Life & Health Insurance Exam Claims and Benefits

Question 1

Under a life insurance policy, who has the right to file a death claim?

Accepted Answer

The beneficiary

Answer

The insured

Answer

The insurance agent

Answer

The state insurance department

Question 2

What is the 'incontestability clause' in a life insurance policy?

Accepted Answer

A clause preventing the insurer from voiding the policy after a specified period

Answer

A clause allowing the insurer to deny all claims

Answer

A clause that waives premium payments

Answer

A clause that doubles the death benefit

Question 3

Which of the following is NOT a standard settlement option for life insurance death proceeds?

Accepted Answer

Automatic policy loan

Answer

Lump-sum payment

Answer

Life income option

Answer

Interest only option

Question 4

What does 'Accidental Death Benefit' (ADB) rider provide?

Accepted Answer

An additional death benefit if the insured dies by accident

Answer

Coverage for accidental disability only

Answer

Waiver of premiums after an accident

Answer

Replacement income during recovery

Question 5

A claimant submits a health insurance claim 30 days after the allowed filing period. The insurer will most likely:

Accepted Answer

Deny the claim due to late filing

Answer

Pay the claim in full

Answer

Pay the claim with a penalty fee

Answer

Refer the claim to arbitration

Question 6

Which provision requires health insurers to pay claims within a specific number of days after receiving proof of loss?

Accepted Answer

Time of payment of claims provision

Answer

Grace period provision

Answer

Reinstatement provision

Answer

Legal actions provision