FLORIDA 240 LICENSE EXAM | ALL QUESTIONS AND CORRECT ANSWERS | ALREADY GRADED A+, Exams of Insurance Economics

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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: ---------CORRECT ANSWER----------------- Recurrent Disability provision When an insured has the same disability within a specified time period and the insurance company provides the same benefits without a new waiting period, the second disability is covered under which of the following benefits? ---------CORRECT ANSWER-----------------Recurrent Disability P received Disability income benefits for 3 months then returns to work. She is able to work one month before her condition returns, leaving her disabled once again. What would the insurance company most likely regard this second period of disability as? ---------CORRECT ANSWER--------------- --Recurrent Disability A disability elimination period is best described as a ---------CORRECT ANSWER-----------------time deductible Z owns a Disability Income policy with a 30-day Elimination period. Z contracts pneumonia that leaves him unable to work from January 1 until January 15. Z then becomes disabled from an accident on February 1 and the disability lasts until July 1 the same year. Z will become eligible to

receive benefits starting on ---------CORRECT ANSWER-----------------March 1 A CEO's personal assistant suffered injuries at home and as a result, was unable to work for four months. Which type of policy will pay a monthly benefit to the personal assistant? ---------CORRECT ANSWER----------------- Disability income What is the primary factor that determines the benefits paid under a disability Income policy? ---------CORRECT ANSWER-----------------wages T was insured under an individual Disability Income policy and was severely burned in a fire. As a result, T became totally disabled. The insurer began making monthly benefit payments, but later discovered that the fire was set by T in what was described as arson. What actions will the insurer take? ---------CORRECT ANSWER-----------------The insurer will rescind the policy, deny the claim, and recover all payments made Bryce purchased a disability income policy with a rider that guarantees him the option of purchasing additional amounts of coverage at predetermined times without requiring to provide evidence of insurability. What kind of rider is this? ---------CORRECT ANSWER-----------------Guaranteed insurability rider A physician opens up a new practice and qualifies for a $7,000/month Disability Income policy. What rider would the physician add if he wants the ability to increase his policy benefit as his practice and income grow? ------- --CORRECT ANSWER-----------------Guaranteed Insurability Option rider

Which of the following types of care is typically not covered in a Long-Term Care policy? ---------CORRECT ANSWER-----------------acupuncture How long is the typical free look period for Long Term care insurance policies? ---------CORRECT ANSWER-----------------30 days Nursing home benefits must be provided for at least 12 consecutive months in which of the following types of policies? ---------CORRECT ANSWER------ -----------long term care Under a Long Term Care policy, which benefit would be typically excluded or limited? ---------CORRECT ANSWER-----------------Alcohol rehabilitation The individual most likely to buy a Medicare Supplement policy would be a(n) ---------CORRECT ANSWER----------------- 68 - year old male covered by Medicare Which Long Term Care insurance statement is true? ---------CORRECT ANSWER-----------------Pre-existing conditions must be covered after the coverage has been in force for six months Which of the following will a Long Term Care plan typically provide benefits for? ---------CORRECT ANSWER-----------------home health care

Medicare Part C is: ---------CORRECT ANSWER-----------------Available to those who are enrolled in Medicare Part A and Part B What is the MINIMUM number of Activities of Daily Living (ADL) an insured must be unable to perform to qualify for Long Term Care benefits? --------- CORRECT ANSWER----------------- 2 Long Term Care policies will usually pay for eligible benefits using which of the following methods? ---------CORRECT ANSWER-----------------Expense incurred Qualified Long-Term Care policies may take into consideration an applicant's pre-existing conditions for a maximum of not more than __ month(s) prior to the effective date of coverage. ---------CORRECT ANSWER----------------- 6 The guarantee of insurability option provides a long-term care policyowner the ability to ---------CORRECT ANSWER-----------------buy additional coverage at a later date A "reimbursement policy" pays what amount of covered Long-Term Care expenses? ---------CORRECT ANSWER-----------------Actual covered expenses up to the daily maximum Medicare Part B does NOT cover ---------CORRECT ANSWER----------------- inpatient hospital services

If a retiree on Medicare required five hospital stays in one year, which policy would provide the best insurance for excess hospital expenses? ------ ---CORRECT ANSWER-----------------Medicare Supplement 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 time period during which the company may dispute a claim's validity is called ---------CORRECT ANSWER-----------------Time Limit on Certain Defenses Which of the following is NOT included in the policy face? --------- CORRECT ANSWER-----------------Exclusions The clause in an Accident and Health policy which defines the benefit amounts the insurer will pay is called the ---------CORRECT ANSWER------- ----------Insuring clause What is the initial requirement for an insured to become eligible for benefits under the Waiver of Premium provision? ---------CORRECT ANSWER-------- ---------Insured must be under a physician's care Which of the following BEST describes a short-term Medical Expense policy? ---------CORRECT ANSWER-----------------nonrenewable An insurance company normally has 2 years to contest information provided on an accident and health application. This 2 year period begins

on the date that the: ---------CORRECT ANSWER-----------------insurer dates the policy Which Accident and Health policy provision addresses preexisting conditions? ---------CORRECT ANSWER-----------------Time Limit on Certain Defenses With Optionally Renewable Health policies, the insurer may --------- CORRECT ANSWER-----------------review the policy annually and determine whether or not to renew it What must the policyowner provide to the insurer for validation that a loss has occurred? ---------CORRECT ANSWER-----------------Proof of Loss J, an Accidental Death and Dismemberment (AD&D) 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? ---------CORRECT ANSWER-----------------The insurer will adjust the benefit to what the premiums paid would have purchased at the insured's actual age The clause identifying which losses resulting from an accident or sickness are insured by the policy is called the ---------CORRECT ANSWER------------ -----Insuring clause If an individual has an Accidental Death and Dismemberment policy and dies, an autopsy can be performed in all these situations, EXCEPT: --------- CORRECT ANSWER-----------------When the state prohibits this by law

According to the Time Limit of Certain Defenses provision in an Individual Health Insurance Policy, non fraudulent misstatements first become incontestable: ---------CORRECT ANSWER-----------------Two years from the date of the policy was issued Health insurance benefits NOT covered due to an act of war are: --------- CORRECT ANSWER-----------------excluded by the insurer in the contract provisions The insuring clause ---------CORRECT ANSWER-----------------States the scope and limits of the coverage With Accidental Death and Dismemberment policies, what is the purpose of the Grace Period? ---------CORRECT ANSWER-----------------Gives the policyowner additional time to pay past due premiums 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 --------- CORRECT ANSWER-----------------Entire Contract provision An insured must notify an insurer of a medical claim within how many days after an accident? ---------CORRECT ANSWER----------------- 20

What is the purpose of Time of Payment if Claims provision? --------- CORRECT ANSWER-----------------Prevents delayed claim payments made by the insurer Which health policy clause specified the amount of benefits to be paid? ----- ----CORRECT ANSWER-----------------Insuring Which of these is considered a mandatory provision? ---------CORRECT ANSWER-----------------Payment of Claims The stated amount or percent of liquid assets that an insurer must have on hand that will satisfy future obligations to its policyholders is called: --------- CORRECT ANSWER-----------------Reserves An insurance applicant MUST be informed of an investigation regarding his/her reputation and character according to the: ---------CORRECT ANSWER-----------------Fair Credit Reporting Act A nonprofit incorporated society that does not have capital stock and operates for the sole benefit of its members is known as: ---------CORRECT ANSWER-----------------A fraternal benefit society What I the name of the law that requires insurers to disclose information gathering practices and where the information was obtained? --------- CORRECT ANSWER-----------------Fair Credit Reporting Act

Who elects the governing body of a mutual insurance company? --------- CORRECT ANSWER-----------------Policyholders A group-owned insurance company that is formed to assume and spread the liability ricks of its members is known as a: ---------CORRECT ANSWER-----------------Risk retention group What type of reinsurance contract involves two companies automatically sharing their risk exposure? ---------CORRECT ANSWER-----------------treaty What year was the McCarran-Ferguson Act enacted? ---------CORRECT ANSWER----------------- 1945 Which of these describe a participating life insurance policy? --------- CORRECT ANSWER-----------------Policy owners are entitled to receive dividends At what point must a life insurance applicant be informed of their rights that fall under the Fair Credit Reporting Act? ---------CORRECT ANSWER-------- ---------Upon completion of the application Which of the following requires insurers to disclose when an applicant's consumer or credit history is being investigated: ---------CORRECT ANSWER----------------- 1970 - Fair Credit Reporting Act

What type of reinsurance contract involves two companies automatically sharing their risk exposure? ---------CORRECT ANSWER----------------- Treaty A group-owned insurance company that is formed to assume and spread the liability risks of its members is known as a: ---------CORRECT ANSWER-----------------risk retention group All of the following are considered to be typical characteristics describing the nature of an insurance contract, EXCEPT: ---------CORRECT ANSWER-----------------Bilateral The part of a life insurance policy guaranteed to be true is called a(n) --------

• CORRECT ANSWER-----------------warranty Statements made on an insurance application that are believed to be true to the best of the applicant's knowledge are called ---------CORRECT ANSWER-----------------representations Q purchases a $500,000 life insurance policy and pays $900 in premiums over the first six months. Q dies suddenly and the beneficiary is paid $500,000. This exchange of unequal values reflects which of the following insurance contract features? ---------CORRECT ANSWER----------------- Aleatory When must insurable interest be present in order for a life insurance policy to be valid? ---------CORRECT ANSWER-----------------When the application is made

A life insurance arrangement which circumvents insurable interest statutes is called: ---------CORRECT ANSWER-----------------Investor-Originated Life Insurance Stranger Originated Life Insurance (STOLI) has been found to be in violation of which of the following contractual elements? ---------CORRECT ANSWER-----------------Legal Purpose (Insurable Interest) Who makes the legally enforceable promises in a unilateral contract? ------- --CORRECT ANSWER-----------------Insurance company A policy of adhesion can only be modified by whom? ---------CORRECT ANSWER-----------------insurance company When third-party ownership is involved, applicants who also happen to be the stated primary beneficiary are required to have: ---------CORRECT ANSWER-----------------insurable interest in the proposed insured Which of these is considered a statement that is assured to be true in every aspect? ---------CORRECT ANSWER-----------------Warranty Which of these require an offer, acceptance, and consideration? --------- CORRECT ANSWER-----------------contract

If a contract of adhesion contains complicated language, to whom would the interpretation be in favor of? ---------CORRECT ANSWER----------------- insured Insurance contracts are known as _____ because certain future conditions or acts must occur before any claims can be paid. ---------CORRECT ANSWER-----------------conditional Insurance policies are offered on a "take it or leave it" basis, which make them: ---------CORRECT ANSWER-----------------Contracts of Adhesion In regards to representations or warranties, which of these statements is TRUE? ---------CORRECT ANSWER-----------------If material to the risk, false representations will void a policy Which of these arrangements allows one to bypass insurable interest laws? ---------CORRECT ANSWER-----------------Investor-Originated Life Insurance In an insurance contract, the insurer is the only party who makes a legally enforceable promise. What kind of contract is this? ---------CORRECT ANSWER-----------------unilateral Which of these is NOT a type of agent authority? ---------CORRECT ANSWER-----------------principal

E and F are business partners. Each takes out a $500,000 life insurance policy on the other, naming himself as primary beneficiary. E and F eventually terminate their business, and four months later E dies. Although E was married with three children at the time of death, the primary beneficiary is still F. However, an insurable interest no longer exists. Where will the proceeds from E's life insurance policy be directed to? --------- CORRECT ANSWER-----------------In this situation, the proceeds from E's life insurance policy will go to F. When must insurable interest exist for a life insurance contract to be valid? ---------CORRECT ANSWER-----------------Inception of the contract Life and health insurance policies are: ---------CORRECT ANSWER----------- ------unilateral contracts A policy of adhesion can only be modified by whom? ---------CORRECT ANSWER-----------------insurance company At what point does an informal contract become binding? ---------CORRECT ANSWER-----------------When one party makes an offer and the other party accepts that offer What is the consideration given by an insurer in the Consideration clause of a life policy? ---------CORRECT ANSWER-----------------Promise to pay a death benefit

What is the consideration given by an insurer in the Consideration clause of life policy? ---------CORRECT ANSWER-----------------Promise to pay a death benefit to a named beneficiary Insurance policies are considered aleatory contracts because: --------- CORRECT ANSWER-----------------performance is conditioned upon a future occurrence Taking receipt of premiums and holding them for the insurance company is an example of ---------CORRECT ANSWER-----------------fiduciary responsibility The Consideration clause in a life insurance contract contains what pertinent information? ---------CORRECT ANSWER-----------------The schedule and amount of premium payments Which of the following consists of an offer, acceptance, and consideration? ---------CORRECT ANSWER-----------------Contract Which of the following consists of an offer, acceptance, and consideration? ---------CORRECT ANSWER-----------------contract Which of these is NOT considered to be an element of an insurance company? ---------CORRECT ANSWER-----------------Negotiating

What is a warranty? ---------CORRECT ANSWER-----------------is a statement guaranteed to be true A life insurance policy would be considered a wagering contract WITHOUT: ---------CORRECT ANSWER-----------------insurable interest G is an accountant who has ten employees and is concerned about how the business would survive financially if G became disabled. The type of policy which BEST addresses this concern is ---------CORRECT ANSWER-- ---------------Business Overhead Expense Which of the following claims are typically excluded from Medical expense policies? ---------CORRECT ANSWER-----------------Intentionally self-inflicted injuries XYZ Company pays the entire premium for its group health plan. The MINIMUM percentage of eligible employees that must be covered is --------- CORRECT ANSWER-----------------100% A Business Overhead Expense policy: ---------CORRECT ANSWER---------- -------covers business expenses such as rent and utilities A Business Overhead Expense policy would cover which of the following if a business owner becomes disabled? ---------CORRECT ANSWER----------- ------Utilities and office rent

What is issued to each employee of an employer health plan? --------- CORRECT ANSWER-----------------certificate The benefits under a Disability Buy-Out policy are ---------CORRECT ANSWER-----------------payable to the company or another shareholder A policy owner would like to change the beneficiary on a Life insurance policy and make the change permanent. Which type of designation would fulfill this need? ---------CORRECT ANSWER-----------------irrevocable Which contract permits the remaining partners to buy-out the interest of a disabled business partner? ---------CORRECT ANSWER----------------- Disability Buy-Sell T and S are named co-primary beneficiaries on a $500,000 Accidental Death and Dismemberment policy insuring their father. Their mother was named contingent beneficiary. Five years later, S dies of natural causes and the father is killed in a scuba accident shortly afterwards. How much of the death benefit will the mother receive? ---------CORRECT ANSWER------ -----------$ Which of the following medical expenses does Cancer insurance NOT cover? ---------CORRECT ANSWER-----------------arthritis The difference between group insurance and blanket health policies is: ----- ----CORRECT ANSWER-----------------Blanket health policies do not issue certificates

Which type of policy would pay an employee's salary if the employer was injured in a bicycle accident and out of work for six weeks? --------- CORRECT ANSWER-----------------Business Overhead Expense On an Accidental Death and Dismemberment (AD&D) insurance policy, who is qualified to change the beneficiary designation? ---------CORRECT ANSWER-----------------Policyowner The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers (and their families) whose employment has been terminated the right to: ---------CORRECT ANSWER-----------------continue group health benefits K is the insured and P is the sole beneficiary on an Accidental Death and Dismemberment (AD&D) insurance policy. Both are involved in a fatal accident where K dies before P. Under the Common Disaster provision, which of these statements is true? ---------CORRECT ANSWER----------------

• Proceeds will be paid to P's estate How would a contingent beneficiary receive the policy proceeds in an Accidental Death and Dismemberment (AD&D) policy? ---------CORRECT ANSWER-----------------If the primary beneficiary dies before the insured Which mode of payment is NOT used by health insurance policies? --------- CORRECT ANSWER-----------------Single Premium

G is an accountant who has ten employees and is concerned about how the business would survive financially if G became disabled. The type of policy which BEST addresses this concern is ---------CORRECT ANSWER-- ---------------Business Overhead Expense Which of the following is the reimbursement of benefits for the treatment of a beneficiary's injuries caused by a third party? ---------CORRECT ANSWER-----------------Subrogation S is employed by a large corporation that provides group health coverage for its employees and their dependents. If S dies, the company must allow his surviving spouse and dependents to continue their group health coverage for a maximum of how many months under COBRA regulations? ---------CORRECT ANSWER----------------- 36 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? ---------CORRECT ANSWER----------------- contributory Which of these circumstances is a Business Disability Buy-Sell policy designed to help in the sale of a business? ---------CORRECT ANSWER---- -------------Business owner becoming disabled An accident policy will most likely pay a benefit for a(n) ---------CORRECT ANSWER-----------------off-the-job accident

An insurance company would MOST likely pay benefits under an Accidental Death and Dismemberment policy for which of the following losses? ---------CORRECT ANSWER-----------------Loss of eyesight due to an accidental injury Health Insurance Portability and Accountability Act (HIPAA) gives privacy protection for: ---------CORRECT ANSWER-----------------health information Under which of the following circumstances will the benefits under COBRA continuation coverage end? ---------CORRECT ANSWER-----------------All group health plans are terminated by the employer The provision in a Group Health policy that allows the insurer to postpone coverage for a covered illness 30 days after the policy's effective date is referred to as the ---------CORRECT ANSWER-----------------waiting period Which of the following statements BEST describes how a policy that uses the "accidental bodily injury" definition of an accident differs from one that uses the "accidental means" definition? ---------CORRECT ANSWER--------- --------Less restrictive Which type of policy pays benefits to a policyholder covered under a Hospital Expense policy? ---------CORRECT ANSWER----------------- reimbursement The federal income tax treatment of employer-provided group Medical Expense insurance can be accurately described as: ---------CORRECT

ANSWER-----------------Employee's premiums paid by the employer is tax- deductible to the employer as a business expenditure P and Q are married and have three children. P is the primary beneficiary on Q's Accidental Death and Dismemberment (AD&D) 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 ---------CORRECT ANSWER-----------------P only 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, Which of the following characteristics is associated with a large group disability income policy? ---------CORRECT ANSWER-----------------No medical underwriting K has an Accidental Death and Dismemberment (AD&D) insurance policy where her husband is beneficiary and her daughter is contingent beneficiary. Under the Common Disaster clause, if K and her husband are both killed in an automobile accident, where would the death proceeds be directed? ---------CORRECT ANSWER-----------------daughter Which of the following statements does NOT accurately describe the tax treatment of premiums and benefits of individual Accident and Health insurance? ---------CORRECT ANSWER-----------------Disability income policy premiums are tax-deductible

coordination of benefits provision ---------CORRECT ANSWER----------------- prevents an insured covered by two health plans from making a profit on a covered loss Accidental Death coverage is provided to commercial airline passengers in which of he following types of policies? ---------CORRECT ANSWER---------- -------Blanket Accident policy 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's contingent beneficiary Which of the following statements is correct regarding an employer/employee group health plan? ---------CORRECT ANSWER--------- --------the employer receives a master policy and the employees receive certificates Which of the following is the reimbursement of benefits for the treatment of a beneficiary's injuries caused by a third party? ---------CORRECT ANSWER-----------------Subrogation All students attending a large university could be covered by --------- CORRECT ANSWER-----------------a blanket policy Many small business owners worry how their business would survive financially if the owner becomes disabled. The policy which BEST

addresses this concern is ---------CORRECT ANSWER----------------- Business Overhead Expense How does group insurance differ from individual insurance? --------- CORRECT ANSWER-----------------Premiums are lower P is an employee who quits her job and wants to convert her group health coverage to an individual policy. After the expiration of COBRA laws, which of the following statements is TRUE? ---------CORRECT ANSWER------------ -----She does NOT need to provide evidence of insurability An insured covered by AD&D insurance has just died. What will happen if the primary beneficiary had already died before the insured and contingent beneficiary? ---------CORRECT ANSWER-----------------Proceeds will go to the contingent beneficiary All of the following statements regarding group health insurance is true, EXCEPT: ---------CORRECT ANSWER-----------------An individual policy is given to each member What kind of Accidental Death and Dismemberment (AD&D) insurance beneficiary requires his/her consent when a change of beneficiary is made? ---------CORRECT ANSWER-----------------Irrevocable beneficiary Which statement is TRUE regarding a group accident & health policy issued to an employer? ---------CORRECT ANSWER-----------------The employer receives the policy and each employee is issued a certificate

P is a new employee and will be obtaining non-contributory group Major Medical insurance from her employer. Which of the following actions must she take during the open enrollment period? ---------CORRECT ANSWER-- ---------------Sign an enrollment card M purchased an Accidental Death and Dismemberment (AD&D) policy and named his son as beneficiary. M has the right to change the beneficiary designation at anytime. What type of beneficiary is his son? --------- CORRECT ANSWER-----------------Revocable T is covered by an Accidental Death and Dismemberment (AD&D) policy that has an irrevocable beneficiary. What action will the insurance company take if T requests a change of beneficiary? ---------CORRECT ANSWER----- ------------Request of the change will be refused Which of these types of coverage is best described as a short term medical policy? ---------CORRECT ANSWER-----------------interim coverage A Business Disability Buyout plan policy is designed: ---------CORRECT ANSWER-----------------to pay benefits to the Corporation or other shareholders Group/voluntary long-term care policy premiums are typically deducted from the employee's income and ---------CORRECT ANSWER----------------- are less costly as compared to individual long term care coverage

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? --------- CORRECT ANSWER-----------------$300,0 00 A policyowner's rights are limited under which beneficiary designation? ----- ----CORRECT ANSWER-----------------irrevocable The reason for a business having a Business Overhead Expense Disability Plan is to cover ---------CORRECT ANSWER-----------------fixed business expenses Which statement is true regarding a minor beneficiary? ---------CORRECT ANSWER-----------------Normally, a guardian is required to be appointed in the Beneficiary clause of the contract T is covered by two health insurance plans: a group plan through his employer and his spouse's plan as a dependent. When T submits a claim, his employer's plan is considered what type of carrier under the Model Group Coordination of Benefits provision? ---------CORRECT ANSWER----- ------------Primary carrier Which of the following BEST describes how a Preferred Provider Organization (PPO) is less restrictive than a Health Maintenance Organization (HMO)? ---------CORRECT ANSWER-----------------More physicians to choose from

The health insurance program which is administered by each state and funded by both the federal and state governments is called: --------- CORRECT ANSWER-----------------Medicaid Under what system do a group of doctors and hospitals in a designated area contract with an insurer to provide services at a prearranged cost to the insured? ---------CORRECT ANSWER-----------------PPO The individual who provides general medical care for a patient as well as the referral for specialized care is known as a ---------CORRECT ANSWER- ----------------primary care physician A 66 year-old is covered under a group health plan while employed with a business that has 40 employees. If she injures herself while walking in the park, what coverage would be considered primary? ---------CORRECT ANSWER-----------------Her group health plan Which of the following does Social Security NOT provide benefits for? ------- --CORRECT ANSWER-----------------dismemberment Medicaid was designed to assist individuals who are ---------CORRECT ANSWER-----------------below a specific income limit What is the maximum Social Security Disability benefit amount an insured can receive? ---------CORRECT ANSWER-----------------100% of the insured's Primary Insurance Amount