a first degree misdemeanor
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What is normally given to an applicant who pays the initial premium at the time of application?
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Conditional receipt
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Florida law provides for a grace period of NOT less than how many days for a monthly-premium health insurance policy?
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10
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Which of the following qualifications is NOT a prerequisite for becoming a licensed agent?
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Having a high school diploma
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When an employee covered on a Group Life policy leaves the group, the conversion privilege gives the employee the right to
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convert to an individual policy upon termination of employment
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All of the following are unfair claim settlement practices EXCEPT
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requiring written documentation of claim details
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Which of the following statements about unfair trade practices is true?
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Twisting is a misrepresentation made by an agent in order to induce a policyholder to lapse a policy and switch insurance companies
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Z gave Z's age as 40 when Z purchased a Life policy. At the time of Z's death six years later, the company discovered Z's true age at issue had been 49. What would the normal procedure be under the misstatement of age provision in regard to the payment of the death claim?
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The proceeds will be reduced based on whatever the premium would have been purchased at age 49
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According to Florida statutes, all of the following provisions must be contained in a Medicare Supplement policy EXCEPT
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A 12-month limitation on pre-existing conditions
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Under Florida insurance law, deceptive advertising is considered a form of
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Misrepresentation
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When a stock life insurance company issues both participating and nonparticipating policies, the company is doing business on a(n)
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mixed plan
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Which type of life policy contains a monthly mortality charge as well as self-directed investment choices?
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Variable Universal Life
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C is a key employee at ABC Incorporated. If a Key Employee life policy is purchased on her life, which of these statements would be true?
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ABC is the policyowner, C is the insured, and ABC is the beneficiary
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Under federal tax laws, what is the tax treatment for an employer providing $50,000 of a contributory group Term Life plan to all its eligible employees?
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Portion of the premiums paid for by the employer may be a tax deduction
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Which of these types of life insurance allows the policyowner to have level premiums and to also choose from a selection of investment options?
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Variable Life
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Additional coverage can be added to a Whole Life policy by adding a(n)
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decreasing term rider
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B has a $100,000 Accidental Death and Dismemberment policy that pays triple indemnity for common carrier death. If B is killed from an accident on a commercial flight, what will the policy pay B's beneficiary?
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$300,000
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In a Disability Income policy, which of these clauses acts as a deductible?
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Elimination Period