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| Section | Weight | Objectives |
|---|---|---|
| Insurance Regulation and General Principles | 20% | - Insurance Concepts
|
| Accident and Health Insurance | 35% | - Government Health Programs
|
| Life Insurance Products and Provisions | 30% | - Types of Life Insurance Policies
|
| Underwriting, Marketing and Sales Practices | 15% | - Application and Underwriting Procedures
|
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NEW QUESTION # 118
The statement, " Any person who knowingly and with intent to defraud any insurer or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime, and shall also be subject to a civil penalty... " MUST appear in all New York
Answer: D
Explanation:
The correct answer is applications for insurance and on all claim forms . Under New York insurance law , insurers are required to include a fraud warning statement on certain insurance documents to help prevent fraudulent insurance activities. This warning informs applicants and claimants that knowingly providing false information or concealing material facts for the purpose of misleading an insurer constitutes insurance fraud , which is a criminal offense and may also lead to civil penalties.
The regulation specifically requires that this fraud notice appear on all insurance applications and claim forms used within the state. The purpose is to ensure that individuals are clearly informed of the legal consequences of submitting false information when applying for insurance coverage or when filing a claim. By placing the warning directly on these documents, New York aims to discourage fraudulent behavior and strengthen compliance with insurance regulations.
The other options are incorrect because the fraud warning requirement does not apply broadly to general insurance communications, public documents, or credit applications. Instead, the law targets the two most critical documents where fraud might occur- insurance applications and claim forms .
NEW QUESTION # 119
The insured, who is 59 years of age decides to replace a long-term care policy they had for five years for a new policy. Which of the following is true of the insurer?
Answer: A
Explanation:
The correct answer is D. The replacement insurer will waive probationary periods pertaining to preexisting conditions satisfied under the original policy. In long-term care insurance replacement rules, an insured should not lose credit for time already served under an existing policy when moving to a new long-term care policy. If the insured has already satisfied a preexisting condition limitation or probationary period under the old policy, the replacing insurer must give credit for that satisfied period instead of starting a new waiting period from the beginning. This protects consumers from being penalized simply because they replaced coverage.
Choice A is incorrect because the original insurer is not required to reimburse unused benefit dollars when a policy is replaced. Choice B is incorrect because the replacement insurer may not simply impose a brand-new probationary or preexisting condition exclusion for periods already satisfied under the old coverage. Choice C is also incorrect because the replacement coverage must recognize prior satisfied waiting periods. Therefore, under long-term care replacement standards, the insurer replacing the policy must waive any probationary periods for preexisting conditions that were already satisfied under the original policy .
NEW QUESTION # 120
At the time of an insured ' s death, a per capita distribution of policy proceeds are paid to
Answer: B
Explanation:
The correct answer is the named living primary beneficiaries . In life insurance beneficiary designations, per capita means "by the head," or equally among the living members of the named class or group . When policy proceeds are distributed per capita, each living beneficiary at the same beneficiary level receives an equal share of the death benefit. If one of the named primary beneficiaries dies before the insured, that deceased beneficiary's share is not passed to that beneficiary's estate or descendants unless the policy specifically provides otherwise. Instead, the proceeds are divided equally among the remaining living primary beneficiaries .
This is what distinguishes per capita from per stirpes . Under per stirpes, the share of a deceased beneficiary would pass down to that beneficiary's descendants. But under per capita, only the surviving named beneficiaries in the class receive the proceeds.
The other options are incorrect because a deceased beneficiary's estate does not automatically receive the share, the children of a deceased primary beneficiary are not paid under per capita unless specifically named, and contingent beneficiaries are paid only if no primary beneficiaries survive. Therefore, D is correct.
NEW QUESTION # 121
Which of the following is a life insurance contract written on the life of an individual?
Answer: B
Explanation:
The correct answer is D. Single-Life Insurance. A single-life insurance policy is a contract that covers one individual only . The death benefit is paid when that one insured person dies, provided the policy is in force.
This is the most basic and common form of life insurance coverage and is used when protection is needed on the life of one person, such as a wage earner, business owner, or parent. Because the contract is based on only one insured life, underwriting, premium calculation, and benefit payment are all tied to that single person's age, health, and policy terms.
The other choices are incorrect. A. Insurance is too broad and is not a specific type of life insurance contract.
B). Survivorship Policy covers two lives and typically pays upon the second death , not on a single individual alone. C. Joint Life Contract also covers two people , usually paying on the first death . Since the question asks for a policy written on the life of an individual , the proper term is Single-Life Insurance .
NEW QUESTION # 122
A policyowner suffers an injury that renders him incapable of performing one or more important job duties.
Any decrease in income resulting from his injury would make him eligible for benefits under which provision?
Answer: D
Explanation:
This situation describes a disability that does not completely prevent the insured from working, but does reduce the insured's ability to perform significant or "material" duties of the occupation , resulting in a loss of income . Under accident and health disability income concepts, that is the definition of partial disability , which pays benefits when the insured can work in a limited capacity (or perform only some duties) and suffers measurable earnings reduction. "Nondisabling injury" is typically a limited benefit that applies when an injury does not create disability as defined by the policy (often paying a small scheduled amount for medical/accidental injuries without inability to work). "Presumptive disability" refers to severe, specified losses (such as loss of sight, hearing, speech, or limbs) that trigger total disability benefits regardless of work capacity. "Flat amount disability" does not match the key clue in the question-eligibility based on decreased income -because partial disability provisions specifically tie benefits to reduced ability to work and corresponding earnings loss.
NEW QUESTION # 123
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