Page 1 of 46
1
KENTUCKY HEALTH INSURANCE EXAM
QUESTIONS AND CORRECT ANSWERS ALREADY
GRADED A+
When medical expenses policies do not state any specific dollar amount, but instead base payments upon the charges for like services in the same geographical area, benefits are designated as which of the following?
- Usual, customary and reasonable charges
- Stated charges
- Percentage of Stated Charges
- Designated Charges - ANSWER-D. Designated Charges
As compared to individual disability income policies, group disability income policies are generally
- More costly and have less liberal provisions
- / 4
Page 2 of 46
2
- More restrictive in terms of covered medical expense
- less costly and have more liberal provisions
- Tied more closely to Social Security disability benefits - ANSWER-C. Less costly and have
more liberal provisions
Required provisions 7 indicated that except in the absence of the insured's legal capacity, if it was not reasonably possible for the insured to provide proof of loss as required in a policy, the latest time the proof of loss may be furnished is
- three years from the time proof is otherwise required
- On year from the time proof is otherwise required
- within 90 days of a final notice from the insurer
- unlimited - ANSWER-B. One year from the time proof is otherwise required
- / 4
Page 3 of 46
3 Many major medical policies include a provision whereby when expenses reach a certain dollar amount, the insured no longer shares in the costs of the expenses; the insurer pays 100% of the remaining covered charges. This is referred to as the
- maximum benefit
- benefit restoration
- coinsurance percentage
- stop loss limit - ANSWER-D. Stop-Loss Limit
What term describes a situation where a policy owner transfers a potion of his or her rights in an insurance policy to another party in order to secure a debt to that party?
- Collateral Assignment
- Absolute Assignment
- Transfer Assignment 3 / 4
Page 4 of 46
4
- Accumulations Assignment - ANSWER-A. Collateral Assignment
An insured disability income policy defines total disability as "the insureds inability to preform the duties of any occupation for which he or she is reaosnily qualified by education, training, or experience." This definition is known as the
- "own occupation" definition and is more restrictive than other definitions
- "any occupation" definition and is more restrictive than other definitions
- "own occupation" definition and is less restrictive than other definitions
- "any occupation" definition and is less restrictive than other definitions - ANSWER-A. "own
occupation" definition and is more restrictive than other definitions
A certain major medical policy states a maximum number of X-rays that will be paid for under any one claim. These are examples of
- first dollar coverage
- / 4